title: Effect of alpha 2-adrenoceptor antagonist on platelet activation during insulin-induced hypoglycaemia in type 2 (non-insulin-dependent) diabetes mellitus.
abstract: The role of epinephrine in platelet activation and the effect of an alpha 2-adrenoceptor antagonist, midaglizole, during insulin-induced hypoglycaemia in Type 2 (non-insulin-dependent) diabetes mellitus were examined. The action of midaglizole as a platelet alpha 2-antagonist was confirmed by in vitro studies using platelet-rich plasma and washed platelet suspension. Hypoglycaemia was induced by a bolus injection of short-acting insulin in 24 diabetic patients. They were divided into two groups, a control group (n = 12) and an alpha 2-group (n = 12), and midaglizole was administered orally 60 min before insulin injection in the latter. Blood glucose and plasma C-peptide levels were significantly decreased (p less than 0.005) by insulin injection in both groups. Counter-regulatory hormones, including epinephrine, and arginine vasopressin were similarly increased at the hypoglycaemic nadir compared with the levels at 0 min in both groups. Plasma beta-thromboglobulin was increased at the hypoglycaemic nadir (165.5 +/- 12.6 ng/ml) compared with the level at 0 min (121.0 +/- 11.5, p less than 0.005) in the control group, whereas no significant increase was demonstrated in the alpha 2-group. These results suggest that plasma epinephrine plays an important role in platelet activation during hypoglycaemia in Type 2 diabetes mellitus, and that the platelet activation is prevented by alpha 2-adrenoceptor antagonist.
authors.affiliation: Department of Metabolic Medicine, Kumamoto University Medical School, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Takeda
authors.forename: H
authors.initials: H
authors.lastname: Kishikawa
authors.forename: M
authors.initials: M
authors.lastname: Shinohara
authors.forename: T
authors.initials: T
authors.lastname: Miyata
authors.forename: K
authors.initials: K
authors.lastname: Suzaki
authors.forename: H
authors.initials: H
authors.lastname: Fukushima
authors.forename: K
authors.initials: K
authors.lastname: Ichinose
authors.forename: M
authors.initials: M
authors.lastname: Shichiri
mesh_terms: D001127:Arginine Vasopressin / Q000494:pharmacology; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004837:Epinephrine / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood*; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D007093:Imidazoles / Q000494:pharmacology*; D066298:In Vitro Techniques; D007328:Insulin; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects*; D012016:Reference Values
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007004:Hypoglycemic Agents; D007093:Imidazoles; D007328:Insulin; D001127:Arginine Vasopressin; C032368:midaglizole; D004837:Epinephrine