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Exaggerated epinephrine response to hypoglycemia in a physically fit, well-controlled IDDM subject.

Davis SN, Goldstein RE, Cherrington AD, Price L
Diabetes Res Clin Pract. 1994 22 (2-3): 139-46

PMID: 8200295 · DOI:10.1016/0168-8227(94)90047-7

Metabolically well controlled insulin-dependent diabetic subjects (IDDM) have deficient autonomic adrenomedullary responses to hypoglycemia. This defect, coupled with the characteristic deficient glucagon response to hypoglycemia, predisposes well-controlled IDDM subjects to an increased incidence of severe hypoglycemic episodes. In this report we describe a physically trained subject with long-duration IDDM (9 years) who was rigorously well-controlled (normal HBA1c), yet had exaggerated epinephrine responses to hypoglycemia compared with normal controls. Steady state epinephrine levels during a low-dose insulin (9 pM/kg/min) hypoglycemic clamp (2.9 +/- 0.1 mM) were approximately 2-fold higher compared with normal controls (10.6 vs. 5.5 +/- 0.7 nM). Epinephrine levels during a high-dose insulin (30 pM/kg/min) hypoglycemic clamp (2.8 +/- 0.1 mM) were also increased compared with normal controls (13.1 vs. 8.8 +/- 0.6 nM). We conclude that physical training in this metabolically well-controlled IDDM subject was associated with an augmented autonomic adrenomedullary response to hypoglycemia.

MeSH Terms (24)

3-Hydroxybutyric Acid Adult Blood Glucose Blood Pressure C-Peptide Diabetes Mellitus, Type 1 Epinephrine Exercise Fatty Acids, Nonesterified Glucagon Growth Hormone Heart Rate Humans Hydrocortisone Hydroxybutyrates Hypoglycemia Insulin Lactates Liver Male Pancreatic Polypeptide Physical Fitness Reference Values Sports

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