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Diabetes 51:3384-3390, 2002
© 2002 by the American Diabetes Association, Inc.

The Role of Insulin in Human Brain Glucose Metabolism

An 18Fluoro-Deoxyglucose Positron Emission Tomography Study

Emma M. Bingham1, David Hopkins2, Diarmuid Smith1, Andrew Pernet1, William Hallett3, Laurence Reed4, Paul K. Marsden3, and Stephanie A. Amiel1

1 GKT School of Medicine, King’s College Hospital, London, U.K
2 Department Diabetes, Central Middlesex Hospital, London, U.K
3 PET Centre, St Thomas’ Hospital, London, U.K
4 Institute of Psychiatry, Maudsley Hospital, London, U.K

The effect of basal insulin on global and regional brain glucose uptake and metabolism in humans was studied using 18-fluorodeoxyglucose and positron emission tomography (FDG-PET). Eight healthy male volunteers aged 49.3 ± 5.1 years were studied twice in random order. On each occasion, they received an infusion of 0.1 mg · kg-1 · min-1 somatostatin to suppress endogenous insulin production. In one study 0.3 mU · kg-1 · min-1 insulin was infused to replace basal circulating insulin levels, and in the other study a saline infusion was used as control. We sought stimulatory effects of basal insulin on brain glucose metabolism particularly in regions with deficiencies in the blood-brain barrier and high density of insulin receptors. Insulin levels were 27.07 ± 1.3 mU/l with insulin replacement and 3.51 ± 0.4 mU/l without (P = 0.001). Mean global rate of brain glucose utilization was 0.215 ± 0.030 mmol · kg-1 · min-1 without insulin and 0.245 ± 0.021 mmol · kg-1 · min-1 with insulin (P = 0.008, an average difference of 15.3 ± 12.5%). Regional analysis using statistical parametric mapping showed that the effect of basal insulin was significantly less in the cerebellum (Z = 5.53, corrected P = 0.031). We conclude that basal insulin has a role in regulating global brain glucose uptake in humans, mostly marked in cortical areas.


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