ISSN:
1432-0428
Keywords:
Key words Antecedent hypoglycaemia
;
catecholamines
;
counterregulation
;
hypoglycaemia
;
hypoglycaemia unawareness.
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary Recent studies have reported reduced endocrine and symptomatic responses to hypoglycaemia 18–24 h after antecedent hypoglycaemia in both non-diabetic subjects and those with insulin-dependent diabetes mellitus. We examined these and peripheral physiological responses in eight non-diabetic subjects aged 23–35 years in the week following antecedent hypoglycaemia. Blood glucose levels were held at plateaus of 5 mmol/l and 2.5 mmol/l for 30 min during hyperinsulinaemic (60 mU · m−2· min−1) morning clamps on days 1, 3 and 8 of two study periods separated by at least 4 weeks. Measurements were made at time 0, 15 and 30 min of each plateau on each day. On the afternoon of Day 1 we also induced either euglycaemia with a blood glucose level of 5 mmol/l (control week) or hypoglycaemia of 2.9 mmol/l (hypo week) for 2 h in random order. The adrenaline response to morning hypoglycaemia (p 〈 0.01 on all days) was attenuated on Day 3 (p 〈 0.05) and Day 8 (p 〈 0.05) compared to Day 1 of hypo week only. Sweating was also attenuated on Day 3 (p 〈 0.05) and Day 8 (p 〈 0.02) of hypo week only. Noradrenaline levels and tremor increased during hypoglycaemia on each study day (p 〈 0.05) but did not differ between days in either week. During hypo week only, the total symptom score response to hypoglycaemia was attenuated on Day 3 (p 〈 0.03) but not Day 8 (p = 0.10). Autonomic symptoms were similarly affected. In summary, the physiological responses to hypoglycaemia are affected differentially by antecedent hypoglycaemia with sweating and adrenaline responses remaining impaired for at least 5 days. [Diabetologia (1995) 38: 1183–1190]
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00422367
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