Phenytoin‐induced Insulin Insensitivity
- 1 December 1991
- journal article
- case report
- Published by Wiley in Diabetic Medicine
- Vol. 8 (10), 968-970
- https://doi.org/10.1111/j.1464-5491.1991.tb01539.x
Abstract
Phenytoin is known to induce hyperglycaemia. The mechanism has generally been considered primarily an inhibition of insulin release. We have recently treated a patient who became hyperglycaemic on phenytoin and whose markedly increased insulin requirements suggested an insulin resistant state. Reduction of the phenytoin dose resulted in amelioration of the hyperglycaemia. In vitro studies of phenytoin in a primary culture system of adipocytes that allowed assessment of both insulin receptor binding and post-binding function showed a 57% reduction in maximum [14C]3-0-methylglucose transport in the presence of phenytoin while having no effect on maximum insulin binding. These results suggest that phenytoin administration can result in insulin insensitivity by inducing a post-binding defect in insulin action.Keywords
This publication has 9 references indexed in Scilit:
- Role of Gestational Hormones in the Induction of Insulin Resistance*Journal of Clinical Endocrinology & Metabolism, 1988
- Primary culture of isolated adipocytes. A new model to study insulin receptor regulation and insulin action.Journal of Biological Chemistry, 1984
- Marked Increase in Insulin Sensitivity of Human Fat Cells 1 Hour after Glucose IngestionJCI Insight, 1983
- THE EFFECT OF LONG‐TERM DIPHENYLHYDANTOIN THERAPY ON GLUCOSE TOLERANCE AND INSULIN SECRETION: A CONTROLLED TRIALClinical Endocrinology, 1980
- Effect of Diphenylhydantoin on Glucose Tolerance in Patients with HypoglycemiaDiabetes, 1974
- Effect of Diphenylhydantoin on Insulin Secretion in ManNew England Journal of Medicine, 1972
- Diphenylhydantoin-induced Hyperglycemia and Impaired Insulin Release: Effect of DosageDiabetes, 1971
- Hyperglycemic, Nonketotic Coma Following Administration of Dilantin (Diphenylhydantoin)Diabetes, 1969