Alcohol and glucose counterregulation during acute insulin-induced hypoglycemia in type 2 diabetic subjects

To investigate the influence of alcohol on glucose counterregulation and re covery during acute insulin-induced hypoglycemia in type 2 diabetic subject s, 8 diet-treated type 2 diabetic subjects were examined twice after an ove rnight fast. A graded hyperinsulinemic (1 mU/kg/min, 60 to 195 minutes) eug lycemic/hypoglycemic clamp was performed with concomitant infusion of 3-H-3 -glucose to assess glucose turnover, After a euglycemic baseline period (15 0 to 180 minutes), 200 mt of water was taken either alone or with alcohol ( 0.4 g/kg body weight). Hypoglycemia (plasma glucose nadir, 2.8 mmol/L) was subsequently induced, and the recovery period followed after discontinuatio n of insulin and the variable glucose infusion. On both study days, circula ting concentrations of insulin and glucose were comparable. Alcohol intake markedly increased plasma lactate (area under the curve [AUC], recovery per iod) (244 +/- 30 v 12 +/- 4 mmol/L x 240 minutes; P = .00009) and suppresse d plasma nonesterified fatty acids (NEFA) (AUC, recovery period) (95 +/- 13 v 161 +/- 18 mmol/L x 240 minutes; P = .0008). No differences were found i n the counterregulatory response of catecholamines, cortisol, and growth ho rmone (GH). However, alcohol intake decreased peak glucagon significantly ( 155 +/- 12 v 200 +/- 17 pg/mL; P = .038). In diet-treated, mild type 2 diab etic subjects, alcohol does not modify recovery from insulin-induced hypogl ycemia. Copyright (C) 2001 by W.B. Saunders Company.