Counterregulation in Type 2 (non-insulin-dependent) diabetes mellitus. Normal endocrine and glycaemic responses, up to ten years after diagnosis

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Abstract
We have examined hormonal and metabolic responses to insulin-induced hypoglycaemia in 10 Type 2 (non-insulin-dependent) diabetic patients treated with tablets and 10 age, sex and weight matched control subjects. Diabetic patients were under 110% ideal body weight, had no autonomie neuropathy and were well controlled (HbA1, 7.1±0.2%). After the diabetic patients were kept euglycaemic by an overnight insulin infusion, hypoglycaemia was induced in both groups by intravenous insulin at 30 mU·m–2·min−1 for 60 min and counterregulatory responses measured for 150 min. There were no significant differences between diabetic patients and control subjects in the rate of fall (3.3±0.3 vs 4.0±0.3 mmol·1−1·h−1), nadir (2.4±0.2 vs 2.3±0.1 mmol/l) and rate of recovery (0.027±0.002 vs 0.030±0.003 mmol·1−1·min−1) of blood glucose. Increments of glucagon (60.5±5.7 vs 70±9.2 ng/l) and adrenaline (1.22±0.31 vs 1.45±0.31 nmol/l) were similar in both groups. When tested using this model, patients with Type 2 diabetes, without microvascular complications and taking oral hypoglycaemic agents show no impairment of the endocrine response and blood glucose recovery following hypoglycaemia.