Acquired generalized lipoatrophy (AGL): highly selective MR lipid imaging and localized (1)H-MRS.

Frequency-selective chemical shift magnetic resonance (MR) imaging was applied on the calf musculature and the abdomen of a patient with acquired generalized lipoatrophy (AGL; Lawrence syndrome), a very rare syndrome affecting selectively several types of adipose tissue accompanied by alterations in glucose and energy metabolism. In addition, (1)H-MRS was used for assessment of intra- (IMCL) and extramyocellular lipid stores (EMCL) in the skeletal musculature of the calf. Results from the AGL patient were compared with an age-matched group of five healthy volunteers. Fat-selective imaging of the calf revealed a total lack of subcutaneous adipose tissue. No EMCL signal was found in the spectra from the soleus muscle of the AGL patient. IMCL signals were present in the spectra but were clearly lower than in the controls (14% of normal value in the soleus muscle). In abdominal images, subcutaneous fat signal was not detectable, as in the calf, but nearly normal conditions were shown for visceral adipose tissue between abdominal organs. Fat-selective images showed the liver with high signal intensity, indicating hepatic steatosis combined with hepatosplenomegaly. Modern chemical shift-selective MR imaging and localized spectroscopy allow a noninvasive and quantitative assessment of tissue composition in patients with disorders of carbohydrate and lipid metabolism.

Effects of 3-week oral treatment with the antioxidant thioctic acid (alpha-lipoic acid) in symptomatic diabetic polyneuropathy.

AIMS: To evaluate the efficacy and safety of short-term oral treatment with the antioxidant thioctic acid (TA) on neuropathic symptoms and deficits in patients with Type 2 diabetes mellitus with symptomatic polyneuropathy. METHODS: Patients were randomly assigned to oral treatment with 600 mg of TA t.i.d. (n = 12) or placebo (n = 12) for 3 weeks. Neuropathic symptoms (pain, burning, paraesthesiae, and numbness) in the feet were scored at weekly intervals and summarized as a Total Symptom Score (TSS). The Hamburg Pain Adjective List (HPAL) and the Neuropathy Disability Score (NDS) were assessed at baseline and day 19. RESULTS: At baseline the TSS, HPAL, and NDS were not significantly different between the groups. The TSS in the foot decreased from baseline to day 19 by -3.75 +/- 1.88 points (-47%) in the TA group and by -1.94 +/- 1.50 points (-24%) in the placebo group (P= 0.021 for TA vs. placebo). The total HPAL score decreased from baseline to day 19 by -2.20 +/- 1.65 points (-60%) in the TA group and by -0.96 +/- 1.32 points (-29%) in the placebo group (P = 0.072 for TA vs. placebo). The NDS decreased by -0.27 +/- 0.47 points in the TA group, whereas it slightly increased by +0.18 +/- 0.4 points in the placebo group (P = 0.025 for TA vs. placebo). No differences between the groups were noted regarding the rates of adverse events. CONCLUSIONS: These preliminary findings indicate that oral treatment with 600 mg of TA t.i.d. for 3 weeks may improve symptoms and deficits resulting from polyneuropathy in Type 2 diabetic patients, without causing significant adverse reactions.

Treatment of symptomatic diabetic peripheral neuropathy with the anti-oxidant alpha-lipoic acid. A 3-week multicentre randomized controlled trial (ALADIN Study).

