Hypoglycaemia insulin

Butterworth, R. F. Metabolism of gluatamate and related amino acids in insulin hypoglycaemia. In L. Hertz, E. Kvamme, E. G. McGeer and A. Schousboe (eds), Glutamine, Glutamate and GABA in the Central Nervous System. New York Alan R. Liss, 1983, pp. 595 - 608. 

Butterworth RF, Merkel AD, Landreville F (1982) Regional amino acid distribution in relation to function in insulin hypoglycaemia. J Neurochem 3S 1483-1489. 

Kadekaro, M., Savaki, H., and Sokoloff, L., 1980, Metabolic mapping of neural pathways involved in gastrosecretory response to insulin hypoglycaemia in the rat, J. Physiol. 300 393-407. 

Cairns D, Deveney CW, Way LW. Mechanism of the release of gastrin by insulin hypoglycaemia. Surg Forum 25 325-327, 1971. 

Stadl F. The effect of vagotomy on gastrin release during insulin hypoglycaemia in ulcer patients. Scand J Gastroenterol 7 225-231, 1972. 

Hypoglycaemia remains the most frequent complication of insulin administration to diabetics. It usually occurs due to (a) administration of an excessive amount of insulin (b) administration of insulin prior to a mealtime, but with subsequent omission of the meal or (c) due to increased physical activity. In severe cases this can lead to loss of consciousness, and even death. Although it may be treated by oral or i.v. administration of glucose, insulin-induced hypoglycaemia is sometimes treated by administration of glucagon. 

An excess of insulin can cause hypoglycaemia and the hormones that respond to this condition to restore normal glucose levels are known as the counter-regulatory hormones. They are adrenaline, glucagon, growth hormone and cortisol. An increase in the blood levels of these hormones can sometimes be used to conhrm a diagnosis of hypoglycaemia. 

This situation arises mainly when the blood level of insulin is high - abnormally high for the given condition. Insulin not only stimulates peripheral utilisation but also inhibits glucose output by the liver so that hypoglycaemia can develop rapidly. Four examples are given. 

When compared with soluble insulin, the human analogue insulin aspart has a faster onset and a shorter duration of action, resulting in a higher fasting and preprandial blood glucose concentration. The incidence of hypoglycaemia tends to be lower with insulin aspart than with soluble insulin. 

Recombinant glucagon Insulin-induced hypoglycaemia emergency treatment for severe hypogycaemic reactions... 

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