INSULIN SENSITIVITY IN ALCOHOLICS IN A WITHDRAWAL STATE

Abstract. Insulin sensitivity in non‐diabetic alcoholics in a withdrawal state was investigated using a euglycaemic clamp technique on two occasions with an interval of 1 week. Insulin was infused at a rate of 40 mU m−2 min−1 (n = 9) and 20 mU m−2 min−1 (n = 9). Hepatic glucose production was estimated with tritiated glucose in six subjects. The fasting glucose level at the first examination, 5.1 ± 0.2 mmol l−1 exceeded that found at the second examination, 4.7 ± 0.1 mmol l−1 (P < 0.05), although the C‐peptide concentration was higher at the first examination (2.7 ± 0.3 vs. 1.6 ± 0.2 ng ml−1: P < 0.001). Both glucose uptake (5.0 ± 0.6 vs 6.2 ± 0.7 mg kg−1 min−1: P < 0.05) and tissue sensitivity (M/I; 0.08 ± 0.02 vs. 0.1 ± 0.02 mg kg−1 min−1/mU l−1; P < 0.05) increased between the first and second euglycaemic clamp (40 mU m−2 min−1). At the low insulin infusion rate (20 mU m−2 min−1), the tissue sensitivity to insulin increased (0.09 ± 0.01 vs. 0.13 ± 0.02 mg kg−1 min−1/mU l−1; P < 0.05). Hepatic glucose production did not change during the examination period (2.2 ± 0.2 vs. 2.3 ± 0.1 mg kg−1 min−1), neither was there a change in the suppression of hepatic glucose output during hyperinsulinaemia (40 mU m−2 min−1). Our findings indicate that, in non‐diabetic alcoholics, insulin sensitivity in peripheral tissues is decreased during the early part of a withdrawal period. 1990 Blackwell Publishing Ltd