Effects of Ketone Bodies on Basal and Insulin-Stimulated Glucose Utilization in Man*

Publisher Website
Google Scholar
Abstract
Using the euglycemic clamp technique, we in vestigated the effects of high ketone body levels on basaland insulinstimulated glucose utilization in normal subjects. Infusionof sodium acetoacetate in the postabsorptive state raised ketone body levels from 150±(150±E) junol/liter tomore than 1 mmol/liter. Endogenous glucose production declined from2.71 150±0.20mg kg-1 min-1 to 1.75 + 0.26(P< 0.01) and glucose utilization from 2.71150±0.20to 1.98 150±0.17 mg kg-1 min-1(P -1 min-1insulin infusion), endogenous glucose production wassuppressed atthe lowest insulin infusion rate; glucose utilization increased first to 7.32 150±0.96mg kg-1 min-1 and then to 16.5150±1.27 mg kg-1 min-1. During euglycemic hyperinsulinemic clamps with simultaneous sodium acetoacetate infusion, similar insulinlevels were attained; endogenous glucose production was also suppressed at the lowest insulin infusion rate, andinsulin-stimulated glucose utilization rates (7.93 150±1.70 and 15.80150±1.30mg kg-1 min-1 were notmodified.In conclusion, acetoacetate infusion decreased basal, but not insulin-stimulated, glucose utilization. Theincrease in lactate during acetoacetate infusion in thepostabsorptive state suggests that ketone body acted by decreasing pyruvate oxidation.