Suppression of counterregulatory hormone response to hypoglycemia by insulin per se

Michael Peter Diamond, Lynn Hallarman, Kathleen Starick-Zych, Timothy W. Jones, Meredith Connolly-Howard, William V. Tamborlane, Robert S. Sherwin

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Although assessment of counterregulatory hormone responses to hypoglycemia relies upon insulin to lower the glucose level, it is not known if the exogenous insulin dose used itself influences the magnitude of the hormone response. To assess this, 12 normal subjects randomly received 2 hypoglycemic clamp studies in which the only variable was the insulin dose (0.6 or 5.0 mU/kg-min). Despite 10-fold differences in circulating insulin (265±29 vs 2576±222 pmol/L respectively), the hypoglycemic stimulus did not vary. Glucose levels fell over one hour, and then were maintained for two hours at the same hypoglycemic plateau (approximately 3.1 mmol/L for each study) by a variable glucose infusion. Although basal counterregulatory hormone levels in low and high dose studies were indistinguishable, during hypoglycemia the response of epinephrine, growth hormone, and glucagon was significantly suppressed when the degree of hyperinsulinemia was increased. We conclude that raising the magnitude of hyperinsulinemia suppresses the magnitude of the counterregulatory hormone response to hypoglycemia in normal subjects. This modulating effect of insulin per se is yet another variable in the interpretation of hypoglycemic counterregulation.

Original languageEnglish (US)
Pages (from-to)1388-1390
Number of pages3
JournalJournal of Clinical Endocrinology and Metabolism
Volume72
Issue number6
DOIs
StatePublished - Jan 1 1991

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Hypoglycemia
Hypoglycemic Agents
Hormones
Insulin
Hyperinsulinism
Glucose
Clamping devices
Glucagon
Epinephrine
Growth Hormone

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Diamond, M. P., Hallarman, L., Starick-Zych, K., Jones, T. W., Connolly-Howard, M., Tamborlane, W. V., & Sherwin, R. S. (1991). Suppression of counterregulatory hormone response to hypoglycemia by insulin per se. Journal of Clinical Endocrinology and Metabolism, 72(6), 1388-1390. https://doi.org/10.1210/jcem-72-6-1388

Suppression of counterregulatory hormone response to hypoglycemia by insulin per se. / Diamond, Michael Peter; Hallarman, Lynn; Starick-Zych, Kathleen; Jones, Timothy W.; Connolly-Howard, Meredith; Tamborlane, William V.; Sherwin, Robert S.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 72, No. 6, 01.01.1991, p. 1388-1390.

Research output: Contribution to journalArticle

Diamond, MP, Hallarman, L, Starick-Zych, K, Jones, TW, Connolly-Howard, M, Tamborlane, WV & Sherwin, RS 1991, 'Suppression of counterregulatory hormone response to hypoglycemia by insulin per se', Journal of Clinical Endocrinology and Metabolism, vol. 72, no. 6, pp. 1388-1390. https://doi.org/10.1210/jcem-72-6-1388
Diamond, Michael Peter ; Hallarman, Lynn ; Starick-Zych, Kathleen ; Jones, Timothy W. ; Connolly-Howard, Meredith ; Tamborlane, William V. ; Sherwin, Robert S. / Suppression of counterregulatory hormone response to hypoglycemia by insulin per se. In: Journal of Clinical Endocrinology and Metabolism. 1991 ; Vol. 72, No. 6. pp. 1388-1390.
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