Influence of acute alcohol ingestion on the hormonal  responses to modest hypoglycaemia in patients with  Type 1 diabetes.
OBJECTIVE
To determine whether mild alcohol intoxication (45-50 mg/dl) influences counterregulatory hormone responses to moderate hypoglycaemia (2.8 mmol/l)in patients with Type 1 diabetes.


METHODS
Seventeen subjects (14 male, age range 21-46 years) with Type 1 diabetes underwent four hyperinsulinaemic glucose clamps: euglycaemia with placebo; euglycaemia with alcohol (0.4 g/kg); hypoglycaemia (2.8 mmol/l for 65 min)with placebo; and hypoglycaemia (2.8 mmol/l for 65 min) with alcohol (0.4 g/kg). Arterialized venous blood samples were taken for measurement of insulin and counterregulatory hormones.


RESULTS
During hypoglycaemia, peak growth hormone concentrations were significantly lower after alcohol compared with placebo (14.3 +/- 2.9 vs.25.9 +/- 3.4 microg/l,P< 0.001) associated with reduced insulin sensitivity in both hypoglycaemia and euglycaemia studies.


CONCLUSIONS
We found an attenuated growth hormone response to hypoglycaemia associated with mild alcohol intoxication. Although this may potentially contribute to impaired recovery of glucose after hypoglycaemia in patients with Type 1 diabetes, it appears to be offset by a reduction in insulin action.
Kerr
D
D
Bournemouth Diabetes and Endocrine Centre, Bournemouth, UK. david.kerr@rbch.nhs.uk
Cheyne
E
E
Thomas
P
P
Sherwin
R
R
D000328:Adult; D000435:Alcoholic Intoxication / Q000150:complications*; D001786:Blood Glucose / Q000187:drug effects*; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D004311:Double-Blind Method; D005260:Female; D013006:Growth Hormone / Q000378:metabolism*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D013006:Growth Hormone