β-Adrenoceptor Blockade and Recovery from Hypoglycaemia in Diabetic Subjects: Normalization after Lactate and Glycerol Infusions

1982 ◽  
Vol 62 (2) ◽  
pp. 131-136 ◽  
Author(s):  
I. Lager ◽  
U. Smith
Keyword(s):  
Blood Glucose ◽  
Recovery Rate ◽  
Type I Diabetes ◽  
Diabetic Patients ◽  
Type I ◽  
Insulin Dependent ◽  
Propranolol Treatment ◽  
Glucose Recovery ◽  
Insulin Dependent Diabetic ◽  
Gluconeogenic Substrates

1. Previous studies have shown that non-selective β-adrenoceptor blockade attenuates the blood glucose recovery rate after hypoglycaemia in type I diabetes. Apart from possible effects on hepatic glycogenolysis propranolol also inhibits the release of the important gluconeogenic substrates lactate and glycerol. 2. To determine whether the effect of non-selective β-adrenoceptor blockade on glucose recovery could be associated with diminished availability of gluconeogenic substrates, lactate and glycerol were infused during hypoglycaemia in four insulin-dependent diabetic patients. Comparisons were made of the blood glucose recovery on placebo, propranolol and propranolol combined with the infusion. 3. The blood glucose recovery rate after hypoglycaemia was less on propranolol than with placebo but was significantly improved and not different from placebo when propranolol treatment was combined with lactate and glycerol infusions. Thus, at least for type I diabetic patients, in whom gluconeogenesis is proportionally greater than in healthy subjects, non-selective β-adrenoceptor blockade attenuates the glucose recovery rate from hypoglycaemia mainly by reducing the availability of gluconeogenic substrates.

Effects of somatostatin on the behaviour of thromboxane B2 and β-thromboglobulin in type I diabetes

1985 ◽  
Vol 109 (1) ◽  
pp. 104-107 ◽  
Author(s):  
G. Gragnoli ◽  
A. M. Signorini ◽  
I. Tanganelli
Keyword(s):  
Platelet Function ◽  
Type I Diabetes ◽  
Thromboxane B2 ◽  
Diabetic Patients ◽  
Base Line ◽  
Type I ◽  
Control Subjects ◽  
Pharmacological Studies ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

Abstract. Pharmacological studies have shown that the addition of somatostatin to insulin promotes a more rapid recovery from diabetic ketoacidosis. However, contradictory results have been reported concerning the action of somatostatin on platelet function, frequently deranged in diabetes. Therefore the plasma levels of thromboxane B2, a stable metabolite of proaggregatory thromboxane A2 and of β-thromboglobulin, a marker of platelet activation, were studied in 9 control subjects and in 13 insulin-dependent diabetic patients before and during somatostatin injection, administered as an initial 250 μg iv bolus followed by infusion of 300 μg over 3 h. In both groups, after somatostatin infusion thromboxane B2 and β-thromboglobulin levels showed, respectively, a progressive fall and an increase up to the second hour. Over the next hour thromboxane B2 increased and μ-thromboglobulin decreased but their levels did not return to basal values. During this experiment β-thromboglobulin plasma values in diabetic patients did not differ from those of control subjects. In contrast, thromboxane B2, decreased in relation to pharmacological treatment, maintained elevated levels. Our data, however, demonstrate that the dose of somatostatin used, produced in the diabetic patients a normal fall of thromboxane B2 in terms of percentage of base-line values, but increases of β-thromboglobulin lower than in control subjects. It is suggested that platelet function should be evaluated when somatostatin is used in the treatment of poorly controlled type I diabetes.

Counterregulatory Hormone Release and Glucose Recovery After Hypoglycemia in Non-insulin-dependent Diabetic Patients

Diabetes ◽  
1983 ◽  
Vol 32 (11) ◽  
pp. 1055-1059 ◽  
Author(s):  
G. Boden ◽  
M. Soriano ◽  
R. D. Hoeldtke ◽  
O. E. Owen
Keyword(s):  
Diabetic Patients ◽  
Hormone Release ◽  
Insulin Dependent ◽  
Glucose Recovery ◽  
Insulin Dependent Diabetic

scholarly journals A Rarely Seen Multilevel Thoracic Vertebral Fracture after a Nocturnal Hypoglycemic Convulsion Attack

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Ebru Atalar ◽  
Cuneyd Gunay ◽  
Hakan Atalar ◽  
Tugba Tunc
Keyword(s):  
Back Pain ◽  
Thoracic Spine ◽  
Type I Diabetes ◽  
Compression Fracture ◽  
Diabetic Patients ◽  
Type I ◽  
Rare Injury ◽  
Compression Fractures ◽  
History Of ◽  
Insulin Dependent Diabetic

A 49-year-old male presented with acute midthoracic severe back pain following a witnessed nocturnal convulsion attack. There was no history of trauma and the patient had a 23-year history of Type I diabetes mellitus. MRI scans of the thoracic spine revealed compression fractures at T5, T6, T7, and T8 vertebrae. The patient was treated conservatively. At 17 months after the initial diagnosis, the complaints of back pain had been resolved and the patient was able to easily undertake daily living activities. Hypoglycaemia is a common problem in diabetic patients treated with insulin. Convulsions may occur as a consequence of insulin-induced hypoglycemia. Nontraumatic compression fractures of the thoracic spine following seizures are a rare injury. Contractions of strong paraspinal muscles can lead to compression fracture of the midthoracic spine. Unrecognized hypoglycaemia should be considered to be a possible cause of convulsions in insulin-dependent diabetic patients. The aim of this report is to point out a case of rarely seen multilevel consecutive vertebrae fractures in a diabetic patient after a nocturnal hypoglycaemic convulsion attack.

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