Summary
The plasma concentration of C-peptide, insulin (IRI) and glucose was measured in 9 healthy subjects during insulin-induced hypoglycaemia followed by a meal. Identical observations were made in the same subjects after an equivalent period of fasting without hypoglycaemia (control study). Endogenous secretion of insulin was suppressed following administration of exogenous insulin and this persisted long after the blood glucose concentration had returned to normal. After the meal the mean blood glucose rose to a peak of 8.4±0.3 mmol/l (mean ± SEM) at 60 min and was still raised at 7.5±0.3 mmol/l at 120 min, compared with a peak value of only 5.1±0.2 mmol/l at 30 min after the meal in the control study. Following hypoglycaemia the mean plasma IRI rose from 8.3±1.3 mU/l to a delayed peak of 81.6±12.7 mU/l at 60 min and was 123.5±14 mU/l at 120 min post-prandially, compared with a peak of 72.4±0.5 mU/l at 30 min after the meal in the control study. Acute hypoglycaemia may thus induce an abnormal pattern of insulin secretion in response to a meal, with impaired carbohydrate tolerance in normal subjects.
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Turner RC, Johnson PC (1973) Suppression of insulin release by fish-insulin-induced hypoglycaemia: with reference to the diagnosis of insulinoma. Lancet I: 1483–1485
Turner RC, Oakley NW, Nabarro JDN (1973) Changes in plasma insulin during ethanol-induced hypoglycaemia. Metabolism 22: 111–121
Horwitz DL, Rubenstein AH, Reynolds C, Molnar GD, Yanaihara N (1975) Prolonged suppression of insulin release by insulin-induced hypoglycemia: demonstration by C-peptide assay. Horm Metab Res 7: 449–452
Horwitz DL, Kuzuya H, Rubenstein AH (1976) Circulating serum C-peptide: A brief review of diagnostic implications. N Engl J Med 295: 207–209
Service FJ, Horwitz DL, Rubenstein AH, Kuzuya H, Mako ME, Reynolds C, Molnar GD (1977) C-peptide suppression test for insulinoma. J Lab Clin Med 90: 180–186
Rubenstein AH, Steiner DF, Horwitz DL, Mako ME, Block MB, Starr JI, Kuzuya H, Melani F (1977) Clinical significance of circulating proinsulin and C-peptide. Recent Prog Horm Res 33: 435–468
Hill JB, Kessler G (1961) An automated determination of glucose utilising a glucose-oxidase-peroxidase system. J Lab Clin Med 57: 970–980
Heding LG (1975) Radioimmunological determination of human C-peptide in serum. Diabetologia 11: 541–548
Ashby JP, Speake RN (1975) Insulin and glucagon secretion from (isolated islets of Langerhans:) the effects of calcium ionophores. Biochem J 150: 89–96
Garber AJ, Cryer PE, Santiago JV, Raymond MW, Pagliara AS, Kipnis DM (1976) The role of adrenergic mechanisms in the substrate and hormonal response to insulin-induced hypoglycaemia in man. J Clin Invest 58: 7–15
Somogyi M (1951) Effect of insulin hypoglycaemia on alimentary hyperglycaemia. J Biol Chem 193: 859–865
Liljenquist JE, Horwitz DL, Jennings AS, Chiasson JL, Keller U, Rubenstein AH (1978) Inhibition of insulin secretion by exogenous insulin in normal man as demonstrated by C-peptide assay. Diabetes 27: 563–570
Service JF, Nelson RL, Rubenstein AH, Go VLW (1978) Direct effect of insulin on secretion of insulin, glucagon, gastric inhibitory polypeptide and gastrin during maintenance of normoglycemia. J Clin Endocrinol Metab 47: 488–493
Shima K, Moroshita S, Sawazaki N, Tanaka R, Turui S (1977) Failure of exogenous insulin to inhibit insulin secretion in man. Horm Metab Res 9: 441–443
Robertson RP, Porte D Jr (1973) Adrenergic modulation of basal insulin secretion in man. Diabetes 22: 1–8
Turner RC, Hart G, London DR (1977) Suppression of basal insulin secretion by adrenalin in normal man and in patients with insulinomas. Diabetologia 13: 19–23
Adrian TE, Bloom SR, Besterman HS, Barnes AJ, Cooke TJC, Russell RCG, Faber RG (1977) Mechanism of pancreatic polypeptide release in man. Lancet I: 161–163
Floyd JC, Fajans SS, Pek S, Chance RE (1977) A newly recognised pancreatic polypeptide: Plasma levels in health and disease. Recent Prog Horm Res 33: 519–570
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Frier, B.M., Corrall, R.J.M., Ashby, J.P. et al. Attenuation of the pancreatic beta cell response to a meal following hypoglycaemia in man. Diabetologia 18, 297–300 (1980). https://doi.org/10.1007/BF00251009
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DOI: https://doi.org/10.1007/BF00251009