title: Effects of insulin-induced hypoglycaemia on energy intake and food choice at a subsequent test meal.
abstract: OBJECTIVE
  Hypoglycaemia is assumed to increase food intake, but there is little data on the magnitude or qualitative nature of this effect. We have therefore investigated the effects of insulin-induced hypoglycaemia on food intake at a test meal.
  
  
  METHODS
  Sixteen healthy men (age 29.8 +/- 11 years; mean +/- SD) were studied; either insulin (0.05 units/kg) or saline was given intravenously in a double-blind crossover design. Blood glucose was monitored at regular intervals. Participants were given an ad libitum breakfast 20 min after injections and food intake and appetite scores were recorded.
  
  
  RESULTS
  Blood glucose was unchanged following saline (4.3 +/- 0.4 to 4.4 +/- 0.3 mmol/L). There was a transient decline in blood glucose after insulin with a nadir at 20 min (4.31 +/- 0.34 to 2.41 +/- 0.45 mmol/L, p < 0.0001), which returned to baseline at 40 min. Total energy intake was 17% higher (1701.1 +/- 895.3 kcal vs 1427.7 +/- 815 kcal, p = 0.026) following insulin administration compared to that following saline. Macronutrient analysis revealed a significant increase in high-fat foods (muffins) (69.2 +/- 54.1 vs 29 +/- 42.3 g, p = 0.009) after insulin. Appetite scores were similar after saline and insulin despite these changes in food intake.
  
  
  CONCLUSIONS
  Transient insulin-induced hypoglycaemia increases energy intake. Participants consumed more fat after insulin compared to that after saline. High-fat foods can lead to passive overconsumption and have a low glycaemic index, which may prolong hypoglycaemia. Both factors could ultimately promote weight gain in individuals with recurrent hypoglycaemia.
authors.affiliation: Diabetes and Endocrinology Research Group, University Hospital Aintree, Liverpool, UK.
authors.forename: Shivani
authors.initials: S
authors.lastname: Dewan
authors.forename: Angela
authors.initials: A
authors.lastname: Gillett
authors.forename: Julie A
authors.initials: JA
authors.lastname: Mugarza
authors.forename: Terence M
authors.initials: TM
authors.lastname: Dovey
authors.forename: Jason C G
authors.initials: JC
authors.lastname: Halford
authors.forename: John P H
authors.initials: JP
authors.lastname: Wilding
mesh_terms: D000328:Adult; D001066:Appetite / Q000187:drug effects; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004435:Eating / Q000187:drug effects*; D002149:Energy Intake / Q000187:drug effects*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007328:Insulin / Q000494:pharmacology*; D008297:Male
chemical_list: D001786:Blood Glucose; D007328:Insulin