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Cited by 143Diabetes Management and ResearchPancreatic function and diabetesGrowth Hormone and Insulin-like Growth Factors

Counterregulatory adaptation to recurrent hypoglycemia in normal humans

DAVIS, MARIS R., SHAMOON, HARRY·1991·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem-73-5-995
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Abstract

We evaluated the effect of antecedent hypoglycemia on glucose counterregulation during hypoglycemia in non-diabetic human subjects. In single hypoglycemia studies, glucose production [( 3H]3-glucose) and counterregulatory hormone concentrations were measured (after a 3.5-h baseline period of euglycemia) during 120 min of hypoglycemia (glucose clamped at 3.0 mmol/L). During the final 60 min of hypoglycemia, counterregulation resulted in significant increments in glucose production (12.88 +/- 0.83 mumol/kg.min), and plasma glucagon (IRG; 185 +/- 22 ng/L), GH (29.3 +/- 7.0 micrograms/L), cortisol (630 +/- 100 nmol/L), epinephrine (3.44 +/- 0.76 nmol/L), and norepinephrine (2.02 +/- 0.21 nmol/L). In the recurrent hypoglycemia experiment, an antecedent period of identical hypoglycemia was induced. Glucose counterregulation during the second of two periods of hypoglycemia (HYPO 2) was then compared to that in single hypoglycemia studies. During HYPO 2, there were decreased responses in Ra (by 32%; P less than 0.03), GH (by 67%; P less than 0.05), F (by 41%; P less than 0.03), and norepinephrine (by 20%; P = 0.03) compared to those in the single hypoglycemia study. In contrast, plasma IRG values were similar in the single hypoglycemia studies and HYPO 2, but were reduced relative to those during the first hypoglycemic period of recurrent hypoglycemia (IRG, 263 +/- 18 ng/L; P less than 0.025 vs. HYPO 2 and P less than 0.05 vs. single hypoglycemia). Our results suggest that 1) antecedent hypoglycemia may alter glucose counterregulation during hypoglycemia; and 2) recurrent hypoglycemia may result in alterations in reduction of hepatic glucose production.

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Authors
DAVIS, M. R., & SHAMOON, H.
Affiliations
Albert Einstein College of Medicine (US)
ORCID
SHAMOON, HARRY
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1991-11
Volume
73
Issue
5
Pages
995-1001
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem-73-5-995
OpenAlex
W2047719843
Cited by
143
References
27
Citations by year
2026: 1 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 2 · 2014: 1 · 2013: 6 · 2012: 2
FWCI
5.23
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01dk036617-03)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK-36617, DK20541)
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 › Growth Hormone and Insulin-like Growth Factors
Keywords
hypoglycemia, glucose counterregulation, recurrent hypoglycemia, hepatic glucose production, glucagon, growth hormone, cortisol, epinephrine, norepinephrine, counterregulatory hormones, glucose clamp, non-diabetic patients, glucose oxidation
MeSH terms
Acclimatization, Adult, Blood Glucose, C-Peptide, Epinephrine, Female, Glucagon, Humans, Hydrocortisone, Hypoglycemia, Insulin, Kinetics, Male, Norepinephrine, Reference Values, Growth Hormone, Time Factors, Glucose Clamp Technique

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