198097b0Nature19848751963040697980028-0836196310.1038/198097b0ukNatureNatureNATUREnatureNature is a weekly international journal publishing the finest peer-reviewed research in all fields of science and technology on the basis of its originality, importance, interdisciplinary interest, timeliness, accessibility, elegance and surprising conclusions. Nature also provides rapid, authoritative, insightful and arresting news and interpretation of topical and coming trends affecting science, scientists and the wider public./nature/journal/v198/n4875issueJournal homeArchiveCurrent issueAdvance online publicationPrivacy policySubscribeNature Publishing GroupCurrent issue198097b0Muscle Glycogen in Juvenile Diabetes before and during Treatment with Insulin
AU  - BERGSTROM, JONAS
AU  - HULTMAN, ERICCentral Laboratory, St. Erik's Hospital,
AU  - ROCH-NORLUND, A. E.Children's Hospital Samariten, Stockholm.IT is well known that insulin stimulates the synthesis of glycogen in isolated muscle tissue from different animals. Insulin is considered to increase the permeability of the cell membrane to glucose. Direct action on the enzymes responsible for the synthesis of glycogen has also been observed. Low muscle glycogen has been found in animals with experimental diabetes. There are, however, few reports on the muscle glycogen content in normal and diabetic man. The glycogen content in muscle biopsy specimens from normal subjects was investigated by Hildes et al.1-3 and by Nichols4. Hildes et al.2,3 also determined the glycogen content in muscle tissue from patients with diabetes. No significant decrease was found in the muscle glycogen compared with the normal subjects. Their patients were adults who, in most cases, had been treated with insulin up to a few days before the examination.This communication reports results from a material consisting of six patients with uncompensated juvenile diabetes. Muscle glycogen was determined before and during insulin treatment.
In four of the cases the diabetes was newly discovered and no insulin had been given before the first examination. Two patients had received insulin treatment for six months; but due to exacerbation of the disease, their insulin doses were insufficient for some weeks before the first examination. In one patient (No. 3) the diabetes was detected by routine examination for glucose of the urine. All the other patients had classical symptoms of diabetes. Metabolic acidosis was present in four cases.
Muscle biopsies were performed immediately before the administration of insulin and after 9-16 days' treatment with adequate doses of insulin. In three patients, biopsies were also performed after one day's acute treatment with insulin and carbohydrate.
Table 1
Case No., sex, age
(1) M 13 <2) M 6
(3) F 7
(4) M 15
(5) M 12
(6) M 9
Duration of symptoms
4 weeks 10 days No symptoms
3 weeks
1 month (diabetes known since 6 months)
1 week
(diabetes known since 7 months)
Time of
biopsy
On admission After 14 days
On admission After 9 days
On admission After 16 days
On admission After 27 hours After 13 days
On admission After 24 hours After 13 days
On admission After 28 hours After 9 days
Insulin
	Bicarbonate
treatment
	content
(l.TT./day)
(mmol./l.)
0
	13

20[ast]
	-
0
	14
8
	-
0
	23-5
4
0
	13-0
160
	-
32
	24-8
8
	12-6
80
	22-0
32
	24 5
8
	21-5
60
	19-5
32
Blood
glucose
(mg/100 ml.)
345
225
170
70
150
170
325
198
195
344
154
124
228
224
134
Ketone Muscle glycogea
bodies (g/100 g
in urine wet weight)
+ + 0-50 0 1-32
0 73 1-76
0-90 1-07
0-54
0 0-93 0 1-94
+ + + 0-50
(+) 1-22
0 1-70
+ + 0-79
0 1-56
0 1-35
Mean value 1 -33 Hange (1-03-1-92)
Normal subjects (n = 24)
" The patient was also given 250 mg chlorpropamide twice daily.
Muscle tissue (5-20 mg) was obtained from m. quadriceps femoris by needle biopsy5. The muscle samples were weighed and homogenized, and the protein was precipitated with trichloroacetic acid within 5 min. The glycogen soluble in trichloroacetic acid was precipitated with ethanol and determined as glucose after hydrolysis by sulphuric acid. Glucose was determined by the ortho-toluidin method6.
A few clinical results are summarized in Table 1.
All the cases with uncompensated diabetes had muscle glycogen values lower than the normal range found in our laboratory. Already on the day after onset of the treatment the muscle glycogen content had increased considerably and after stabilization of the treatment the content was within the normal range in all the cases. The most severe diabetic cases, as observed clinically, had the lowest muscle glycogen values.
Apparently the results are in contradiction to those of Hildes et al.2'3. On the other hand, the materials are so different with regard to age distribution and treatment that no direct comparison can be made.
This work was supported by grants from Pfizer AB, Nasby Park, and by the City of Stockholm.Hildes, , J. A., Purser, , S. H., and Sherlock, , S., J. Physiol., 109, 232 (1949).PubMedISIChemPortHildes, , J. A., Sherlock, , S., and Walshe, , V., Clin. Sci., 7, 287 (1949).ISIChemPortHildes, , J. A., Sherlock, , S., and Walshe, , V., Clin. Sci., 7, 297 (1949).ISIChemPortNichols, , N., J. Clin. Invest., 34, 1710 (1955).PubMedISIChemPortBergstrom, , J., Scand. J. Clin. Lab. Invent., 14, Supp. 68, 110 (1962).Hultman, , E., Nature, 183, 108 (1959).PubMedISIChemPort