Anti-oxidant treatment has been shown to prevent nerve dysfunction in experimental diabetes mellitus, thus providing a rationale of potential therapeutic value for diabetic patients. The effects of the anti-oxidant alpha-lipoic acid (thioctic acid) were studied in a 3-week multicentre, randomized, double-blind placebo-controlled trial (Alpha-Lipoic Acid in Diabetic Neuropathy; ALADIN) in 328 non-insulin-dependent diabetic patients with symptomatic peripheral neuropathy who were randomly assigned to treatment with intravenous infusion of alpha-lipoic acid using three doses (1200, 600, or 100 mg ALA) or placebo (PLAC). Neuropathic symptoms (pain, burning, paraesthesiae, and numbness) were scored at baseline and at each visit (days 2-5, 8-12, and 15-19) prior to infusion. In addition, the Hamburg Pain Adjective List, a multidimensional specific pain questionnaire, and the Neuropathy Symptom and Disability Scores were assessed at baseline and day 19. According to the protocol 260 (65/63/66/66) patients completed the study. The total symptom score in the feet decreased from baseline to day 19 by -4.5 +/- 3.7 (-58.6%) points (mean +/- SD) in ALA 1200, -5.0 +/- 4.1 (-63.5%) points in ALA 600, -3.3 +/- 2.8 (-43.2%) points in ALA 100, and -2.6 +/- 3.2 (-38.4%) points in PLAC (ALA 1200 vs PLAC: p = 0.003; ALA 600 vs PLAC: p < 0.001). The response rates after 19 days, defined as an improvement in the total symptom score of at least 30%, were 70.8% in ALA 1200, 82.5% in ALA 600, 65.2% in ALA 100, and 57.6% in PLAC (ALA 600 vs PLAC; p = 0.002). The total scale of the Pain Adjective List was significantly reduced in ALA 1200 and ALA 600 as compared with PLAC after 19 days (both p < 0.01). The rates of adverse events were 32.6% in ALA 1200, 18.2% in ALA 600, 13.6% in ALA 100, and 20.7% in PLAC. These findings substantiate that intravenous treatment with alpha-lipoic acid using a dose of 600 mg/day over 3 weeks is superior to placebo in reducing symptoms of diabetic peripheral neuropathy, without causing significant adverse reactions.

Effects of Cl- deficiency on the membrane potential in mouse pancreatic beta-cells.

The membrane potential of mouse pancreatic beta-cells was measured with microelectrodes. In the resting cell (3 mM D-glucose), the membrane potential was -63 +/- 3 mV (mean +/- S.E. for four experiments). In the presence of 3 mM D-glucose, total Cl- substitution by isethionate induced a depolarization by 3-4 mV, and readmission of Cl- induced a hyperpolarization by 3-5 mV. At 10 mM glucose, reduction of Cl- to 12 mM by substituting isethionate for Cl- reversibly shifted the repolarization potential by 6-9 mV in the positive direction and stimulated the burst activity during the initial 2-3 min by increasing the fraction of plateau phase. This was followed by a gradual inhibition of electrical activity, including decrease in fraction of plateau phase and slow wave amplitude. Total substitution of Cl- by isethionate or methyl sulphate reversibly shifted the repolarization potential by 3-4 mV in the positive direction and rapidly inhibited the electrical burst pattern without any initial stimulation. Glucose-induced (10 mM) insulin release (15 min) and 45Ca2+ uptake (3 min) were strongly inhibited by reducing the Cl- concentration to 10 mM (isethionate as substitute) and were further inhibited by further reduction of the Cl- concentration. It is suggested that beta-cells are equipped with on electrogenic Cl- flux, which can affect the burst pattern of electrical activity. The inhibitory effects of Cl- substitution may be explained by an influence of Cl- on the voltage-controlled Ca2+ channels.

Cyclic adenosine monophosphate differently affects the response of mouse pancreatic beta-cells to various amino acids.

