Counterregulation in Type 2 (non-insulin-dependent) diabetes mellitus. Normal endocrine and glycaemic responses, up to ten years after diagnosis
Open accessAbstract
We have examined hormonal and metabolic responses to insulin-induced hypoglycaemia in 10 Type 2 (non-insulin-dependent) diabetic patients treated with tablets and 10 age, sex and weight matched control subjects. Diabetic patients were under 110% ideal body weight, had no autonomic neuropathy and were well controlled (HbA1, 7.1 +/- 0.2%). After the diabetic patients were kept euglycaemic by an overnight insulin infusion, hypoglycaemia was induced in both groups by intravenous insulin at 30 mU.m-2.min-1 for 60 min and counterregulatory responses measured for 150 min. There were no significant differences between diabetic patients and control subjects in the rate of fall (3.3 +/- 0.3 vs 4.0 +/- 0.3 mmol.l-1.h-1), nadir (2.4 +/- 0.2 vs 2.3 +/- 0.1 mmol/l) and rate of recovery (0.027 +/- 0.002 vs 0.030 +/- 0.003 mmol.l-1.min-1) of blood glucose. Increments of glucagon (60.5 +/- 5.7 vs 70 +/- 9.2 ng/l) and adrenaline (1.22 +/- 0.31 vs 1.45 +/- 0.31 nmol/l) were similar in both groups. When tested using this model, patients with Type 2 diabetes, without microvascular complications and taking oral hypoglycaemic agents show no impairment of the endocrine response and blood glucose recovery following hypoglycaemia.
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In type 2 diabetes, the glucagon response to hypoglycemia has been diversely reported as being either modestly diminished or preserved.
“In type 2 diabetes, the glucagon response to hypoglycemia has been diversely reported as being either modestly diminished (16, 30,50) or preserved (33,34,37,38).”
From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [33]
Most investigators reporting preservation of the glucagon response have studied people with type 2 diabetes who were unlikely to be insulin deficient, and, with one exception, all of these studies have examined counterregulatory responses in middle-aged subjects in their 5th or 6th decade.
“Most investigators reporting preservation of the glucagon response have studied people with type 2 diabetes who were unlikely to be insulin deficient (33,34,36,38), and, with one exception (16), all of these studies have examined counterregulatory responses in middle-aged subjects in their 5th or 6th decade.”
From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [33]
Plasma free fatty acids increase in response to hypoglycemia in type 2 diabetes but do not in type 1 diabetes.
“Plasma free fatty acids increase in response to hypoglycemia in type 2 diabetes (30,33,50) but do not in type 1 diabetes (54).”
From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [33]
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References 35 · Cited by 43
Research works printed but not linked: 2
- [10]10. Bennett T (1983) Physiological investigation of diabetic autonomic failure. In: Bannister R (ed) Autonomic failure. A textbook of clinical disorders of the autonomic nervous system. Oxford University Press, Oxford, pp 403–436
- [19]19. Genstat (1980) A General Statistical Program. Rothamstead Experimental Station. Numerical Algorithms Group Ltd, Oxford
- Authors
- Heller, S. R., Macdonald, I. A., & Tattersall, R. B.
- Affiliations
- University of Nottingham (GB)
- Venue
- Diabetologia
- Published
- 1987-12
- Volume
- 30
- Issue
- 12
- Pages
- 924-929
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W1993458227
- Cited by
- 43
- References
- 35
- Citations by year
- 2024: 2 · 2020: 1 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 1 · 2014: 1 · 2013: 2 · 2012: 2
- FWCI
- 0.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- type 2 diabetes, counterregulatory response, insulin-induced hypoglycemia, glucagon, epinephrine, oral antidiabetic drugs, autonomic function, long-term glycemic control
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 2, Epinephrine, Fatty Acids, Nonesterified, Female, Glucagon, Hemodynamics, Humans, Hydrocortisone, Hydroxybutyrates, Insulin, Male, Middle Aged, Pancreatic Polypeptide, Growth Hormone
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