Insulin Pulse Characteristics and Insulin Action in Non-diabetic Humans

Marcello C. Laurenti, Chiara Dalla Man, Ron T. Varghese, James C. Andrews, John G. Jones, Cristina Barosa, Robert A. Rizza, Aleksey Matveyenko, Giuseppe De Nicolao, Kent R. Bailey, Claudio Cobelli, Adrian Vella

Research output: Contribution to journalArticlepeer-review


Objective: Pulsatile insulin secretion is impaired in diseases such as type 2 diabetes that are characterized by insulin resistance. This has led to the suggestion that changes in insulin pulsatility directly impair insulin signaling. We sought to examine the effects of pulse characteristics on insulin action in humans, hypothesizing that a decrease in pulse amplitude or frequency is associated with impaired hepatic insulin action. Methods: We studied 29 nondiabetic subjects on two occasions. On 1 occasion, hepatic and peripheral insulin action was measured using a euglycemic clamp. The deuterated water method was used to estimate the contribution of gluconeogenesis to endogenous glucose production. On a separate study day, we utilized nonparametric stochastic deconvolution of frequently sampled peripheral C-peptide concentrations during fasting to reconstruct portal insulin secretion. In addition to measuring basal and pulsatile insulin secretion, we used approximate entropy to measure orderliness and Fourier transform to measure the average, and the dispersion of, insulin pulse frequencies. Results: In univariate analysis, basal insulin secretion (R2=0.16) and insulin pulse amplitude (R2=0.09) correlated weakly with insulin-induced suppression of gluconeogenesis. However, after adjustment for age, sex, and weight, these associations were no longer significant. The other pulse characteristics also did not correlate with the ability of insulin to suppress endogenous glucose production (and gluconeogenesis) or to stimulate glucose disappearance. Conclusions: Overall, our data demonstrate that insulin pulse characteristics, considered independently of other factors, do not correlate with measures of hepatic and peripheral insulin sensitivity in nondiabetic humans.

Original languageEnglish (US)
Pages (from-to)1702-1709
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Issue number6
StatePublished - Jun 1 2021


  • C-peptide kinetics
  • endogenous glucose production
  • gluconeogenesis
  • glucose disappearance
  • insulin action
  • insulin pulses

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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