{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:53:24Z","timestamp":1787025204418,"version":"build-2736575974"},"reference-count":0,"publisher":"American Diabetes Association","issue":"2","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1993,2,1]]},"abstract":"<jats:p>The aim off this study was to determine if differing concentrations of insulin can modify the counterregulatory response to equivalent hypoglycemia in normal humans. Experiments were conducted in 9 normal, lean men, who had fasted overnight. Insulin was infused in two separate, randomized protocols so that steady-state levels of 486 \u00b1 33 (low) and 3056 \u00b1 236 pM (high) were obtained. Glucose was infused during both protocols to ensure that the rate of fall of plasma glucose (0.07 mM\/min) and hypoglycemic plateau (2.8 \u00b1 0.1 mM) were similar. Despite similar plasma glucose levels, EPI (8.7 \u00b1 0.7 vs. 5.5 \u00b1 0.7 nM), NE (3.3 \u00b1 0.3 vs. 2.3 \u00b1 0.2 nM), and cortisol (811 \u00b1 36 vs. 611 \u00b1 72 nM) significantly increased during high compared with low insulin infusion, respectively (P &amp;lt; 0.05). Glucagon, growth hormone, and pancreatic polypeptide levels increased briskly and significantly but were not different during the two insulin infusions. HGP rose significantly from 12.1 \u00b1 0.3 to 18.1 \u00b1 1.1 \u03bcmol \u00b7 kg\u22121 \u00b7 min\u22121 in response to the high insulin level (P &amp;lt; 0.05) but remained unchanged (12.1 \u00b1 0.4 and 11.7 \u00b1 1.4 \u03bcmol \u00b7 kg\u22121 \u00b7 min\u22121) in the presence of the low insulin level. GRa increased significantly during high insulin levels (3.4 \u00b1 0.3 to 4.8 \u00b1 0.7 \u03bcmol \u00b7 kg\u22121 \u00b7 min\u22121\u2008P &amp;lt; 0.05) but remained at a basal rate (3.0 \u00b1 0.3 to 2.7 \u00b1 0.6 \u03bcmol \u00b7 kg\u22121 \u00b7 min\u22121) in the presence of low insulin levels. sBP and heart rate increased more during high insulin infusion (18 \u00b1 5 vs. 6 \u00b1 5 mmHg and 18 \u00b1 4 vs. 7 \u00b1 2 beats\/min, respectively, P &amp;lt; 0.05). In summary, the 6-fold higher insulin level resulted in significantly greater increases in catecholamine and cortisol secretion, HGP, lipolysis, heart rate, and sBP despite equivalent hypoglycemia. We conclude that at moderate hypoglycemia, high doses of insulin can augment certain aspects of the counterregulatory response in normal humans.<\/jats:p>","DOI":"10.2337\/diab.42.2.263","type":"journal-article","created":{"date-parts":[[2013,9,19]],"date-time":"2013-09-19T13:22:06Z","timestamp":1379596926000},"page":"263-272","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":46,"title":["The Effects of Differing Insulin Levels on the Hormonal and Metabolic Response to Equivalent Hypoglycemia in Normal Humans"],"prefix":"10.2337","volume":"42","author":[{"given":"Stephen N","family":"Davis","sequence":"first","affiliation":[{"name":"Departments of Medicine, Surgery, and Molecular Physiology and Biophysics, Vanderbilt University School of Medicine\u2008Nashville, Tennessee\u2008Department of Anesthesiology, Shriners Burn Institute\u2008Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Surgery, and Molecular Physiology and Biophysics, Vanderbilt University School of Medicine\u2008Nashville, Tennessee\u2008Department of Anesthesiology, Shriners Burn Institute\u2008Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Surgery, and Molecular Physiology and Biophysics, Vanderbilt University School of Medicine\u2008Nashville, Tennessee\u2008Department of Anesthesiology, Shriners Burn Institute\u2008Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Price","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Surgery, and Molecular Physiology and Biophysics, Vanderbilt University School of Medicine\u2008Nashville, Tennessee\u2008Department of Anesthesiology, Shriners Burn Institute\u2008Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Surgery, and Molecular Physiology and Biophysics, Vanderbilt University School of Medicine\u2008Nashville, Tennessee\u2008Department of Anesthesiology, Shriners Burn Institute\u2008Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan D","family":"Cherrington","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Surgery, and Molecular Physiology and Biophysics, Vanderbilt University School of Medicine\u2008Nashville, Tennessee\u2008Department of Anesthesiology, Shriners Burn Institute\u2008Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","container-title":["Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.org\/diabetes\/diabetes\/article-pdf\/42\/2\/263\/359951\/42-2-263.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article-pdf\/42\/2\/263\/359951\/42-2-263.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,2]],"date-time":"2022-11-02T12:23:03Z","timestamp":1667391783000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/diabetes\/article\/42\/2\/263\/9994\/The-Effects-of-Differing-Insulin-Levels-on-the"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,2,1]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1993,2,1]]}},"URL":"https:\/\/doi.org\/10.2337\/diab.42.2.263","relation":{},"ISSN":["0012-1797","1939-327X"],"issn-type":[{"value":"0012-1797","type":"print"},{"value":"1939-327X","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,2,1]]}}}