Counterregulatory hormones in insulin-treated diabetic patients admitted to an accident and emergency department with hypoglycaemia.

Bidragets oversatte titel: Counterregulatory hormones in insulin-treated diabetic patients admitted to an accident and emergency department with hypoglycaemia.

A Hvidberg, N J Christensen, Jannik Hilsted

2 Citationer (Scopus)

Abstract

The aim of the study was (1) to describe hormone responses in insulin-induced hypoglycaemia and (2) to investigate if a combined treatment with intravenous glucose and intramuscular glucagon (group A) would improve glucose recovery as compared to treatment with intravenous glucose alone (group B). Eighteen adult patients with insulin-treated diabetes mellitus admitted to the Accident and Emergency Department with hypoglycaemia (plasma glucose 1.23 +/- 0.15 mmol l(-1) on admission) were randomized to one of the above treatments and plasma glucose and counterregulatory hormones were measured before and 30-120 min after treatment. Pre-treatment counterregulatory hormone concentrations were significantly lower than hormone concentrations during induced hypoglycaemia in healthy control subjects but significantly higher than healthy fasting concentrations for plasma adrenaline (p = 0.020), glucagon (p = 0.008), growth hormone (p = 0.011), and cortisol (p<0.00001). Thus, although glucagon and adrenaline responses may be absent when studying Type 1 diabetic patients in the experimental setting, both hormones increase to a significant extent in 'real-life' hypoglycaemia in this patient group, although to a lesser degree than might be expected. Plasma glucose did not differ significantly between the two treatments at any time point. Despite access to food, one of four patients in group B and one of five patients in group A had plasma glucose below 4.0 mmol l(-1) after 120 min. In conclusion, low yet significantly elevated concentrations of adrenaline and glucagon were found in diabetic patients admitted with severe hypoglycaemia to an Accident and Emergency Department.
Bidragets oversatte titelCounterregulatory hormones in insulin-treated diabetic patients admitted to an accident and emergency department with hypoglycaemia.
OriginalsprogEngelsk
TidsskriftDiabetic Medicine
Vol/bind15
Udgave nummer3
Sider (fra-til)199-204
Antal sider6
ISSN0742-3071
StatusUdgivet - 1998

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