Key result
Insulin-induced hypoglycaemia in Göttingen minipigs induced a 25-fold increase in epinephrine and QTc-interval prolongation, closely resembling human physiological responses.
Why the study?
The potentially fatal cardiovascular effects of hypoglycaemia are not well understood, and large animal models are needed to elucidate the counter-regulatory responses and cardiovascular consequences of insulin-induced hypoglycaemia in humans.
Does hyperinsulinaemic hypoglycaemia induce counter-regulatory endocrine responses and electrocardiographic changes in a minipig model?
Does hyperinsulinaemic hypoglycaemia induce counter-regulatory endocrine responses and electrocardiographic changes in a minipig model?
This minipig model demonstrates that hyperinsulinaemic hypoglycaemia induces human-like counter-regulatory endocrine responses and proarrhythmic electrocardiographic changes, providing a translational platform for studying hypoglycaemia-induced cardiovascular events.
Supports Göttingen minipigs as hypoglycemia model; leaves open translation to human arrhythmia risk.
The potentially fatal cardiovascular effects of hypoglycaemia are not well understood and large animal models of the counter-regulatory responses and cardiovascular consequences of insulin-induced hypoglycaemia are needed to understand the mechanisms in humans. The aim of this study was to develop a human-like minipig model of hypoglycaemia including healthy and diabetic pigs to investigate endocrine, electrocardiographic and platelet effects. Hypoglycaemia was induced using a hyperinsulinaemic, hypoglycaemic clamp and an insulin bolus protocol. Plasma glucose, glucagon, C-peptide, insulin, epinephrine and platelet aggregation responses were measured before, during and after hypoglycaemia. Continuous electrocardiographic recordings were obtained. Hypoglycaemia at a plasma glucose concentration of 0.8-1.0 mM in the clamp induced 25-fold increase in epinephrine and sixfold and threefold increase in glucagon for healthy and diabetic pigs, respectively. The hypoglycaemic clamp induced QTc-interval prolongation and increase in cardiac arrhythmias. In the bolus approach, the non-diabetic group reached plasma glucose target of 1.5 mM and QTc-interval was prolonged after insulin injection, but before glucose nadir. The diabetic group did not reach hypoglycaemic target, but still demonstrated QTc-interval prolongation. These results demonstrate effects of hyperinsulinaemic hypoglycaemia closely resembling human physiology, indicating the minipig as a translational animal model of counter-regulatory endocrine and myocardial effects of hypoglycaemia.
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Lyhne et al. (2021) studied Hypoglycaemia (n=14). Insulin-induced hypoglycaemia vs. Baseline/normoglycaemia was evaluated on Counter-regulatory endocrine response and electrocardiographic changes. Insulin-induced hypoglycaemia in Göttingen minipigs induced a 25-fold increase in epinephrine and QTc-interval prolongation, closely resembling human physiological responses.
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