{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:27:03Z","timestamp":1788316023958,"version":"build-2803163510"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Innovative Medicines Initiative 2","award":["777460"],"award-info":[{"award-number":["777460"]}]},{"name":"National Health Service in the East of England through the Clinical Academic Reserve"},{"DOI":"10.13039\/501100001734","name":"Copenhagen University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001734","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Diabetol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Aim<\/jats:title>\n                <jats:p>The 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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials<\/jats:title>\n                <jats:p>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\u2013euglycaemic-(5.2\u2009\u00b1\u20090.4 mmol\/L)-hypoglycaemic-(2.8\u2009\u00b1\u20090.13 mmol\/L)-clamp.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The glucagon response was lower in people with type 1 diabetes (9.4\u2009\u00b1\u20090.8 pmol\/L, 8.0 [7.0\u201310.0]) compared to type 2 diabetes (23.7\u2009\u00b1\u20093.7 pmol\/L, 18.0 [12.0\u201328.0], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and controls (30.6\u2009\u00b1\u20094.7, 25.5 [17.8\u201335.8] pmol\/L, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The adrenaline response was lower in type 1 diabetes (1.7\u2009\u00b1\u20090.2, 1.6 [1.3\u20135.2] nmol\/L) compared to type 2 diabetes (3.4\u2009\u00b1\u20090.7, 2.6 [1.3\u20135.2] nmol\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) and controls (2.7\u2009\u00b1\u20090.4, 2.8 [1.4\u20133.9] nmol\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.012). Growth hormone was lower in people with type 2 diabetes than in type 1 diabetes, at baseline (3.4\u2009\u00b1\u20091.6 vs 7.7\u2009\u00b1\u20091.3 mU\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.042) and during hypoglycaemia (24.7\u2009\u00b1\u20097.1 vs 62.4\u2009\u00b1\u20095.8 mU\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). People with 1 diabetes had lower overall symptom responses than people with type 2 diabetes (45.3\u2009\u00b1\u20092.7 vs 58.7\u2009\u00b1\u20096.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.018), driven by a lower neuroglycopenic score (27.4\u2009\u00b1\u20091.8 vs 36.7\u2009\u00b1\u20094.2, <jats:italic>p<\/jats:italic>\u2009=\u20090.012).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Acute 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.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00592-024-02239-8","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T14:02:45Z","timestamp":1708437765000},"page":"623-633","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["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"],"prefix":"10.1007","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6344-5408","authenticated-orcid":false,"given":"Therese W.","family":"Fabricius","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9905-7669","authenticated-orcid":false,"given":"Clementine E. M.","family":"Verhulst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5431-824X","authenticated-orcid":false,"given":"Peter L.","family":"Kristensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6853-3805","authenticated-orcid":false,"given":"Jens J.","family":"Holst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0322-1653","authenticated-orcid":false,"given":"Cees J.","family":"Tack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3957-1981","authenticated-orcid":false,"given":"Rory J.","family":"McCrimmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2425-9565","authenticated-orcid":false,"given":"Simon R.","family":"Heller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8122-8987","authenticated-orcid":false,"given":"Mark L.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1255-7741","authenticated-orcid":false,"given":"Bastiaan E.","family":"de Galan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0588-4880","authenticated-orcid":false,"given":"Ulrik","family":"Pedersen-Bjergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Hypo-RESOLVE consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"2239_CR1","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1007\/S00125-020-05366-3","volume":"64","author":"SA Amiel","year":"2021","unstructured":"Amiel SA (2021) The consequences of hypoglycaemia. 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CV: None. PLK: Has received lecture fees from AstraZeneca and Sanofi. JJH: Appears on advisory boards and has received lecture fees from Novo Nordisk. MLE: Has received personal fees from lecturing and\/or advisory boards from Abbott Diabetes Care, Eli Lilly, Medtronic, Dexcom, Novo Nordisk, Astra Zeneca, Zucara and received research support from Novo Nordisk. SRH: Has served as a member of an expert panel of the U.K. CAA, and provides consultancy for Novo Nordisk, Eli Lilly, and Zealand Pharma for which his institution receives remuneration and serves on speaker panels for Novo Nordisk and Astra Zeneca for which he receives personal remuneration. RM: Has received personal fees from lecturing and\/or advisory boards from Sanofi and Novo Nordisk. CT: Has received research support from AstraZeneca, served on advisory boards for Bayer, Boehringer-Ingelheim, MSD and Novo Nordisk and has received lecture fees from AstraZeneca and Novo Nordisk. BG: Has received research support from Novo Nordisk. UPB: Has served on advisory boards for Sanofi-Aventis, Novo Nordisk and Vertex and has received lecture fees from Abbott, Sanofi-Aventis and Novo Nordisk.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}