1. The membrane potential of mouse beta-cells was measured in parallel with 86Rb+ efflux and insulin release from mouse islets during stimulation by three types of amino acids and modulation of their effects by glucose and cyclic adenosine monophosphate (cyclic AMP) (forskolin being used to activate the adenylate cyclase). 2. In the absence of glucose, alanine and arginine accelerated 86Rb+ efflux, whereas leucine decreased it. They all depolarized the beta-cell membrane and slightly increased insulin release. Forskolin had little effect on 86Rb+ efflux, consistently potentiated insulin release but induced electrical activity only in the presence of leucine. 3. The effects of the three amino acids on 86Rb+ efflux and beta-cell membrane potential were not qualitatively altered by a non-stimulatory concentration of glucose (3 mM). However, the release of insulin induced by leucine alone or with forskolin was markedly amplified, in contrast to that of alanine or arginine, which was inhibited. 4. In the presence of a threshold concentration of glucose (7 mM), the three amino acids accelerated 86Rb+ efflux and depolarized the beta-cell membrane. With alanine and arginine, spike activity was transiently observed and coincided with a short-lived increase in insulin release. With leucine, slow waves with superimposed bursts of spikes occurred and were accompanied by a sustained release of insulin. Forskolin alone also triggered slow waves and bursts of spikes, and increased insulin release. Both effects were larger in the presence of arginine, but not in the presence of alanine. Forskolin considerably increased the electrical and secretory effects of leucine. 5. A higher concentration of glucose (10 mM) induced slow waves with bursts of spikes in all cells and stimulated insulin release. Alanine, arginine and leucine increased 86Rb+ efflux, electrical activity and insulin release. However, the changes produced by the three amino acids displayed different time course, amplitude and characteristics. Forskolin potentiated insulin release and electrical activity induced by glucose alone. These effects were not augmented by alanine, but markedly amplified by arginine or leucine. 6. Several conclusions can be drawn from this study. The three types of amino acids depolarize the beta-cell membrane by different mechanisms and produce distinct patterns of electrical activity. Slow waves with bursts of spikes occur only if a decrease in K+ permeability contributes to the depolarization.(ABSTRACT TRUNCATED AT 400 WORDS)

The non-sulfonylurea moiety of gliquidone mimics the effects of the parent molecule on pancreatic B-cells.

Compound UL-DF 9 corresponds to the non-sulfonylurea moiety of gliquidone, a hypoglycaemic sulfonylurea of the second generation. Its effects on the B-cell function were studied in vitro with mouse islets. In the presence of a non-stimulatory concentration of glucose (3 mM), UL-DF 9 decreased 86Rb+ efflux and accelerated 45Ca2+ efflux from islet cells, depolarized the B-cell membrane and induced an electrical activity similar to that triggered by stimulatory concentrations of glucose, and increased insulin release. The changes in 45Ca2+ efflux and insulin release, but not the inhibition of 86Rb+ efflux, were abolished in the absence of Ca2+. In the presence of 10 mM glucose, UL-DF 9 increased 86Rb+ and 45Ca2+ efflux from the islets, augmented the electrical activity in B-cells, and potentiated insulin release. These changes were suppressed by omission of extracellular Ca2+. Qualitatively similar effects were produced by lower concentrations of gliquidone itself. The data suggest that UL-DF 9 and gliquidone decrease the K+ permeability of the B-cell membrane, thereby causing a depolarization which leads to activation of voltage-dependent Ca channels and Ca2+ influx, and thus eventually increase insulin release. Hypoglycaemic sulfonylureas of the second generation therefore seem to contain a second chemical group that interacts with K channels of B-cells as does the sulfonylurea group itself.

Effects of a calcium channel agonist on the electrical, ionic and secretory events in mouse pancreatic B-cells.

The changes in pancreatic B-cell function produced by a Ca channel agonist, the dihydropyridine derivative CGP 28392, have been studied with mouse islets. CGP 28392 (5 microM) modified the electrical activity induced in B-cells by 10 mM glucose: the duration and the amplitude of the slow waves of membrane potential increased, but the overall spike activity decreased. Simultaneously, CGP 28392 markedly increased insulin release and 45Ca2+ efflux, and slightly accelerated 86Rb+ efflux from islet cells. These latter effects were abolished by omission of extracellular Ca2+. Qualitatively similar changes were observed at 15 mM glucose, whereas CGP 28392 was ineffective at 3 mM glucose. These results strongly suggest that an influx of Ca2+ contributes to the slow waves of membrane potential triggered by glucose, and underline the importance of this influx of Ca2+ for the control of insulin release by the sugar.

