Failure of thermoregulation in the cold during hypoglycaemia induced by exercise and ethanol

1. After young men had exercised for approximately 2 hr at 70% maximum O(2) uptake, and taken 28 ml. ethanol by mouth, their mean blood glucose fell to 2.17 mM. It fell further to 1.77 mM during a 30 min exposure to air at 14.5 degrees C. Plasma lactate, glycerol, beta-hydroxybutyrate and free fatty acid concentrations increased.2. Rectal temperature fell to reach a mean level of 34.49 degrees C by the end of the cold exposure; oesophageal temperature fell to as low as 33.00 degrees C in one case.3. Virtually no increase in metabolic rate and no visible shivering occurred during the cold exposure.4. Administration of glucose (mean 60.4 g) prevented the falls in temperature, and restored metabolic response to the cold to the size found in control experiments without exercise or ethanol.5. Neither exercise without ethanol or ethanol without exercise significantly lowered the blood glucose or impaired the maintenance of body temperature in the cold.6. One obese subject showed almost as great a fall in blood glucose and depression of metabolic response to cold as the thinner men, but no fall in body temperature.