There is a diurnal variation in insulin secretion, with higher values in the morning (AM) than in the afternoon (PM). This study tested the hypothesis that nocturnal human growth hormone (hGH) secretion might be the mechanism producing this diurnal variation in insulin secretion. Six healthy normal-weight men were studied on four occasions: twice in the early morning (AM) and twice in the afternoon (PM). Oral methscopolamine (Pamine), an anticholinergic agent that blocks hGH release, was administered at bedtime prior to the AM study or before breakfast for the PM study. An index of insulin secretion in all four tests was obtained from measurement of the acute release of insulin in response to two intravenous (IV) boluses of arginine, one given basally and the other given after raising glucose levels to approximately 150 mg/dL above the baseline. Insulin secretion was significantly greater in the morning than in the afternoon in both control and methscopolamine-pretreated subjects. The mean peak hGH was reduced in subjects pretreated with oral methscopolamine. Drug treatment reduced insulin secretion proportionally in the morning and afternoon. These results suggest that the diurnal insulin response to stimulation with arginine during a hyperglycemic clamp persists despite complete suppression of hGH by anticholinergic blockade, and that the diurnal insulin secretion is not caused by sleep- or meal-induced GH secretion.

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http://dx.doi.org/10.1016/0026-0495(91)90171-rDOI Listing

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