Dietary sodium restriction impairs insulin sensitivity in noninsulin-dependent diabetes mellitus

J Clin Endocrinol Metab. 1998 May;83(5):1552-7. doi: 10.1210/jcem.83.5.4835.

Abstract

Dietary sodium restriction has a variety of effects on metabolism, including activation of the renin-angiotensin system. Angiotensin II has complex metabolic and cardiovascular effects, and these may be relevant to the effects of both nonpharmacological and pharmacological interventions in noninsulin-dependent diabetes mellitus (NIDDM). We have assessed the effect of dietary sodium restriction on insulin sensitivity and endogenous glucose production in eight normotensive patients with diet-controlled NIDDM who underwent hyperinsulinemic clamp studies in a randomized, double-blind, placebo-controlled cross-over protocol after two 4-day periods on sodium replete (160 mmol/day) and sodium deplete (40 mmol/day) diets. Mean +/- SD 24-h urinary sodium was 197 +/- 76.0 mmol (replete) and 67 +/- 19.5 mmol (deplete), P = 0.03. Insulin sensitivity was 42.0 +/- 11.3 mumol/kg.min (replete) and 37.0 +/- 11.6 mumol/kg.min (deplete), P = 0.04 (a reduction of 12%). Blood pressure was 130 +/- 21/78 +/- 11 mmHg (replete) and 128 +/- 12/73 +/- 10 mmHg (deplete). Dietary sodium restriction may result in a decrease in peripheral insulin sensitivity in normotensive patients with NIDDM, possibly via an elevation in prevailing angiotensin II concentrations.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aldosterone / blood
  • Angiotensin II / blood
  • Cross-Over Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diet, Sodium-Restricted*
  • Double-Blind Method
  • Electrolytes / blood
  • Female
  • Glucose / biosynthesis
  • Glucose Clamp Technique
  • Humans
  • Insulin / blood
  • Insulin / pharmacology*
  • Male
  • Middle Aged
  • Placebos
  • Renin / blood
  • Triglycerides / blood

Substances

  • Electrolytes
  • Insulin
  • Placebos
  • Triglycerides
  • Angiotensin II
  • Aldosterone
  • Renin
  • Glucose