Insulin induced hypoglycaemia: comparison of glucose and glycerol concentrations in plasma and microdialysate from subcutaneous adipose tissue

Abstract

Aims-To investigate the dynamics between plasma and dialysate glucose during hypoglycaemia in children. Study design-Six children in prepuberty or early puberty were investigated by multiple blood sampling and microdialysis of subcutaneous adipose tissue during a standard arginine-insulin tolerance test. Glucose and glycerol, as an index of lipolysis, were measured in samples from both compartments. Plasma concentrations of insulin and the main counterregulatory hormones were also measured. Results-Plasma and dialysate glucose concentrations were very similar at baseline and increased in concert after infusion of arginine, probably in response to glucagon release. After insulin injection, glucose in both plasma and dialysate fell in parallel. The subsequent hypoglycaemic stress response induced a rapid rebound in the plasma concentration with a mean (SD) delay in the dialysate of 16 (3) minutes. Plasma glycerol was approximately fivefold lower than in the dialysate and did not fluctuate significantly. Dialysate glycerol decreased with arginine infusion and reached a nadir immediately following insulin administration. Subsequently, the antilipolytic eVect of insulin was overcome by the hypoglycaemic stress response, and lipolysis prevailed in spite of hyperinsulinaemia. Conclusion-After rapidly induced hypoglycaemia, rebound of interstitial glucose concentrations is significantly delayed compared with plasma concentrations, and the antilipolytic eVect of hyperinsulinaemia is opposed possibly by the hypoglycaemic stress response. (Arch Dis Child 1999;80:42-45)

Effect of fasting on young adults who have symptoms of hypoglycemia in the absence of frequent meals

“…Subcutaneous microdialysis was used to follow short-time variation in glucose (Kamel et al, 1999). A CMA 60 catheter (length 30 mm, cutoff 60 kDa, CMA Microdialysis, Solna, Sweden) was inserted in the umbilical subcutaneous fat in every subject.…”

Effects of Domperidone on Human Plasma Levels of Motilin, Somatostatin, Gastrin, Adrenocorticotropic Hormone and Cortisol

“…These effects of placebo on ACTH are assumed to result from mental and/or physiological stress in volunteers due to repetitive blood sampling. 15,16) Volunteers in whom samples were taken at intervals of 120 min are assumed to be under less stress. Domperidone suppressed the increases in ACTH-IS levels compared with placebo.…”

“…15,16) Repetitive blood sampling places subjects under artificial stress, and venipuncture as a stressor is useful for evaluation of the pharmacological effects of drug.…”

“…15,16) Repetitive blood sampling places subjects under artificial stress, and venipuncture as a stressor is useful for evaluation of the pharmacological effects of drug. 17) The purpose of this study was to determine the effects of domperidone on plasma levels of motilin-IS, somatostatin-IS, gastrin-IS, ACTH-IS, and cortisol in healthy individuals.…”

Comparison of the Effects of Sho-hange-ka-bukuryo-to and Nichin-to on Human Plasma Adrenocorticotropic Hormone and Cortisol Levels with Continual Stress Exposure

“…In general, venipuncture for blood sampling is postulated to be a stress factor that can increase circulating ACTH and cortisol levels, etc. 8,9) Repetitive blood sampling places subjects under artificial stress and venipuncture as a stressor is useful for the evaluation of the pharmacological effects of drugs.10-12) Naito et al reported other Kampo medicines (Rikkunshi-to, Hange-shashin-to, Hange-koboku-to) regulated plasma ACTH and cortisol levels under stress.13) These medicines also commonly included Pinelliae Tuber and Zingiberis Rhizoma.To determine whether the pharmacological effects of Shohange-ka-bukuryo-to and Nichin-to on stress-related hormone levels (ACTH and cortisol) under continual stress, and to determine the contribution of the herbs to the pharmacological effects of Kampo, we compared the plasma ACTH-IS and cortisol levels after administration of these Kampo medicines and related herbs. …”