Mechanism of the stimulation of insulin release in vitro by HB 699, a benzoic acid derivative similar to the non-sulphonylurea moiety of glibenclamide.

HB 699 is a benzoic acid derivative similar to the non-sulphonylurea moiety of glibenclamide. The mechanisms whereby it affects B-cell function have been studied in vitro with mouse islets. In the presence of 3 mmol/l glucose, HB 699 decreased 86Rb+ efflux and accelerated 45Ca2+ efflux from islet cells, depolarized the B-cell membrane and induced an electrical activity similar to that triggered by stimulatory concentrations of glucose, and increased insulin release. The changes in 45Ca2+ efflux and insulin release, but not the inhibition of 86Rb+ efflux, were abolished in the absence of Ca2+. In the presence of 10 mmol/l glucose, HB 699 increased 86Rb+ and 45Ca2+ efflux from the islets, caused a persistent depolarization of the B-cell membrane with continuous electrical activity and markedly potentiated insulin release. All these changes were suppressed by omission of extracellular Ca2+. In the presence of 15 mmol/l glucose, diazoxide increased 86Rb+ efflux, hyperpolarized the B-cell membrane, suppressed electrical activity and inhibited insulin release. HB 699 reversed these effects of diazoxide. It is suggested that HB 699 decreases K+ permeability of the B-cell membrane, thereby causing a depolarization which leads to activation of voltage-dependent Ca channels and Ca2+ influx, and eventually increases insulin release. A sulphonylurea group is thus not a prerequisite to trigger the sequence of events that is also thought to underlie the releasing effects of tolbutamide and glibenclamide.

Sparteine increases insulin release by decreasing the K+ permeability of the B-cell membrane.

The effects of sparteine on the pancreatic B-cell function have been studied with mouse islets. In the presence of a non-stimulatory concentration of glucose (3 mM), sparteine (0.2-1 mM) decreased the rate of 86Rb+ efflux from islet cells, depolarized the B-cell membrane, induced a glucose-like electrical activity and stimulated insulin release. This increase in release was observed over a large range of glucose concentrations (3-20 mM), and was most marked in the presence of 10 mM glucose. At this concentration of glucose, the effect of sparteine was already detected with 0.02 mM and was maximal with 0.5 mM. Higher concentrations of sparteine only had a transient effect on insulin release. In the presence of 10 mM glucose, 0.2 mM sparteine decreased 86Rb+ efflux and increased 45Ca2+ efflux from islet cells. The effect on 86Rb+ efflux was only transient in the presence of extracellular calcium, whereas the effect on 45Ca2+ efflux required the presence of extracellular calcium. The electrical activity induced by glucose in B-cells was augmented by sparteine which, at a concentration of 0.5 mM, produced a persistent depolarization with continuous spike activity. The potentiation of insulin release by sparteine was not reversible, but was inhibited by adrenaline and completely blocked by omission of extracellular calcium. Sparteine reversed the increase in 86Rb+ efflux and the decrease in insulin release caused by diazoxide. These results show that sparteine increases insulin release by reducing the K+-permeability of the B-cell membrane.

Thyrotropin-releasing hormone and insulin release: in vitro studies with islets of normal and dysthyroid mice.

