Effect of anesthetics on insulin secretion and their mechanism

Abstract

Proper glycemic control is an essential goal of critical care medicine, including perioperative patient care that can influence patients’ prognosis. Insulin secretion from pancreatic β-cells is generally assumed to play a critical role in glycemic control in response to an elevated blood glucose concentration. A line of animal and human studies have demonstrated that perioperative drugs, including volatile anesthetics, have an impact on glucose-stimulated insulin secretion (GSIS). However, the effects of intravenous anesthetics on glucose metabolism and insulin sensitivity are largely unknown at present. We have shown that propofol, at clinically relevant doses, facilitates GSIS in MIN6 and INS-1 cells and inhibits stromatoxin-1-sensitive voltage-gated potassium (Kv) channels. In other words, propofol specifically blocks Kv currents in β-cells, and the inhibitions result in the facilitation of insulin secretion in the presence of glucose. Elucidating the effects of anesthetics on insulin secretion and their mechanism is important to understand their impact on patients in clinical use.