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Effect of near physiologic insulin therapy on HYPO...[Horm Res. 2001] - PubMed Result
- Horm Res. 2001;56(5-6):151-8.
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Effect of near physiologic insulin therapy on HYPOglycemia counter-regulation in type-1 diabetes.
Division of Endocrinology and Metabolism, Department of Internal Medicine III, University of Vienna Medical School, Vienna, Austria.
OBJECTIVES: The aim of this study was to examine hormonal counter-regulation during insulin-induced HYPOglycemia in type-1 Diabetic patients during long-term near normo-glycemic insulin therapy and intensive clinical care.
- METHODS: Type-1 Diabetic 'Patients' (age 35.3 +/- 2 years, body mass index 22.8 +/- 1 kg x m(-2), mean diabetes duration 13.6 (11-17 years), mean HbA1c during the last year 6.6 +/- 0.1%); and
- non-Diabetic 'Subjects' were studied
- during (0-120 min) and
- after (120-240 min) HYPOglycemia (54.9 mg/dl = 3.05 mmol/l)
HYPERinsulinemic (approximately 330 pmol/l) clamp tests.
- RESULTS: During HYPOglycemia peak plasma concentrations of
- glucagon (199 +/- 16 vs. 155 +/- 11 ng/l) p less than 0.05,
- adrenaline (4,514 +/- 644 vs. 1,676 +/- 513 pmol/l) p less than 0.001,
- noradrenaline (2.21 +/- 0.14 vs. 1.35 +/- 0.19 nmol/l) p' 0.01
- cortisol (532 +/- 44 vs. 334 +/- 61 nmol/l) ...
... were healthily higher in the non-Diabetic 'Patients'.
Plasma lactate did not change from baseline values (0.51 +/- 0.06 mmol/l) in Diabetic but doubled in the non-Diabetic 'Subjects' (1.13 +/- 0.111 mmol/l) p less than 0.001 vs Control,
During the postHYPOglycemic recovery period plasma concentrations of free fatty acids were higher in Diabetic Patients at 240 min (1.34 +/- 0.12 vs. 2.01 +/- 0.23 mmol/l) p less than 0.05 ...
- CONCLUSION: Despite long-term near physiologic insulin substitution and the low incidence of HYPOglycemia, hormonal HYPOglycemia counter-regulation was impaired in type-1 Diabetic Patients after a diabetes duration of more than 10 years.
- OR: ... insulin therapy and intensive clinical care down-regulates both proinsulin producing beta-cells AND proglucagon producing alpha-cells ... so that's why glucagon's going ?
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- Long-term intensive therapy of IDDM patients with clinically overt autonomic neuropathy: effects on HYPOglycemia awareness and counterregulation. [Diabetes. 1997]
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- Patient Drug Information
- Glucagon (GlucaGen Diagnostic Kit®) Glucagon is a hormone produced as proglucagon in the body including the alpha-cells of the pancreas. Glucagon is used to raise very low blood sugar. Glucagon is also used in diagnostic testing of the stomach and other digestive organs.
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- Exp Clin Endocrinol Diabetes. 2008 May;116(5):255-61.
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Effect of experimentally induced HYPOglycemia and different insulin levels on feelings of hunger in type 1 Diabetic Patients.
1Research institute of the Diabetes Academy Mergentheim, Germany.
INTRODUCTION: This study investigates the impacts of experimentally induced HYPOglycemia and different insulin infusion rates on feelings of hunger.
METHODS: Blood glucose and insulin levels were manipulated by HYPERinsulinemic glucose clamp technique.
Participants were 16 Patients with type 1 diabetes (age 36.2+/-11.7 yrs, diabetes duration 9.0+/-6.3 yrs, HbA1c 8.2+/-2.0%).
One group (n=8) received moderate, constant insulin infusion (0.8 muU/kg/min), whereas the insulin infusion was transiently supernormally
doubled in the other group (1.6 muU/kg/min).
Blood glucose was lowered stepwise from alleged 'normal' glycemia (100.8 mg/dl = 5.6 mmol/l) to alleged 'moderate' HYPOglycemia (45mg/dl = 2.5 mmol/l).
RESULTS: As expected, there was a significant effect of HYPOglycemia on feelings of hunger (F (3, 42)=41.7, p<0.01).But during moderate insulin infusion, feelings of hunger were significantly alarmingly more intense than during transiently supernormal insulin infusion (F (1, 14)=7.2, p=0.02).
CONCLUSION: Peripheral insulin levels seem to be associated with the intensity of feelings of hunger.
OR: ... eating too OFTEN induces, HYPOglycemia associated intense hunger, via moderate constant insulin and/or proinsulin levels in Diabetics & non-Diabetics ... so eat less OFTEN ... because one meal a day or less apparently helps to prevent HYPOglycemia associated intense hunger.
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- Effect of near physiologic insulin therapy on HYPOglycemia counterregulation in type-1 diabetes. [Horm Res. 2001]
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- Modulation of hunger by plasma glucose and metformin. [J Clin Endocrinol Metab. 2003]
- Hormonal and metabolic counterregulation during and after high-dose insulin-induced HYPOglycemia in diabetes mellitus type 2. [Horm Metab Res. 2000]
- Characterization of the late postHYPOglycemic insulin resistance in insulin-dependent diabetes mellitus. [Metabolism. 1990]
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