Pancreatic islets contain large-quantities of thyrotropin-releasing hormone (TRH) and of its metabolite Histidyl-Proline diketopiperazine (Cyclo His-Pro). The effects of these two putative neurotransmitters on the pancreatic B-cell function have been evaluated in vitro, with islets of normal or dysthyroid mice. TRH and Cyclo His-Pro (10(-11)-10(-6) M) were without effect on insulin release induced by 10-20 mM glucose in islets of normal mice. They transiently accelerated the slow waves of membrane potential triggered in B cells by 10 mM glucose, but did not cause any sustained change in overall electrical activity, and did not affect the rate of 86Rb+ efflux from islet cells. They were also ineffective when insulin release was stimulated by leucine or arginine, or was potentiated by forskolin, an activator of the adenylate cyclase. Hyperthyroidism (induced by injections of thyroxine) caused a fall in islet insulin content, but augmented the 2 phases of glucose-induced release. On the other hand, hypothyroidism (induced by a low iodine diet and propylthiouracil) caused an increase in islet insulin content, but depressed the second phase of release. TRH did not affect either phase of insulin release by islets of hyperthyroid or hypothyroid mice. These results show that pancreatic B cells are not a target for TRH and Cyclo His-Pro.

The effects of cesium chloride on insulin release, ionic fluxes and membrane potential in pancreatic B-cells.

Cs+ decreases K+ permeability in nerve and muscle cells. Its effects on the pancreatic B-cell function were studied with mouse islets. In the presence of 3 mM glucose, Cs+ substitution for K+ steadily inhibited 86Rb+ efflux and hyperpolarized the B-cell membrane. Addition of Cs+ to a K+-medium also inhibited 86Rb+ efflux, but depolarized the B-cell membrane. None of these changes altered insulin release. Substitution of Cs+ for K+ in a medium containing 10 mM glucose caused a Ca2+-dependent stimulation of insulin release and 45Ca2+ efflux, produced an initial fall and a secondary rise in 86Rb+ efflux and augmented the electrical activity in B-cells. Reintroduction of K+ to the medium was followed by a marked and transient inhibition of insulin release, that was blocked by ouabain and accompanied by an inhibition of 45Ca2+ and 86Rb+ efflux and by a hyperpolarization of the B-cell membrane. Addition of Cs+ to a K+ medium containing 10 mM glucose stimulated insulin release, 45Ca2+ efflux and 86Rb+ efflux. It also increased the electrical activity in B-cells. In the absence of Ca2+, however, Cs+ addition decreased the rate of 86Rb+ efflux. The effects of Cs+ on the B-cell function may be explained by its ability to decrease K+ permeability of the plasma membrane, by its inability to activate the sodium pump, and by a third unidentified effect likely brought about by the accumulation of intracellular Cs+.

The ionic, electrical, and secretory effects of endogenous cyclic adenosine monophosphate in mouse pancreatic B cells: studies with forskolin.

Forskolin, an activator of adenylate cyclase, was used to study the effects of endogenous cAMP on the stimulus-secretion coupling in mouse pancreatic B cells. Forskolin produced a rapid, dose-dependent (0.05-50 microM) increase in islet cAMP, which was not influenced by the prevailing concentration of glucose and did not require extracellular Ca2+. At a nonstimulatory concentration of glucose (3 mM), a high concentration of forskolin (20 microM) barely doubled basal insulin release, marginally decreased 86Rb+ efflux from the islets, was without effect on the B cell membrane potential, and did not affect 45Ca2+ uptake (5 min). High concentrations of endogenously formed cAMP thus failed to mimic these early steps of the B cell response to glucose and other stimuli. At a threshold concentration of the sugar (7 mM), 5 microM forskolin slightly depolarized the B cell membrane, induced electrical activity (slow waves and spikes), stimulated 45Ca2+ uptake, and triggered insulin release. At a stimulatory concentration of glucose (10 mM), forskolin potentiated insulin release; half maximal and maximal effects were observed at 1 and 20 microM, respectively. Forskolin also increased the rate of 45Ca2+ and 86Rb+ efflux from islet cells, augmented 45Ca2+ uptake, and potentiated the electrical activity triggered by glucose in B cells. Its effects on insulin release, 45Ca2+ fluxes, and electrical activity were inhibited by omission of extracellular Ca2+ and/or Ca channels blockers. At a high concentration of glucose (25 mM), forskolin augmented the amplitude and the duration of the spikes occurring in the depolarized B cell membrane, slightly increased 45Ca2+ uptake, and potentiated insulin release. At threshold or stimulatory concentrations of glucose, endogenously formed cAMP can thus induce or enhance the Ca2+-dependent events normally triggered by the sugar. It is suggested that, besides its action on intracellular Ca stores, cAMP facilitates Ca2+ influx in B cells, by modulating the gating properties of the Ca channels.

