Insulin secretion in response to protein ingestion.

Abstract

W\e have reported previously that the oral or intravenous administration of the amino acid l-leucine to healthy subjects results in increases in plasma insulin and decreases in blood glucose and plasma free fatty acids (2, 3). After the ad- ministration of leucine to healthy subjects pre- treated with either chlorpropamide or tolbutamide (2, 3), and also to some patients with functioning islet cell tumors of the pancreas (4), increments in plasma leucine caused increases in plasma insulin and decreases in blood glucose that were sig- nificantly greater than those observed in healthy subjects not pretreated with sulfonylurea drugs. We have also shown that increased release of in- sulin from the pancreatic beta cells is the mecha- nism by which leucine increases peripheral levels of insulin (5). We suggested that a rising plasma level of leucine is a physiologic stimulus for the release of insulin, and that the more pronounced sensitivity to leucine hypoglycemia produced ex- perimentally by. administration of sulfonylureas and observed in some patients with idiopathic hypoglycemia or insulin-secreting tumors of the pan- creas represents a great exaggeration of a normal physiologic phenomenon (6, 7).