From the Sleep 2012 Conference-
(0801) Insulin Sensitivity In Narcolepsy And The Effect Of Sodium Oxybate As Measured By A Hyperinsulinemic-Euglycemic Clamp
Introduction: Hypocretin deficiency causes narcolepsy, a condition characterized by excessive daytime sleepiness, cataplexy, and fragmented nocturnal sleep. Co-morbid obesity is present in more than half of narcolepsy patients. While a higher prevalence of the metabolic syndrome and Type 2 Diabetes Mellitus (T2DM) has been reported in narcolepsy, recent studies could not detect differences in insulin sensitivity between patients and controls. However, none of these studies applied the gold standard, i.e. the hyperinsulinemic-euglycemic clamp, to measure insulin sensitivity. Therefore, we performed a study using this gold standard to quantify insulin sensitivity in both narcolepsy patients and individually matched controls. Additionally, we investigated the effect on insulin sensitivity of three months of treatment with sodium oxybate (SXB).
Methods: Nine hypocretin deficient patients with narcolepsy-cataplexy (seven males), and nine sex, age, body mass index, and fat mass matched controls were enrolled. A hyperinsulinemic-euglycemic clamp was performed at baseline (40mU/m2/min insulin infusion for 2 hours to attain a
circulating insulin level of about 40mU/L). In seven patients (five males)a second hyperinsulinemic-euglycemic clamp was performed after three months of treatment with SXB.
Results: Glucose disposal rate per unit serum insulin was significantly higher in narcolepsy patients compared to individually matched controls indicating higher insulin sensitivity in patients. Narcolepsy patients lost a substantial amount of weight (mean of 5.2 kg) after 3 months of treatment with SXB. Moreover, SXB treatment lowered insulin sensitivity in narcolepsy patients to levels comparable to those of control subjects.
Conclusion: Our findings suggest that narcolepsy patients are actually more insulin sensitive than body weight and fat mass matched controls. Therefore, any potential tendency to develop T2DM probably stems from their propensity to grow obese. SXB decreased weight, and normalized insulin sensitivity.
I am working on the roundup. This was just too good to wait.
Hartelijk bedankt to the Dutch researchers who did this work!!!
I love you guys...