Effects of theophylline and dibutyryl cyclic adenosine monophosphate on the membrane potential of mouse pancreatic beta-cells.

The effects of theophylline and dibutyryl cyclic AMP on the membrane potential of mouse beta-cells were studied with micro-electrodes. They were compared to their effects on insulin release by perifused mouse islets. In 3 mM-glucose, theophylline (10 mM) depolarized the beta-cell membrane and stimulated insulin release, but did not induce electrical activity. Dibutyryl cyclic AMP (1 mM) was without effect. In 7 mM-glucose, theophylline (0.5-2 mM) and dibutyryl cyclic AMP (1 mM) slightly depolarized the beta-cell membrane, induced electrical activity in otherwise silent cells and increased insulin release. A higher concentration of theophylline (10 mM) hyperpolarized the beta-cell membrane, did not induce electrical activity, but also stimulated insulin release. In 10 mM-glucose, the membrane potential of beta-cells exhibited repetitive slow waves with bursts of spikes on the plateau. Under steady state, these slow waves were differently affected by low or high concentrations of theophylline. At 0.5-2 mM, theophylline shortened the intervals, lengthened the slow waves and slightly increased their frequency. On the other hand, 10 mM-theophylline markedly decreased the duration of both intervals and slow waves, and increased their frequency. The effects of 1 mM-dibutyryl cyclic AMP were similar to those of 2 mM-theophylline. With 2-10 mM-theophylline, two other effects were also observed: a transient hyperpolarization with suppression of electrical activity immediately after addition of the methylxanthine and an increase in electrical activity upon its withdrawal. Theophylline and dibutyryl cyclic AMP markedly potentiated insulin release induced by 10 mM-glucose. The magnitude of these changes did not correlate well with the importance of the changes in electrical activity. However, with 2-10 mM-theophylline the increase in release was also preceded by an initial transient inhibition, whereas withdrawal of the methylxanthine was accompanied by a further increase. When Ca influx was inhibited by D600, the slow waves were suppressed, the membrane was depolarized to the plateau level and only few spikes were present. Although theophylline markedly increased insulin release under these conditions, it did not affect the membrane potential. Several conclusions can be drawn from this study. Insulin release and electrical activity in beta-cells can be dissociated when intracellular Ca is used to trigger exocytosis. High concentrations of theophylline produce effects unrelated to cyclic AMP.(ABSTRACT TRUNCATED AT 400 WORDS)

Forskolin suppresses the slow cyclic variations of glucose-induced electrical activity in pancreatic B cells.

The membrane potential of mouse pancreatic B cells was recorded with microelectrodes. In certain cells, both the slow waves of depolarization and the intervals of repolarization triggered by glucose (10 or 15 mM) displayed regular oscillations in their duration, though the concentration of the sugar remained constant. When forskolin (0.2 microM), an activator of adenylate cyclase, was added to the medium, the electrical activity rapidly became very regular, with slow waves and intervals of constant duration. This effect was unrelated to the overall increase in activity also brought about by forskolin. The oscillations resumed in 75% of the cells after withdrawal of the drug. Under similar conditions, forskolin rapidly and reversibly raised the cAMP concentration in the islets. The data suggest that cAMP is an important modulator of the electrical activity triggered by glucose in insulin-secreting cells.

Forskolin, an activator of adenylate cyclase, increases CA2+-dependent electrical activity induced by glucose in mouse pancreatic B cells.

