Evidence map›Paper›PMID 38376580›Full record

ArticleActa diabetologica2024

Counterregulatory hormone and symptom responses to hypoglycaemia in people with type 1 diabetes, insulin-treated type 2 diabetes or without diabetes: the Hypo-RESOLVE hypoglycaemic clamp study.

Therese W Fabricius, Clementine E M Verhulst, Peter L Kristensen, Jens J Holst, Cees J Tack, Rory J McCrimmon, Simon R Heller, Mark L Evans, Bastiaan E de Galan, Ulrik Pedersen-Bjergaard and 1 more

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Article in Acta diabetologica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 4 countries.

Therese W FabriciusDepartment of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark. Therese.emilie.wilbek.fabricius@regionh.dk.ORCID http://orcid.org/0000-0002-6344-5408
Clementine E M VerhulstDepartment of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-9905-7669
Peter L KristensenDepartment of Endocrinology and Nephrology, Nordsjællands Hospital, Hillerød, Denmark.ORCID http://orcid.org/0000-0001-5431-824X
Jens J HolstDepartment of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.ORCID http://orcid.org/0000-0001-6853-3805
Cees J TackDepartment of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0003-0322-1653
Rory J McCrimmonSystems Medicine, School of Medicine, University of Dundee, Dundee, UK.ORCID http://orcid.org/0000-0002-3957-1981
Simon R HellerDepartment of Oncology and Metabolism, University of Sheffield, Sheffield, UK.ORCID http://orcid.org/0000-0002-2425-9565
Mark L EvansWelcome MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0001-8122-8987
Bastiaan E de GalanDepartment of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-1255-7741
Ulrik Pedersen-BjergaardDepartment of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0003-0588-4880
Hypo-RESOLVE consortium
Radboud University Nijmegen · NLUniversity of Copenhagen · DKNordsjællands Hospital · DKUniversity of Cambridge · GBUniversity of Dundee · GBUniversity of Sheffield · GB

Funding

Innovative Medicines Initiative 2 777460
6 · The paper itself

Abstract

aimThe sympathetic nervous and hormonal counterregulatory responses to hypoglycaemia differ between people with type 1 and type 2 diabetes and may change along the course of diabetes, but have not been directly compared. We aimed to compare counterregulatory hormone and symptom responses to hypoglycaemia between people with type 1 diabetes, insulin-treated type 2 diabetes and controls without diabetes, using a standardised hyperinsulinaemic-hypoglycaemic clamp. MATERIALS: We included 47 people with type 1 diabetes, 15 with insulin-treated type 2 diabetes, and 32 controls without diabetes. Controls were matched according to age and sex to the people with type 1 diabetes or with type 2 diabetes. All participants underwent a hyperinsulinaemic-euglycaemic-(5.2 ± 0.4 mmol/L)-hypoglycaemic-(2.8 ± 0.13 mmol/L)-clamp.

resultsThe glucagon response was lower in people with type 1 diabetes (9.4 ± 0.8 pmol/L, 8.0 [7.0-10.0]) compared to type 2 diabetes (23.7 ± 3.7 pmol/L, 18.0 [12.0-28.0], p < 0.001) and controls (30.6 ± 4.7, 25.5 [17.8-35.8] pmol/L, p < 0.001). The adrenaline response was lower in type 1 diabetes (1.7 ± 0.2, 1.6 [1.3-5.2] nmol/L) compared to type 2 diabetes (3.4 ± 0.7, 2.6 [1.3-5.2] nmol/L, p = 0.001) and controls (2.7 ± 0.4, 2.8 [1.4-3.9] nmol/L, p = 0.012). Growth hormone was lower in people with type 2 diabetes than in type 1 diabetes, at baseline (3.4 ± 1.6 vs 7.7 ± 1.3 mU/L, p = 0.042) and during hypoglycaemia (24.7 ± 7.1 vs 62.4 ± 5.8 mU/L, p = 0.001). People with 1 diabetes had lower overall symptom responses than people with type 2 diabetes (45.3 ± 2.7 vs 58.7 ± 6.4, p = 0.018), driven by a lower neuroglycopenic score (27.4 ± 1.8 vs 36.7 ± 4.2, p = 0.012).

conclusionAcute counterregulatory hormone and symptom responses to experimental hypoglycaemia are lower in people with type 1 diabetes than in those with long-standing insulin-treated type 2 diabetes and controls.

Indexed as

Diabetes Mellitus, Type 1Diabetes Mellitus, Type 2GlucagonGlucose Clamp TechniqueHypoglycemiaInsulinAdultAgedBlood GlucoseCase-Control StudiesEpinephrineFemaleHumansHypoglycemic AgentsMaleMiddle AgedBlood GlucoseEpinephrineGlucagonHypoglycemic AgentsInsulinCounterregulatory responseDiabetesHyperinsulinaemic–hypoglycaemic clampHypoglycaemia

Identifiers

PMID38376580
PMCPMC11055751
OpenAlexW4391955455

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.