REDUCED NEUROENDOCRINE AND SYMPTOMATIC RESPONSES TO SUBSEQUENT HYPOGLYCEMIA AFTER 1 EPISODE OF HYPOGLYCEMIA IN NONDIABETIC HUMANS
REDUCED NEUROENDOCRINE AND SYMPTOMATIC RESPONSES TO SUBSEQUENT HYPOGLYCEMIA AFTER 1 EPISODE OF HYPOGLYCEMIA IN NONDIABETIC HUMANS
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DOI：
10.2337/diabetes.40.2.223
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发表时间：
1991-02-01
期刊：
影响因子：
7.7
通讯作者：
CRYER, PE
中科院分区：
文献类型：
--
作者：
HELLER, SR;CRYER, PE
为了检验低血糖本身会导致对随后低血糖的神经内分泌和症状反应降低这一假设，我们在9名非糖尿病患者中测量了连续两次早晨钳夹低血糖（2.8 mM）期间的这些反应，一次是间隔下午（1400-1600）低血糖（3 mM），另一次是间隔下午低血糖（5 mM）。 没有一个测量到的反应被间隔时间减少。 与此相反，血浆肾上腺素（P < 0.005），胰高血糖素（P < 0.005），胰多肽（P < 0.01），皮质醇（P < 0.02），和总（P < 0.001），神经源性（P < 0.001）和神经性低血糖（P < 0.05）症状反应上午低血糖后间隔下午低血糖降低。 因此，单次低血糖发作导致对后续低血糖的神经内分泌和症状反应普遍减少，这一发现可能对胰岛素依赖型糖尿病医源性低血糖的发病机制很重要。
To test the hypothesis that hypoglycemia itself causes reduced neuroendocrine and symptomatic responses to subsequent hypoglycemia, we measured those responses during clamped hypoglycemia (2.8 mM) on consecutive mornings on two occasions, with interval afternoon (1400-1600) hypoglycemia (3 mM) on one occasion and interval afternoon euglycemia (5 mM) on the other, in nine nondiabetic humans. None of the measured responses were reduced by interval euglycemia. In contrast, plasma epinephrine (P < 0.005), glucagon (P < 0.005), pancreatic polypeptide (P < 0.01), cortisol (P < 0.02), and total (P < 0.001), neurogenic (P < 0.001) and neuroglycopenic (P < 0.05) symptom responses to morning hypoglycemia were reduced after interval afternoon hypoglycemia. Thus, a single episode of hypoglycemia caused a generalized reduction of the neuroendocrine and symptomatic responses to subsequent hypoglycemia, a finding that may be important to the pathogenesis of iatrogenic hypoglycemia in insulin-dependent diabetes mellitus.