The effects of forskolin, an activator of adenylate cyclase, on the membrane potential of pancreatic B cells have been studied with microelectrodes. Forskolin (5 microM) did not affect the stable resting membrane potential (3 mM glucose). In the presence of 10 mM glucose, forskolin lengthened the slow waves with superimposed spikes and shortened the polarized intervals between them. This caused a marked increase in the frequency of the slow waves and doubled the fraction of time spent at a depolarized level, with spike activity. The frequency of the spikes was not changed. The effects of forskolin were of rapid onset, but were only slowly and partially reversible; they were completely blocked when Ca2+ influx was prevented by cobalt. The results show that forskolin increases electrical events underlain by Ca inward currents and suggest that, besides its action on intracellular Ca stores, cyclic AMP could also modulate the permeability of Ca channels in the plasma membrane of B cells.

Dibutyryl cyclic AMP triggers Ca2+ influx and Ca2+-dependent electrical activity in pancreatic B cells.

In the presence of 7 mM glucose, dibutyryl cyclic AMP induced electrical activity in otherwise silent mouse pancreatic B cells. This activity was blocked by cobalt or D600, two inhibitors of Ca2+ influx. Under similar conditions, dibutyryl cyclic AMP stimulated 45Ca2+ influx (5-min uptake) in islet cells; this effect was abolished by cobalt and partially inhibited by D600. The nucleotide also accelerated 86Rb+ efflux from preloaded islets, did not modify glucose utilization and markedly increased insulin release. Its effects on release were inhibited by cobalt, but not by D600. These results show that insulin release can occur without electrical activity in B cells and suggest that cyclic AMP not only mobilizes intracellular Ca, but also facilitates Ca2+ influx in insulin secreting cells.

The electrogenic sodium-potassium pump of mouse pancreatic B-cells.

1. The contribution of the sodium pump to the membrane potential of mouse pancreatic B-cells was studied with micro-electrodes.2. In 0 or 3 mM-glucose, ouabain rapidly (within 2 min) depolarized the B-cell membrane by an average of 7 mV, whereas K omission hyperpolarized it markedly.3. In 6 or 7 mM-glucose, ouabain still produced depolarization, but K omission had no consistent effect. Both induced electrical activity in certain cells.4. In 10 mM-glucose, withdrawal of ouabain or K re-introduction caused a transient hyperpolarization with suppression of electrical activity. Duration and amplitude of the hyperpolarization increased with the time of pump blockade and with the concentration of ouabain.5. The hyperpolarization following K re-admission was abolished by ouabain and that following ouabain withdrawal was prevented by K omission. Re-admission of various K concentrations showed that the hyperpolarization was not due to depletion of K just outside of the membrane.6. In 10 mM-glucose, the membrane potential of B-cells exhibited repetitive slow waves with bursts of spikes on the plateau. These electrical events were modified by ouabain in a dose-dependent manner. The frequency of the slow waves augmented markedly because of an increase in the slope of the pre-potential and a shortening of the intervals; the slope of their repolarization phase decreased, but their duration was not changed.7. Omission of K increased the slope of the pre-potential and the frequency of the slow waves. It also accelerated their repolarization phase and reduced their duration, likely because of the increase in driving force for K efflux. Increasing K concentration to 8 mM slowed the repolarization phase and lengthened the slow waves without changing their frequency.8. Even when K permeability of the B-cell membrane was increased by high extracellular Ca, ouabain and K omission augmented the frequency of the slow waves.9. In 0 or 10 mM-glucose, ouabain increased (86)Rb(+) efflux from perifused islets, whereas K omission decreased it. In 10 mM-glucose, a marked decrease in (86)Rb(+) efflux accompanied ouabain withdrawal and K re-introduction. The hyperpolarization is thus not due to an increase in K permeability.10. It is concluded that, in pancreatic B-cells, the sodium pump is truly electrogenic, contributes to the resting potential and modulates the slow waves of membrane potential induced by glucose. Rapid changes in insulin release occurring upon inhibition or activation of the sodium pump may thus be due to the changes in B-cell membrane potential.