Effect of alpha 2-adrenoceptor antagonist on platelet activation during insulin-induced hypoglycaemia in type 2 (non-insulin-dependent) diabetes mellitus

Diabetologia. 1988 Sep;31(9):657-63. doi: 10.1007/BF00278748.


The role of epinephrine in platelet activation and the effect of an alpha 2-adrenoceptor antagonist, midaglizole, during insulin-induced hypoglycaemia in Type 2 (non-insulin-dependent) diabetes mellitus were examined. The action of midaglizole as a platelet alpha 2-antagonist was confirmed by in vitro studies using platelet-rich plasma and washed platelet suspension. Hypoglycaemia was induced by a bolus injection of short-acting insulin in 24 diabetic patients. They were divided into two groups, a control group (n = 12) and an alpha 2-group (n = 12), and midaglizole was administered orally 60 min before insulin injection in the latter. Blood glucose and plasma C-peptide levels were significantly decreased (p less than 0.005) by insulin injection in both groups. Counter-regulatory hormones, including epinephrine, and arginine vasopressin were similarly increased at the hypoglycaemic nadir compared with the levels at 0 min in both groups. Plasma beta-thromboglobulin was increased at the hypoglycaemic nadir (165.5 +/- 12.6 ng/ml) compared with the level at 0 min (121.0 +/- 11.5, p less than 0.005) in the control group, whereas no significant increase was demonstrated in the alpha 2-group. These results suggest that plasma epinephrine plays an important role in platelet activation during hypoglycaemia in Type 2 diabetes mellitus, and that the platelet activation is prevented by alpha 2-adrenoceptor antagonist.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arginine Vasopressin / pharmacology
  • Blood Glucose / metabolism
  • C-Peptide / blood
  • Diabetes Mellitus, Type 2 / blood*
  • Epinephrine / pharmacology*
  • Female
  • Humans
  • Hypoglycemia / blood*
  • Hypoglycemic Agents / pharmacology*
  • Imidazoles / pharmacology*
  • In Vitro Techniques
  • Insulin*
  • Male
  • Middle Aged
  • Platelet Aggregation / drug effects*
  • Reference Values


  • Blood Glucose
  • C-Peptide
  • Hypoglycemic Agents
  • Imidazoles
  • Insulin
  • Arginine Vasopressin
  • midaglizole
  • Epinephrine