Abstract:
As until now there is no possibility of healing the widespread disease diabetes, the prevention of secondary complications by reaching near normal blood glucose levels due to an insulin administration as physiological as possible, remains the ultimate ambition. Insulin detemir is nearly able to reach this due to its flat action profile caused by albumin binding based on a myristic acid moiety.
By now, many studies have shown, that detemir – in comparison to traditional insulins – does not cause the expected weight gain. For this reason, the effect of insulin detemir on the important target organ adipose tissue was investigated by means of the differentiation process of 3T3-L1-preadipocytes. Three levels were explored, in each case compared to human insulin: the enzymatic level with the photometrically determined GPDH-activity as a marker for differentiation; the morphologic one by light microscopy after staining of the lipid droplets and, furthermore, the level of gene expression; during adipogenesis there are over 2000 regulated genes; in this study PPARG2 and leptin were quantified as markers for differentiation using polymerase chain reaction. As in preliminary experiments a strong differentiation inhibition due to albumin could be shown, all experiments had to be performed in the absence of albumin.
In contrast to the expectations, to literature and the known weight neutrality, a significantly higher adipogenity of detemir emerged at supraphysiological concentrations. This could be due to the effect of the high concentration of the fatty acid moiety. Therefore, the aim was to perform the experiments at insulin concentrations as physiological as possible and an appropriate differentiation protocol has been established.
For the same glucose-lowering effects as reached by human insulin, a four-fold molar concentration of detemir is needed; thus, the results were obtained at equimolar and equipotent concentrations. A less adipogenic effect of insulin detemir could be shown, equimolar as well as equipotent. One possible explanation – the myristic acid moiety – could be excluded in corresponding control experiments. On the basis of the protein course a less mitogenic/survival-promoting effect of insulin detemir could be proposed, as only in human insulin treated cells post-confluent mitoses were detected. A morphologically assumed also less lipogenic effect of detemir leads to new interesting questions.
In conclusion, the obtained results of the less adipogenic effects of insulin detemir provide another reasonable explanation – for the first time on the molecular level – for the weight neutral properties of insulin detemir.