Hypothalamic-pituitary activation does not differ during human and porcine insulin-induced hypoglycemia in insulin-dependent diabetes mellitus

• Published in: The Clinical Investigator 1993-12, Vol.72 (1), p.56-59
• Main Authors: LINGENFELSER, T, PICKERT, A, PFOHL, M, RENN, W, RADJAIPOUR, M, COLLET, C, EGGSTEIN, M, JAKOBER, B
• Format: Article
• Language: English
• Subjects: Adrenocorticotropic Hormone - secretion; Adult; Animals; beta-Endorphin - secretion; Biological and medical sciences; Blood Glucose - analysis; Diabetes Mellitus, Type 1 - physiopathology; Diabetes. Impaired glucose tolerance; Double-Blind Method; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Growth Hormone - secretion; Higher Nervous Activity; Humans; Hypoglycemia - chemically induced; Hypoglycemia - physiopathology; Hypoglycemia - psychology; Hypothalamo-Hypophyseal System - drug effects; Hypothalamo-Hypophyseal System - physiopathology; Insulin - adverse effects; Insulin - pharmacology; Male; Medical sciences; Pituitary-Adrenal System - physiopathology; Species Specificity; Swine
• ISSN: 0941-0198; 1432-1440
• DOI: 10.1007/BF00231119

Although pituitary hormones play only a minor role in acute hormonal counterregulation during insulin-induced hypoglycemia, their concomitant secretion with the profound sympathoadrenal response provides an indicator of hypothalamic-pituitary activation. The release of different amounts of beta-endorphin, growth hormone, and adrenocorticotropin during human (HI) and porcine (PI) insulin-induced hypoglycemia would serve as a pointer to a different insulin species effect on hypothalamic-pituitary response. We performed a controlled, double-blind study with randomization to either HI or PI to compare insulin effects during developing and established hypoglycemia. The glucose clamp technique was used to lower the blood glucose concentration stepwise (3.3, 2.2, 1.7 mmol/l) over similar periods in ten patients with insulin-dependent diabetes mellitus. beta-endorphin, growth hormone, and adrenocorticotropin levels were determined by radioimmunoassay from arterialized blood at the above plateaus. A different action of HI or PI on peripheral glucose metabolism was not found. Pituitary hormones increased significantly during hypoglycemia (analysis of variance for hypoglycemic effects: beta-endorphin, P < 0.02; growth hormone, P < 0.04; adrenocorticotropin, P < 0.05). No insulin species effect was detected. Hypothalamic-pituitary activation during insulin-induced hypoglycemia is independent of the insulin species used, which supports earlier observations of an identical sympathoadrenal response during HI- and PI-induced hypoglycemia.