Conference Resources | Abstracts
September 3
rd
– 6
th
, 2014 | Toronto, Canada |
244
Poster Tour 20: Acute and Chronic Complications V
P156
Adrenaline and cortisol levels are decreased under nocturnal versus day time hypoglycemia in
prepubertal children with T1D
P. Foli
1
, S. Fredheim
1
, G. Laerkholm
1
, J. Svensson
1,2
, C.B. Juhl
3
, B. Olsen
1
, K. Pilgaard
1
, J.
Johannesen
1,2
1
Herlev University Hospital, Dept of Paediatrics, Copenhagen, Denmark,
2
University of Copenhagen,
Faculty of Health and Medical Sciences, Copenhagen, Denmark,
3
HypoSafe A/S, Copenhagen,
Denmark
Objective:
To investigate the counter regulatory hormone profile (glucagon, cortisol, adrenaline and
growth hormone (GH)) in children during a hyperinsulinaemic hypoglycaemic clamp procedure during
day and night time.
Methods:
8 children (4 boys) age 9.6±2.3 yrs with type 1 diabetes, diabetes duration 3.0±1.4 yrs,
HbA1c 55.5±3.4 mmol/mol, 7/8 on CSII. Two clamps were performed: (i) at day- and (ii) night time.
After a run in period of 45 min with an iv infusion of glucose (3.3-6.7 mg/kg/min) and insulin (80
mU/m
2
/min) with BG at 7-9 mmol/l, blood sampling for counter regulatory hormones at baseline were
collected. Venous blood glucose (BG) was measured every 5 minutes and the hyperinsulinaemic
hypoglycaemic clamp was initialized by a slow reduction in glucose infusion until BG reached 3.5
mmol/l (hypo) and ≤2.2 mmol/l (nadir), where the 2nd and 3rd set of hormones were collected. Paired
t-testing and multiple linear regression models for the respective analyses were performed. P-value <
0.05 was considered significant.
Results:
The BG levels (mmol/l) were comparable during the two clamp settings: baseline: 8.3±1.9 vs
7.3±2.7; hypo: 3.3±0.4 vs 3.4±0.4 and nadir: 2.3±0.5 vs 2.1±0.3; day and night, respectively. The rate
of BG decline were 0.04 vs 0.06 mmol/l/min (NS) from hypo to nadir, day vs night, respectively. The
levels of glucagon and GH at nadir day and night were comparable; however the levels of adrenalin
(nmol/l) 0.6±0.5 vs 1.9±1.3 and cortisol (nmol/l) 42±40 vs 319±229 were blunted at night compared to
daytime. The increase in hormone concentration from hypo to nadir were independent of BG decline
day and night, but the increase in adrenalin and GH were higher during daytime vs night (p=0.04 and
p=0.01, resp).
Conclusions:
The response of adrenalin were blunted comparing night to day for
(i) absolute level as well as for
(ii) rate of increase when BG dropped from hypo to nadir, whereas only the absolute level was
reduced during night time for cortisol.
