Suspected postprandial hypoglycemia is associated with beta-adrenergic hypersensitivity and emotional distress
Abstract
Suspected postprandial (reactive or idiopathic) hypoglycemia is characterized by predominantly adrenergic symptoms appearing after meals rich in carbohydrates and by their rare association with low blood glucose level (< 2.77 mmol/L). We studied heart rate, blood pressure, plasma insulin, C-peptide, and catecholamine responses during a 5-h oral glucose tolerance test in eight patients with suspected postprandial hypoglycemia and eight age-, sex-, and body mass index-matched healthy controls. We also evaluated beta-adrenergic sensitivity by using the isoproterenol sensitivity test. Psychological profile was assessed by the Symptom Checklist (SCL-90R) self-report symptom inventory. Patients with suspected postprandial hypoglycemia had higher beta-adrenergic sensitivity (defined as the dose of isoproterenol required to increase the resting heart rate by 25 beats/min) than controls (mean +/- SEM, 0.8 +/- 0.13 vs. 1.86 +/- 0.25 microgram isoproterenol; P = 0.002). After administration of glucose (75 g) blood glucose, plasma C-peptide, plasma epinephrine, and plasma norepinephrine responses were identical in the two groups, but plasma insulin was higher in the patients (group effect, P = 0.02; group by time interaction, P = 0.0001). Both heart rate and systolic blood pressure were significantly higher (but remained in the normal range) after glucose administration in patients with suspected postprandial hypoglycemia than in controls (group by time interactions, P = 0.004 and 0.0007…
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In a study by Berlin et al., hypoglycemia was induced in 10% of healthy subjects.
“In a study by Berlin et al., hypoglycemia was induced in 10% of healthy subjects [39].”
From Spontaneous hypoglycemia: should we mind the gap? Long-term follow-up of healthy people who met Whipple’s triad criteria (2024) · cites this paper as [39]
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Self-citation
- Authors
- Berlin, I., Grimaldi, A., Landault, C., Cesselin, F., & Puech, A. J.
- Affiliations
- Pitié-Salpêtrière Hospital (FR)
- ORCID
- Berlin, I
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 1994-11
- Volume
- 79
- Issue
- 5
- Pages
- 1428-1433
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1981824707
- Cited by
- 34
- References
- 25
- Citations by year
- 2024: 1 · 2022: 1 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 3 · 2014: 1 · 2013: 1
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- postprandial hypoglycemia, reactive hypoglycemia, idiopathic hypoglycemia, emotional distress, anxiety, somatization, depression, obsessive-compulsive symptoms, plasma insulin, catecholamines, epinephrine, norepinephrine, heart rate, blood pressure, glucose tolerance
- MeSH terms
- Adult, Blood Glucose, Blood Pressure, C-Peptide, Catecholamines, Eating, Female, Glucose, Glucose Tolerance Test, Heart Rate, Humans, Hypersensitivity, Hypoglycemia, Insulin, Isoproterenol, Male, Receptors, Adrenergic, beta, Stress, Psychological
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