Elsevier

Metabolism

Volume 28, Issue 3, March 1979, Pages 191-194
Metabolism

Preliminary report
Effects of insulin infusion on plasma phosphate in diabetic patients

https://doi.org/10.1016/0026-0495(79)90063-5Get rights and content

Abstract

A clinical association between insulin therapy and hypophosphatemia has frequently been made but a dose-response relationship has not been reported. Furthermore, the rapidity by which hypophosphatemia may be induced following an increment in plasma-free insulin concentration is not well defined. Therefore this study compared the effects of different rates of insulin infusion on the changes in plasma phosphate concentration in ketotic, hyperglycemic diabetic man. Sixteen prospective studies were performed in four insulin-dependent ketotic diabetic subjects. Insulin was infused according to one of four different protocols: high dose (1.0 U/kg/hr), low dose (0.1 U/kg/hr), very low dose (0.01 U/kg/hr) and control (saline only). Plasma phosphate, glucose, and free insulin concentrations were measured sequentially during the 60 min infusion periods. We observed that plasma phosphate concentrations declined significantly only with lowdose and high-dose insulin infusions. The magnitude and rapidity of fall of the mean phosphate concentration were greatest with high-dose insulin infusion. Significant hypophosphatemia can be observed within 30 min following the onset of insulin therapy.

References (18)

  • KGMM Alberti et al.

    2,3-Diphosphoglycerate and tissue oxygenation in uncontrolled diabetes mellitus

    Lancet

    (1972)
  • J Ditzel et al.

    The problem of tissue oxygenation in diabetes mellitus

    Acta Med Scand

    (1975)
  • Y Kanter et al.

    2,3-Diphosphoglycerate, nucleotide phosphate, and organic and inorganic phosphate during the early phases of diabetic ketoacidosis

    Diabetes

    (1977)
  • GM Guest et al.

    Role of acid soluble phosphorous compounds in red blood cells in experimental rickets, renal insufficiency, pyloric obstruction, gastroenteritis, ammonium chloride acidosis and diabetic acidosis

    Am J Dis Child

    (1939)
  • KM Piters et al.

    Comparison of continuous and intermittent intravenous insulin therapies for diabetic ketoacidosis

    Diabetologia

    (1977)
  • DS Schade et al.

    Dose response to insulin in man: Differential effects on glucose and ketone body regulation

    J Clin Endocrinol Metab

    (1977)
  • ASG Hagett et al.

    Use of glucose oxidase, peroxidase, and O-diansidine in determination of blood and urinary glucose

    Lancet

    (1957)
  • CM Hales et al.

    Immunoassay of insulin and antibody precipitation

    Biochem J

    (1963)
  • SH Nakagawa et al.

    A simple method for the determination of serum free insulin levels in insulin-treated patients

    Diabetes

    (1973)
There are more references available in the full text version of this article.

Cited by (0)

Supported by grants from the Clinical Research Center Program of the Division of Research Resources, National Institutes of Health #RR-00997-02, The KROC Foundation, and NIAMD #1 R01 AM 18681-01.

1

David S. Schade is the recipient of a Research Career Development Award #1KZ4AM00260-01.

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