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Somatostatin Enhances Insulin-Mediated Glucose Disposal in Elderly Subjects^*

GRAYDON S. MENEILLY, DARIUSH ELAHI, KENNETH L. MINAKER and JOHN W. ROWE

Division on Aging; and the Charles A. Dana Research Institute and the Harvard Thorndike Laboratory, Joint Department of Medicine, Beth Israel and Brigham and Women's Hospitals, Harvard Medical School; and the Geriatric Research Education Clinical Center, Brockton/West Roxbury Veterans Administration Medical Center Boston, Massachusetts 02215

Address all correspondence and requests for reprints to: J. W. Rowe, M.D., Beth Israel Hospital, 330 Brookline Avenue, Boston, Massachusetts 02215.

Somatostatin (SRIH) infusion has been widely used in metabolic studies of carbohydrate metabolism. While the effects of SRIH itself on various aspects of carbohydrate economy have been assessed in young adults, such studies have not been conducted in the elderly, which represent an increasingly important study group. To examine the effect of SRIH on insulin-mediated glucose disposal in the elderly, we studied 12 (7 men and 5 women) healthy nonobese subjects, aged 65–80 yr. Paired 3-h euglycemic insulin clamp studies were performed in random order employing insulin alone (22 mU/m²-min) or insulin with SRIH (250 µg/h) and glucagon (0.4 ng/kg-min) to maintain normal basal plasma glucagon levels. Basal plasma insulin, glucose, glucagon, GH, and glucose production and disappearance were similar on each occasion. Steady state (10–180 min) mean plasma insulin [insulin alone, 298 ± 12 (±SE); insulin; glucagon, and SRIH, 304 ± 15 pmol/L] and glucagon (insulin alone, 85 ± 7; insulin, glucagon, and SRIH, 96 ± 9 ng/L) concentrations were similar. At steady state (150-180 min) glucose production was suppressed to similar levels (insulin alone, 26 ± 7; insulin, glucagon, and SRIH, 36 ± 13 µmol/kg·min). However, steady state glucose disposal was significantly higher during the SRIH infusion (insulin alone, 295 ± 26; insulin, glucagon, and SRIH, 346 ± 32 µmol/kg·min; P < 0.02). We conclude that SRIH augments insulin-mediated glucose disposal in healthy older subjects at physiological levels of insulin.

^* This work was supported in part by USPHS Grant AG-600599 and General Clinical Research Grant RR-01032.

Fellow of the Medical Research Council of Canada.

Recipient of the Greenwall Foundation Award from the American Federation of Aging Research.

Supported in part by the MacArthur Foundation Research Program on Successful Aging.

Received December 4, 1987.