Abstract
Counterregulatory responses to insulin-induced hypoglycemia were measured in 6 diabetics with frequent severe hypoglycemic episodes (group 1) and in 6 without severe hypoglycemia (group 2). Group 1 did not differ from group 2 regarding age (17.8±SD2.Syr vs 18.4±1.6), duration of diabetes (12.7±2.2yr vs 10.0±3.4), HbA1 (9.7±1.0% vs 10.9±1.9), s.c. insulin therapy and glucose levels on the morning of the test (4.9±1.3mM vs 6.2±1.1). The insulin infusion was then adjusted to lower plasma glucose to 2.5±0.4mM and 2.5±0.7 within 2h. Rate of glucose disappearance, calculated from plasma isotopic enrichment of stable dideuteroglucose, increased to 4.4±1.0mg/kg/min and 4.0±1.1, rate of appearance dropped to 2.2±0.5mg/kg/min and 1.7±0.4. Hormonal responses to hypoglycemia (area under curve of glucagon, epinephrine, growth hormone and Cortisol) were not different lietwoen the groups. Marked decreases occurred in free fatty acids, 3-OH-butyrate and branched-chain amino acids. Alanine did not change. Six patients were found, 1 in each group, who had either no glucagon response to hypoglycemia (below 130pg/mL), or a very low epinephrine response (below 3.0 nmol/L), or both combined. In conclusion, despite severe hypoglycemic episodes, hormonal counterregulation may be unimpaired in some patients. On the other hand, long-term absence of hypoglycemic attacks does not guarantee intact glucose counterregulation.
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Schwarz, H., Fauchere, J., Huerzeler, H. et al. SEVERE HYPOCLYCEMIC EPISODES ARE NOT PREDICTIVE OF IMPAIRED GLUCOSE COUNTERRECULATION IN TYPE 1 DIABETES. Pediatr Res 23, 115 (1988). https://doi.org/10.1203/00006450-198801000-00084
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DOI: https://doi.org/10.1203/00006450-198801000-00084