Effect of Fasting on Hypoglycemic Counterregulation in Type 1 Diabetes
University of Cincinnati
Summary
Iatrogenic hypoglycemia is still considered to be the number one barrier to effective glycemic control in patients with type 1 diabetes (T1D). In a previous study, it was observed in people without diabetes that fasting can be detrimental to the hormonal and hepatic responses to insulin-induced hypoglycemia. In the experiments described herein, the impact fasting has on hypoglycemic counterregulation in people with T1D will be determined.
Description
Because patients with type 1 diabetes (T1D) are required to estimate and administer their own insulin requirements, they frequently overestimate their needs. This often leads to debilitating insulin-induced hypoglycemia, which is the number one barrier to the safe, effective management of glycemia in this population. In addition to the difficulty estimating one's own insulin requirements after a meal, counterregulatory hormone responses to hypoglycemia are impaired in patients with T1D, thereby reducing hepatic glucose production (HGP) and increasing the depth and duration of the hypoglycemic…
Eligibility
- Age range
- 18–45 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * males and females of any race or ethnicity * non-obese (BMI \< or = to 30) * have a diagnosis of type 1 diabetes * C-peptide negative Exclusion Criteria: * pregnant women * cigarette smoking * Taking inflammation-targeting steroids (e.g., prednisone). * Taking medications targeting adrenergic signaling (e.g., beta-blockers, bronchodilators). * Hematocrit less than 33%. * Presence of HIV or hepatitis (due to their deleterious effects on the liver). * The presence of cardiovascular or peripheral vascular disease. * The presence of neuropathy, retinopathy or nephropathy.…
Interventions
- OtherFasting
Subjects remain fasted prior to insulin-induced hypoglycemia.
- OtherFeeding
Subjects eat a normal breakfast and lunch prior to insulin-induced hypoglycemia.
Location
- University of CincinnatiCincinnati, Ohio