Alcohol and glucose counterregulation during acute insulin-induced hypoglycemia in type 2 diabetic subjects

Metabolism. 2001 Apr;50(4):451-7. doi: 10.1053/meta.2001.21697.

Abstract

To investigate the influence of alcohol on glucose counterregulation and recovery during acute insulin-induced hypoglycemia in type 2 diabetic subjects, 8 diet-treated type 2 diabetic subjects were examined twice after an overnight fast. A graded hyperinsulinemic (1 mU/kg/min, 60 to 195 minutes) euglycemic/hypoglycemic clamp was performed with concomitant infusion of 3-(3)H-glucose to assess glucose turnover. After a euglycemic baseline period (150 to 180 minutes), 200 mL of water was taken either alone or with alcohol (0.4 g/kg body weight). Hypoglycemia (plasma glucose nadir, 2.8 mmol/L) was subsequently induced, and the recovery period followed after discontinuation of insulin and the variable glucose infusion. On both study days, circulating concentrations of insulin and glucose were comparable. Alcohol intake markedly increased plasma lactate (area under the curve [AUC], recovery period) (244 +/- 30 v 12 +/- 4 mmol/L x 240 minutes; P = .00009) and suppressed plasma nonesterified fatty acids (NEFA) (AUC, recovery period) (95 +/- 13 v 161 +/- 18 mmol/L x 240 minutes; P = .0008). No differences were found in the counterregulatory response of catecholamines, cortisol, and growth hormone (GH). However, alcohol intake decreased peak glucagon significantly (155 +/- 12 v 200 +/- 17 pg/mL; P = .038). In diet-treated, mild type 2 diabetic subjects, alcohol does not modify recovery from insulin-induced hypoglycemia.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Blood Glucose / metabolism*
  • Central Nervous System Depressants / pharmacology*
  • Diabetes Mellitus, Type 2 / blood*
  • Ethanol / pharmacology*
  • Female
  • Glucose Clamp Technique
  • Hormones / blood
  • Humans
  • Hypoglycemia / chemically induced*
  • Hypoglycemia / metabolism*
  • Hypoglycemic Agents* / blood
  • Insulin* / blood
  • Kinetics
  • Lactic Acid / blood
  • Lipids / blood
  • Male
  • Middle Aged

Substances

  • Blood Glucose
  • Central Nervous System Depressants
  • Hormones
  • Hypoglycemic Agents
  • Insulin
  • Lipids
  • Lactic Acid
  • Ethanol