The physiological role of circulating insulin-like growth factor-II (IGF-II) in adult humans is poorly understood, We recently generated an IGF-II transgenic murine model of persistent IGF-II production (plasma IGF-II similar to 30-fold increased above normal) through overexpression of the transgene driven by the major urinary protein promoter (Rinderknecht, E., and Humbel, R. E. (1978) J. Biol. Chem. 269, 13779-13784), To determine whether in vivo insulin action is improved in these transgenic mice, we performed euglycemic insulin (18 milliunits/kg . min) clamp studies in conscious IGF II transgenic and in age- and weight-matched control mice, Plasma glucose and insulin concentrations were significantly lower in the IGF-II transgenic compared with both control groups, Despite decreased plasma glucose concentration, basal hepatic glucose production (HGP) and glucose clearance were increased. During the insulin clamp studies in IGF-II transgenic mice compared with control mice (a) the rates of glucose infusion and glucose uptake were increased by similar to 65 and similar to 55%, respectively; (b) glycolysis was increased by similar to 12% while glycogen synthesis was similar to 2-fold higher; (c) while the suppression of plasma free fatty acid was similar, the increment in plasma lactate concentration was significantly higher; (d) although HGP was similarly inhibited by insulin, phosphoenolpyruvate gluconeogenesis was enhanced and accounted for a larger portion of HGP (64% versus similar to 40% in control mice). Our data suggest that the persistence of circulating IGF-II in adult mice to levels commonly observed in adult humans (50-70 nM) causes a marked improvement in peripheral (skeletal muscle) insulin action, which is not due to changes in body composition, These results suggest that circulating IGF-II may exert a regulatory role on insulin sensitivity and body composition in humans.