This Article Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by NOSADINI, R. Articles by CREPALDI, G. Search for Related Content PubMed PubMed Citation Articles by NOSADINI, R. Articles by CREPALDI, G.

Porcine and Human Insulin Absorption From Subcutaneous Tissues in Normal and Insulin-Dependent Diabetic Subjects: A Deconvolution-Based Approach^*

Istituto di Medicina Internet, Patologia Medica 1° (R.N., S.D.K., E.D., E.I., A.A., R.T., P.F., A.D., G.C), and Clinica Medica II (CM.), Policlinico Universitario; Dipartimento di Elettronica e Informatica, Uniuersita di Padova (C.C); and Istituto di Dinamica dei Sistemi e Bioingegneria del CNR (C.C, A.M.) Padova, Italy
Novo Research Institute (I.J.) Bagsvaerd, Denmark

Address all correspondence and requests for reprints to: R. Nosadini, Istituto di Medicina Interna, Patologia Medica I°, Policlinico Universitario, Via Giustiniani, 2-35128 Padova, Italy.

The mechanisms of sc insulin absorption are not understood, and models for interpreting in vivo data cannot be developed without gross simplification. To overcome this difficulty we developed a new approach which makes use of deconvolution analysis and does not require any model of the sc tissue. In five normal subjects and seven insulin-dependent diabetic (IDDM) patients endogenous insulin secretion was suppressed by means of a hypoglycemic glucose clamp procedure (2.8 mmol/L) sustained by a continuous insulin infusion (4 pmol/min · kg). A bolus injection of insulin (5.4 nmol) was administered iv, and plasma insulin concentrations were measured frequently for 2 h to assess iv insulin kinetics. Insulin then was injected sc in the abdominal region, and plasma insulin concentrations were measured for 8 h. Each subject was studied twice, with porcine and semisynthetic human insulin (Actrapid, Novo). The rate of insulin absorption was reconstructed by deconvolution from the plasma concentrations and iv insulin kinetic data. Linearity of the iv insulin kinetics, essential for deconvolution analysis, was confirmed by a dose-response study in the range of the measured concentrations (150–1800 pmol/L). In most instances, a two-compartment model was adequate to describe the iv response. The mean plasma insulin clearance rates were 15.5 ± 1.9 (±SD) mL/min · kg (porcine) and 17.2 ± 6.0 (human) in normal subjects and 20.7 ± 8.8 (porcine) and 20.9 ± 9.1 (human) in the IDDM patients. The rate of appearance of human insulin from sc tissue was faster than that of porcine insulin in both normal and IDDM subjects, but no significant differences were found in bioavailability, which was 55 ± 12% (±SD; porcine) and 61 ± 34% (human) in the normal subjects, and 84 ± 28% (porcine) and 86 ± 23% (human) in the IDDM patients. The rate of absorption and bioavailability were higher in the IDDM patients than in the normal subjects, a difference possibly related to increased sc blood flow in the IDDM patients. No differences were found with regard to glucose requirement values, normalized to plasma insulin concentrations, in agreement with the finding that the bioavailability of the two insulin species was similar.

Received September 10, 1987.