Gender differences in counterregulation to hypoglycaemia
Open accessAbstract
To investigate the effect of gender on catecholamine responses to hypoglycaemia, single-step euglycaemic-hypoglycaemic clamps have been performed in 14 healthy men and 17 women. Adrenaline responses were 44% lower in females (p < 0.01) and noradrenaline 17% lower (p = 0.08). In response to low-dose intravenous insulin infusion (0.3 mU.kg-1.min-1), plasma glucose fall and counterregulation in seven men and seven women had a different course (p < 0.001), with different glucose kinetics. In men, endogenous glucose output recovered quickly to levels that exceeded basal; in women suppression of endogenous glucose output was more prolonged, without rates ever exceeding basal (p < 0.05). Peripheral glucose uptake was stimulated in men only. The hormones of acute glucose counterregulation (catecholamines and glucagon) did not differ between the sexes during this challenge, the catecholamine response in the women being supported by the continuous fall in plasma glucose. These results suggest that: 1) catecholamine responses to moderately controlled hypoglycaemia are diminished in women, and 2) peripheral insulin sensitivity in men is enhanced over that of women but hepatic sensitivity to insulin may be greater in women.
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This suggests that females are less insulin sensitive than males, at least under hypoglycaemic conditions, as previously reported by Amiel et al.
“This suggests that females are less insulin sensitive as compared to males, at least under hypoglycaemic conditions, as previously reported by Amiel et al. [12].”
These data are partly at variance with Amiel et al., who found lower adrenaline but not glucagon responses in females than males.
“These data are partly at variance with those of Widom et al. [13] who found higher thresholds for all counterregulatory hormones and symptoms in female as compared to male subjects, and those of Amiel et al. [12] who found lower adrenaline, but not glucagon responses in females as compared to males, but are largely in agreement with those of Davis et al. [15].”
In both nondiabetic and type 1 diabetic subjects, female subjects have lower counterregulatory responses to hypoglycemia than male subjects, although no information is available in type 2 diabetes.
“In both nondiabetic and type 1 diabetic subjects, female subjects have lower counterregulatory responses to hypoglycemia than male subjects (39 -42), although no information is available in type 2 diabetes.”
From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [39]
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- Authors
- Amiel, S. A., Maran, A., Powrie, J. K., Umpleby, A. M., & Macdonald, I. A.
- Affiliations
- Guy's Hospital (GB)
- St Thomas' Hospital (GB)
- University of Nottingham (GB)
- Venue
- Diabetologia
- Published
- 1993-05
- Volume
- 36
- Issue
- 5
- Pages
- 460-464
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2032344007
- Cited by
- 113
- References
- 15
- Citations by year
- 2026: 7 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 2 · 2020: 2 · 2019: 5 · 2018: 6 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 4 · 2013: 3 · 2012: 5
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion, other-oa)
- Funders
- Leverhulme Trust
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- sex differences, catecholamines, epinephrine, norepinephrine, insulin infusion, peripheral glucose uptake, insulin sensitivity, hepatic insulin sensitivity, glucagon, glucose kinetics
- MeSH terms
- Adult, Blood Glucose, Female, Homeostasis, Humans, Hypoglycemia, Infusions, Intravenous, Insulin, Kinetics, Male, Sex Characteristics, Time Factors, Glucose Clamp Technique, Multivariate Analysis
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