PMID: 589316Dec 10, 1977

Defective blood glucose counter-regulation in diabetics is a selective form of autonomic neuropathy

British Medical Journal
L V CampbellL Lazarus

Abstract

Administration of a low-dose insulin infusion to normal subjects results in a mild drop in blood glucose concentration (1.1 mmol/1 (20 mg/100 ml)) and the resetting of the basal glucose at the lower concentration. Clinical hypoglycaemia does not develop, and there is a significant release of glucagon, growth hormone, and cortisol. A similar infusion in insulin-requiring diabetics results in hypoglycaemia accompanied by a release of growth hormone and cortisol but no significant release of glucagon. Subsequently giving arginine to these patients results in a significant release of glucagon, indicating that the alpha cell is intact and can respond to local, direct stimulation. In one patient the defect in glucagon response to impending hypoglycaemia developed after two years' insulin treatment. This type of dissociated response' of the alpha cell has been reported in animals after denervation of the pancreas, and insulin-requiring diabetics may develop a selective form of autonomic neuropathy affecting the vagal control of glucagon release.

Citations

Jun 1, 1979·Diabetologia·L V CampbellL Lazarus
Oct 1, 1979·Diabetologia·B F ClarkeI W Campbell
Jan 1, 1980·Annals of Biomedical Engineering·J V Santiago, N H White
Jan 1, 1983·Progress in Neurobiology·W W Lautt
Apr 9, 1981·The New England Journal of Medicine
Jul 25, 1985·The New England Journal of Medicine·P E Cryer, J E Gerich
Dec 1, 1991·Archives of Disease in Childhood·L BarkaiI Vámosi
Nov 1, 1986·Diabetic Medicine : a Journal of the British Diabetic Association·B M Frier
Sep 7, 2001·Diabetes/metabolism Research and Reviews·J Radziuk, S Pye
Jan 1, 1983·Alcoholism, Clinical and Experimental Research·E T TanE A Whiteside
Dec 1, 1979·Australian and New Zealand Journal of Medicine·F P Alford, D J Chisholm
Jun 1, 1984·Australian and New Zealand Journal of Medicine·D J ChisholmM J Hewett
May 1, 1988·Diabetes/metabolism Reviews·A Vinik, B Mitchell
Jul 1, 1994·The Journal of Pediatric Endocrinology·R P HoffmanD J Becker
May 17, 2007·Arquivos brasileiros de endocrinologia e metabologia·Helena Schmid

Related Concepts

Arginine hydrochloride
Autonomic Nervous System
Blood Glucose
Diabetes Mellitus
Symmetric Diabetic Proximal Motor Neuropathy
Glucagon
Novolin

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