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 HighWire Citing Articles via Google Scholar Google Scholar Articles by ARSLANIAN, S. A. Articles by DRASH, A. L. Search for Related Content PubMed PubMed Citation Articles by ARSLANIAN, S. A. Articles by DRASH, A. L.

Sexual Dimorphism in Insulin Sensitivity in Adolescents with Insulin-Dependent Diabetes Mellitus^*

SILVA A. ARSLANIAN, BRIAN V. HEIL, DOROTHY J. BECKER and ALLAN L. DRASH

Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, Children's Hospital, University of Pittsburgh Pittsburgh, Pennsylvania 15213

Address requests for reprints to: Silva A. Arslanian, M.D., Division of Endocrinology, Children's Hospital of Pittsburgh, 3705 Fifth Avenue at DeSoto Street, Pittsburgh, Pennsylvania 15213.

Recipient of Clinical Associate Physician Award of Children's Hospital General Clinical Research Center (RR-00084-25)

Sex-related differences in insulin sensitivity were evaluated in male and female adolescents with insulin-dependent diabetes mellitus (IDDM). They were matched for age, pubertal staging, body mass index, and glycohemoglobin levels. During a 1.7 mU/kg·min hyperinsulinemic-euglycemic clamp, the insulin-mediated glucose disposal rate was lower (26.9 ± 2.1 vs. 47.1 ± 3.7 µmol/kg·min; P < 0.001), and GH levels were higher (6.5 ± 1.2 vs. 2.9 ± 0.8 µg/L; P = 0.03) in females than in males. Plasma glucagon, cortisol, epinephrine, and norepinephrine levels during the clamp were similar in the two sexes, except for pancreatic polypeptide, which showed a tendency to be higher in females (19 ± 4 vs. 11 ± 1 pmol/L; P = 0.07).

During insulin-induced hypoglycemia, the rate of drop in plasma glucose was faster (0.16 ± 0.01 vs. 0.11 ± 0.01 mmol/L·min; P = 0.001), and the rate of glucose recovery was slower in males than in females (0.04 ± 0.01 vs. 0.06 ± 0.01 mmol/L·min; P = 0.05). Plasma glucose concentrations were lower in males than in females (glucose nadir, 2.3 ± 0.2 vs. 3.3 ± 0.2 mmol/L; P = 0.002; glucose peak, 3.7 ± 0.2 vs. 5.3 ± 0.4 mmol/L; P = 0.002), with similar plasma free insulin concentrations. Despite a greater degree of hypoglycemia, GH responses were lower in males than in females. The remaining counterregulatory hormone responses were similar in both sexes.

We conclude that there is a distinct sexual dimorphism in insulin sensitivity in adolescents with IDDM. This is likely to be due to sex-related differences in GH levels. Furthermore, male patients with IDDM are apt to develop greater degrees of hypoglycemia accompanied by lower GH responses. (J Clin Endocrinol Metab 72: 920–926, 1991)

^* This work was supported by USPHS Grant 5-Mol-RR-00086-25 (to the General Clinical Research Center), 5-Mol-RR-00084-25 (to Clinical Associate Physician), and the Renziehausen Fund. Presented in part at the Annual Meeting of the Society for Pediatric Research, Anaheim, CA, May 1990.

Received June 27, 1990.

This article has been cited by other articles:

				J. Rieusset, J. Seydoux, S. I. Anghel, P. Escher, L. Michalik, N. Soon Tan, D. Metzger, P. Chambon, W. Wahli, and B. Desvergne Altered Growth in Male Peroxisome Proliferator-Activated Receptor {gamma} (PPAR{gamma}) Heterozygous Mice: Involvement of PPAR{gamma} in a Negative Feedback Regulation of Growth Hormone Action Mol. Endocrinol., October 1, 2004; 18(10): 2363 - 2377. [Abstract] [Full Text] [PDF]

				J. Hamilton, E. Cummings, V. Zdravkovic, D. Finegood, and D. Daneman Metformin as an Adjunct Therapy in Adolescents With Type 1 Diabetes and Insulin Resistance: A randomized controlled trial Diabetes Care, January 1, 2003; 26(1): 138 - 143. [Abstract] [Full Text] [PDF]

				A. L. Sunehag, G. Toffolo, M. S. Treuth, N. F. Butte, C. Cobelli, D. M. Bier, and M. W. Haymond Effects of Dietary Macronutrient Content on Glucose Metabolism in Children J. Clin. Endocrinol. Metab., November 1, 2002; 87(11): 5168 - 5178. [Abstract] [Full Text] [PDF]

				D. G. Rogers Puberty and Insulin-Dependent Diabetes Mellitus Clinical Pediatrics, March 1, 1992; 31(3): 168 - 173. [PDF]