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Haemodynamic changes in insulin-induced hypoglycaemia in normal man
Diabetologia
|May 1, 1984
Summary
Insulin-induced hypoglycemia transiently alters circulation in healthy men, decreasing plasma volume and increasing cardiac output via heart rate and stroke volume, suggesting sympatho-adrenal activation.
Area of Science:
- Cardiovascular Physiology
- Endocrinology
Background:
- Insulin-induced hypoglycemia is a common complication of diabetes treatment.
- Understanding its effects on the cardiovascular system is crucial for patient management.
Purpose of the Study:
- To investigate the acute haemodynamic and hormonal responses to insulin-induced hypoglycemia in healthy individuals.
- To elucidate the mechanisms underlying circulatory changes during hypoglycemia.
Main Methods:
- Measurements of haemodynamic variables (plasma volume, heart rate, blood pressure, cardiac output, stroke volume, vascular resistance) and plasma catecholamines.
- Induction of hypoglycemia using insulin in seven healthy men.
- Serial measurements before, during, and after the hypoglycemic period.
Main Results:
- Significant decrease in plasma volume (mean 222 ml) at glucose nadir, returning to baseline within 30 minutes.
- Increased cardiac output (mean 2.8 L/min), initially from heart rate, later from stroke volume.
- Decreased total peripheral and lower extremity vascular resistance; unchanged hepato-splanchnic vascular resistance.
- Evidence suggests increased sympatho-adrenal activity rather than Frank-Starling mechanism.
Conclusions:
- Insulin-induced hypoglycemia causes significant, transient alterations in cardiovascular function.
- These changes are mediated by increased cardiac output and altered vascular resistance, likely driven by sympatho-adrenal activation.