ALCOHOL INTAKE IMPAIRS GLUCOSE COUNTERREGULATION DURING ACUTE INSULIN-INDUCED HYPOGLYCEMIA IN IDDM PATIENTS - EVIDENCE FOR A CRITICAL ROLE OF FREE FATTY-ACIDS

In this study, we assessed the effects of alcohol intake on glucose co unterregulation in response to acute insulin-induced hypoglycemia in I DDM patients and in normal control subjects. Nine euglycemic IDDM pati ents and 9 normal control subjects were studied. After a baseline peri od, insulin (0.15 U/kg) was administered subcutaneously to induce hypo glycemia. Each IDDM patient was studied 3 times. In the first study, a lcohol was orally administered as wine. In the second (control) study, water was administered instead of wine. In the third study, wine was given; however, a continuous infusion of heparin plus Intralipid was a dministered to prevent the fall in plasma free fatty acid. Normal cont rol subjects underwent only the alcohol and the control studies. In ID DM patients alcohol intake impairs, whereas in normal subjects it supp orts glucose counterregulation. Alcohol intake is associated with norm al catecholamine responses in both IDDM diabetic patients and normal s ubjects. In both IDDM patients and normal subjects, hepatic glucose pr oduction in th recovery phase of the alcohol study was normal. Plasma glucose rate of disappearance was significantly increased by alcohol i ntake in IDDM (13.72 +/- 0.82 vs. 11.84 +/- 0.53 mumol . kg-1 . min-1; P < 0.05). Alcohol intake in both normal subjects and IDDM patients d ecreased plasma free fatty acid (267 +/- 22 vs. 156 +/- 20 muM; P < 0. 01 and 356 +/- 29 vs. 96 +/- 12 muM; P < 0.01). We hypothesized that i n IDDM patients, deficient glucose recovery during alcohol intake is t he result Of the ability of alcohol to depress lipolysis.