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Serum insulin levels of "diabetic" and "nondiabetic" patients on chronic hemodialysis.

Patients with chronic renal failure have abnormalities of glucose metabolism. Many factors have been proposed as causes. Insulin levels and reserves in nine patients on chronic hemodialysis were studied. Four patients had the diagnosis of maturity-onset diabetes mellitus. The other five were “nondiabetic.” Proposed diagnoses of the causes of renal failure, ages, clinical status, blood urea nitrogen, and electrolyte measurements were comparable in the “diabetic” and “nondiabetic” groups. Serum insulin levels were measured before and immediately after hemodialysis. The predialysis samples averaged 26 micro units insulin per ml. serum for the “nondiabetic” group and 65 micro units per ml. serum for the “diabetic” group. Postdialysis figures were 35 micro units insulin per ml. and 78 micro units insulin per ml. for the “nondiabetic” and “diabetic” groups, respectively. Fasting serum levels and reserves as measured by immunoassay do not appear to be influenced by the uremic state, but rather reflect the pre-existing diabetic or nondiabetic status.