Hypoglycaemia induces a sustained pro-inflammatory response in people with type 1 diabetes and healthy controls

Clementine E M Verhulst, Julia I P van Heck*, Therese W Fabricius, Rinke Stienstra, Steven Teerenstra, Rory J McCrimmon, Cees J Tack, Ulrik Pedersen-Bjergaard, Bastiaan E de Galan, Hypo-RESOLVE consortium

*Corresponding author af dette arbejde
1 Citationer (Scopus)

Abstract

AIM: To determine the duration and the extension of the pro-inflammatory response to hypoglycaemia both in people with type 1 diabetes and healthy controls.

MATERIALS AND METHODS: Adults with type 1 diabetes (n = 47) and matched controls (n = 16) underwent a hyperinsulinaemic-euglycaemic hypoglycaemic (2.8 ± 0.1 mmoL/L [49.9 ± 2.3 mg/dL]) glucose clamp. During euglycaemia, hypoglycaemia, and 1, 3 and 7 days later, blood was drawn to determine immune cell phenotype, monocyte function and circulating inflammatory markers.

RESULTS: Hypoglycaemia increased lymphocyte and monocyte counts, which remained elevated for 1 week. The proportion of CD16+ monocytes increased and the proportion of CD14+ monocytes decreased. During hypoglycaemia, monocytes released more tumour necrosis factor-α and interleukin-1β, and less interleukin-10, after ex vivo stimulation. Hypoglycaemia increased the levels of 19 circulating inflammatory proteins, including high sensitive C-reactive protein, most of which remained elevated for 1 week. The epinephrine peak in response to hypoglycaemia was positively correlated with immune cell number and phenotype, but not with the proteomic response.

CONCLUSIONS: Overall, despite differences in prior exposure to hypoglycaemia, the pattern of the inflammatory responses to hypoglycaemia did not differ between people with type 1 diabetes and healthy controls. In conclusion, hypoglycaemia induces a range of pro-inflammatory responses that are sustained for at least 1 week in people with type 1 diabetes and healthy controls.

OriginalsprogEngelsk
TidsskriftDiabetes, Obesity and Metabolism
Vol/bind25
Udgave nummer11
Sider (fra-til)3114-3124
Antal sider11
ISSN1462-8902
DOI
StatusUdgivet - nov. 2023

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