On the mechanism of glucose release from the muscle of juvenile diabetics in acute insulin deficiency

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Abstract
In 53 healthy subjects and 23 juvenile diabetics the measurement of arterial and deep venous glucose concentrations showed that the substrate was taken up by the tissues of the forearm of all the healthy subjects and released from it in all the diabetic ones. In 6 of the diabetics glucose output was accelerated almost 5-fold during the intrabrachial arterial administration of metaproterenol (1.62 nmol/min), indicating that basal glucose release from muscle may result from enhanced glycogenolysis during acute insulin deficiency. In line with this view a reduction of glucose uptake by muscle was observed in 6 healthy subjects receiving metaproterenol infusion. However, since the production of lactate by the forearm appeared smaller in the diabetics, the basal glucose output could also partly be due to impaired glycolysis. Glucose released from muscle during acute insulin deficiency may be of clinical importance, especially when the rate of glycogenolysis is further stimulated by, for example, enhanced catecholamine drive.