Catecholamine response during human and pork insulin-induced hypoglycemia in IDDM patients.
OBJECTIVE
To evaluate the catecholamine response during human and pork insulin-induced hypoglycemia.


METHODS
Ten insulin-dependent diabetes mellitus (IDDM) patients without any signs of autonomic neuropathy received either human or pork insulin in a randomized crossover fashion on 2 nonconsecutive days. The glucose clamp technique was applied to achieve stable glycemic plateaus of 5.6, 3.3, 2.2, and 1.7 mM.


RESULTS
The effect of both types of insulin on glucose metabolism and circulating catecholamines was almost identical. There was a sharp rise of both epinephrine (P less than 0.05) and norepinephrine (P less than 0.02) during hypoglycemia, which did not depend on the type of insulin applicated. Symptom awareness increased significantly during the decrease of blood glucose concentration. Only during developing hypoglycemia (3.3-mM plateau), was this effect more pronounced (cumulative symptom score 2 vs. 26, P less than 0.05) with pork insulin.


CONCLUSIONS
AN attenuated catecholamine secretion seems not to be the putative mechanism of a reduced awareness of human insulin-induced hypoglycemia.
Lingenfelser
T
T
Department of Medicine, Eberhard-Karls-University Tuebingen, Germany.
Renn
W
W
Plonz
C
C
Radjaipour
M
M
Eggstein
M
M
Jakober
B
B
D000328:Adult; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D004837:Epinephrine / Q000097:blood*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology; D007328:Insulin / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D009638:Norepinephrine / Q000097:blood*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D013552:Swine
D001786:Blood Glucose; D007328:Insulin; D011994:Recombinant Proteins; D009638:Norepinephrine; D004837:Epinephrine