Summary
The interrelationship of glucose and insulin was investigated in obese nondiabetic subjects with asymptomatic reactive hypoglycemia. Results were compared to those obtained from obese control subjects and normal individuals. The diagnostic criteria for asymptomatic reactive hypoglycemia were the appearance of blood glucose values of 40 mg/dl and below during the postabsorptive phase of a 6-h OGTT and the absence of related symptoms. The blood glucose nadir occurred earlier in obese hypoglycemics than in obese controls. Maximum insulin response was similar in both obese groups, but occurred significantly later in obese hypoglycemics than in obese subjects without hypoglycemia and normal subjects. In obese hypoglycemics the blood glucose nadir was inversely proportional to the time of the insulin peak (i.e. the later the insulin peak the lower the blood glucose nadir) but correlated poorly to maximum insulin values. Delayed insulin response was found to be the major abnormality in asymptomatic reactive hypoglycemia and a probable cause of the decreased ability to maintain post-hyperglycemic glucose homeostasis. Decreased glucose tolerance in some obese hypoglycemics pre-treated with prednisolone suggests that asymptomatic reactive hypoglycemia could be the manifestation of an early diabetic stage.
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References
Anderson J. W., Herman R. H.: Treatment of reactive hypoglycemia with sulfonylureas — Amer. J. Med. Sci.261, 16, 1971.
Antony D., Dippe S., Hofeldt F. D., Davis J. W., Forsham P. H.: Personality disorders and reactive hypoglycemia. A quantitative study — Diabetes22, 664, 1973.
Bleicher S. J.: Hypoglycemia — In:Ellenberg M., Rifkin H. (Eds): Diabetes mellitus: theory and practice. McGraw-Hill Book Co., New York, 1970; p. 958.
Burns T. W., Bregant R., Van Peenan H. J., Hove T. E.: Observation on blood glucose concentration of human subjects during continuous sampling — Diabetes14, 186, 1965.
Cahill G. F. Jr., Soeldner J. S.: A non-editorial on non-hypoglycemia — New Engl. J. Med.291, 905, 1974.
Conn J. W., Seltzer H. S.: Spontaneous hypoglycemia — Amer. J. Med.19, 460, 1955.
Fabrykant M.: Clinical versus laboratory hypoglycemia. An analysis of 81 oral glucose tolerance tests with arterial and venous blood glucose measurements — Metabolism4, 153, 1955.
Farriss B. L.: Prevalence of post-glucose load glycosuria and hypoglycemia in a group of healthy young men — Diabetes23, 189, 1974.
Freinkel N., Metzger B. E.: Oral glucose tolerance curve and hypoglycemias in the fed state — New Engl. J. Med.280, 820, 1969.
Hales C. N., Randle P. J.: Immunoassay of insulin with insulin-antibody precipitate — Biochem. J.88, 137, 1963.
Hofeldt F. D.: Reactive hypoglycemia — Metabolism24, 1193, 1975.
Hofeldt F. D., Adler R. A., Herman R. H.: Postprandial hypoglycemia: fact or fiction? — J. Amer. med. Ass.233, 1308, 1975.
Hofeldt F. D., Adler R. A., Herman R. H., Dippé S., Forsham P. H.: Diagnosis and classification of reactive hypoglycemia based on hormonal changes in response to oral and intravenous glucose administration — Amer. J. clin. Nutr.25, 1193, 1972.
Hofeldt F. D., Lufkin E. G., Hagler L., Block M. B., Dippé S. E., Davis J. W., Levin S. R., Forsham P. H., Herman R. H.: Are abnormalities in insulin secretion responsible for reactive hypoglycemia? — Diabetes23, 589, 1974.
Jarret M. A.: Die Differentialdiagnose bei hypoglykämischen Krankheitsbildern — Sandorama1, 4, 1975.
Jung Y., Khurana R. C., Corredor D. G., Hastillo A., Lain R. F., Patrick D., Turkeltaub P., Danowski T. S.: Reactive hypoglycemia in women. Results of a health survey — Diabetes20, 428, 1971.
Kalkhoff R. K., Richardson B. L., Stoddard F. J.: Defective insulin response during glucose tolerance test in subclinical diabetic mothers with heavy infants — Diabetes17, 37, 1968.
Luyckx A. S., Lefèbvre P. J.: Plasma insulin in reactive hypoglycemia — Diabetes20, 435, 1971.
Marks V.: The measurement of blood glucose and the definition of hypoglycemia — In:Andreani D., Lefèbvre P., Marks V. (Eds): Hypoglycemia. Proceedings of the European Symposium Rome. Georg Thieme Verlag, Stuttgart, 1976; p. 1.
Park B. N., Kahn C. B., Gleason R. E., Soeldner J. S.: Insulin-glucose dynamics in non-diabetic reactive hypoglycemia and asymptomatic biochemical hypoglycemia in normals, prediabetics and chemical diabetics — Diabetes21, 373, 1972.
Permutt M. A.: Postprandial hypoglycemia — Diabetes25, 719, 1976.
Sekso M., Solter M., Zjačić V., Čabrijan T.: Treatment of reactive hypoglycemia with buformin — Amer. J. clin. Nutr.28, 1271, 1975.
Sekso M., Solter M., Zjačić V., Vizner B., Čabrijan T.: Secretion of insulin, growth hormone and cortisol during prolonged glucose tolerance test in obese nondiabetics and chemical diabetics — Proc. 1st Yugosl. Congr. Nuclear Medicine, Split 1974; p. 111.
Standardization of the oral glucose tolerance test. Report of the Committee on Statistics of the American Diabetes Association — Diabetes18, 299, 1969.
Statement on hypoglycemia — Diabetes22, 137, 1973.
Sussman K. E., Stimmler L., Birenboim H.: Plasma insulin levels during reactive hypoglycemia — Diabetes15, 1, 1966.
Yalow R. S., Berson S. A.: Immunoassay of plasma insulin in man — J. clin. Invest.39, 1157, 1960.
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Solter, M., Sekso, M. Glucose-insulin interaction in obese individuals with asymptomatic reactive hypoglycemia. Acta diabet. lat 16, 119–127 (1979). https://doi.org/10.1007/BF02581091
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DOI: https://doi.org/10.1007/BF02581091