Adrenaline and cortisol levels are lower during nighttime than daytime hypoglycaemia in children with type 1 diabetes

TY - JOUR

T1 - Adrenaline and cortisol levels are lower during nighttime than daytime hypoglycaemia in children with type 1 diabetes

AU - Fredheim, S

AU - Foli-Andersen, P

AU - Lærkholm, G

AU - Svensson, J

AU - Juhl, C B

AU - Olsen, B

AU - Pilgaard, K

AU - Johannesen, J

N1 - ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

PY - 2018/10

Y1 - 2018/10

N2 - Aim: We investigated children's counter regulatory hormone profiles during a hyperinsulinaemic hypoglycaemic clamp procedure at day and night. Methods: In 2013, we assessed the counter regulatory response to hypoglycaemia in eight outpatients with type 1 diabetes, recruited from the Herlev Hospital, Denmark, at a mean age of 9.6 ± 2.3 years. Hyperinsulinaemic 80 mU/m2/min clamps were performed with a stepwise reduction in plasma glucose from euglycaemia (7–9 mmol/L) to hypoglycaemia (<3.5 mmol/L) and the glucose nadir (≤2.2 mmol/L) during the day and night. Adrenaline, cortisol, glucagon and growth hormone levels were assessed. Results: Adrenaline and growth hormone levels were higher during the day versus the night (p = 0.04 and p = 0.01, respectively). However, at the glucose nadir, the level of adrenaline was lower during the night than the day (0.6 ± 0.2 versus 1.9 ± 0.5 nmol/L, p = 0.016) and cortisol was lower during the day than the night (42 ± 15 versus 319 ± 81 nmol/L, p = 0.016). No differences were demonstrated for glucagon and growth hormone levels based on the same criteria. Conclusion: The adrenaline response was blunted during nocturnal iatrogenic hypoglycaemia in our study cohort, and no increase in cortisol levels was demonstrated.

AB - Aim: We investigated children's counter regulatory hormone profiles during a hyperinsulinaemic hypoglycaemic clamp procedure at day and night. Methods: In 2013, we assessed the counter regulatory response to hypoglycaemia in eight outpatients with type 1 diabetes, recruited from the Herlev Hospital, Denmark, at a mean age of 9.6 ± 2.3 years. Hyperinsulinaemic 80 mU/m2/min clamps were performed with a stepwise reduction in plasma glucose from euglycaemia (7–9 mmol/L) to hypoglycaemia (<3.5 mmol/L) and the glucose nadir (≤2.2 mmol/L) during the day and night. Adrenaline, cortisol, glucagon and growth hormone levels were assessed. Results: Adrenaline and growth hormone levels were higher during the day versus the night (p = 0.04 and p = 0.01, respectively). However, at the glucose nadir, the level of adrenaline was lower during the night than the day (0.6 ± 0.2 versus 1.9 ± 0.5 nmol/L, p = 0.016) and cortisol was lower during the day than the night (42 ± 15 versus 319 ± 81 nmol/L, p = 0.016). No differences were demonstrated for glucagon and growth hormone levels based on the same criteria. Conclusion: The adrenaline response was blunted during nocturnal iatrogenic hypoglycaemia in our study cohort, and no increase in cortisol levels was demonstrated.

U2 - 10.1111/apa.14310

DO - 10.1111/apa.14310

M3 - Journal article

C2 - 29520851

SN - 0803-5253

VL - 107

SP - 1759

EP - 1765

JO - Acta paediatrica (Oslo, Norway : 1992)

JF - Acta paediatrica (Oslo, Norway : 1992)

IS - 10

ER -