Low-Carbohydrate Diet Impairs the Effect of Glucagon in the Treatment of Insulin-Induced Mild Hypoglycemia: A Randomized Crossover Study

TY - JOUR

T1 - Low-Carbohydrate Diet Impairs the Effect of Glucagon in the Treatment of Insulin-Induced Mild Hypoglycemia

T2 - A Randomized Crossover Study

AU - Ranjan, Ajenthen

AU - Schmidt, Signe

AU - Damm-Frydenberg, Camilla

AU - Steineck, Isabelle

AU - Clausen, Trine Ryberg

AU - Holst, Jens Juul

AU - Madsbad, Sten

AU - Nørgaard, Kirsten

N1 - © 2017 by the American Diabetes Association.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - OBJECTIVE This study compared the ability of glucagon to restore plasmaglucose (PG) after mild hypoglycemia in patients with type 1 diabetes on an isocaloric high-carbohydrate diet (HCD) versus a low-carbohydrate diet (LCD). RESEARCH DESIGN AND METHODS Ten patients with insulin pump-treated type 1 diabetes randomly completed 1 week of the HCD (≥250 g/day) and 1 week of the LCD (≤50 g/day). After each week, mild hypoglycemia was induced by a subcutaneous insulin bolus in the fasting state. When PG reached 3.9 mmol/L, 100 mg glucagon was given subcutaneously, followed by 500 mg glucagon 2 h later. RESULTS Compared with the HCD, the LCD resulted in lower incremental rises in PG after the first (mean 6 SEM: 1.3 ± 0.3 vs. 2.7 ± 0.4 mmol/L, P = 0.002) and second glucagon bolus (4.1 ± 0.2 vs. 5.6 ± 0.5 mmol/L, P = 0.002). No differences were observed between the diets regarding concentrations of insulin, glucagon, and triglycerides. CONCLUSIONS The LCD reduces the treatment effect of glucagon on mild hypoglycemia. Carbohydrate intake should be considered when low-dose glucagon is used to correct hypoglycemia.

AB - OBJECTIVE This study compared the ability of glucagon to restore plasmaglucose (PG) after mild hypoglycemia in patients with type 1 diabetes on an isocaloric high-carbohydrate diet (HCD) versus a low-carbohydrate diet (LCD). RESEARCH DESIGN AND METHODS Ten patients with insulin pump-treated type 1 diabetes randomly completed 1 week of the HCD (≥250 g/day) and 1 week of the LCD (≤50 g/day). After each week, mild hypoglycemia was induced by a subcutaneous insulin bolus in the fasting state. When PG reached 3.9 mmol/L, 100 mg glucagon was given subcutaneously, followed by 500 mg glucagon 2 h later. RESULTS Compared with the HCD, the LCD resulted in lower incremental rises in PG after the first (mean 6 SEM: 1.3 ± 0.3 vs. 2.7 ± 0.4 mmol/L, P = 0.002) and second glucagon bolus (4.1 ± 0.2 vs. 5.6 ± 0.5 mmol/L, P = 0.002). No differences were observed between the diets regarding concentrations of insulin, glucagon, and triglycerides. CONCLUSIONS The LCD reduces the treatment effect of glucagon on mild hypoglycemia. Carbohydrate intake should be considered when low-dose glucagon is used to correct hypoglycemia.

U2 - 10.2337/dc16-1472

DO - 10.2337/dc16-1472

M3 - Journal article

C2 - 27797928

SN - 0149-5992

VL - 40

SP - 132

EP - 135

JO - Diabetes Care

JF - Diabetes Care

IS - 1

ER -