Heterogeneity in Epinephrine Response to Experimental Hypoglycemia in Type 1 Diabetes and Controls

Figures

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  Figure 1.. Preinduction protocol. The preinduction protocol consisted of 3 hypoglycemia clamps done over 2 days. For each, subjects were infused with insulin 2.0 mU/kg/min and blood glucose was targeted at 50 mg/dL. Samples for epinephrine were drawn at baseline (30 minutes after placement of the last IV catheter) and at 60, 90, and 120 minutes after starting insulin during the first and third clamps.

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  Figure 2.. Hypoglycemia-induced epinephrine responses during clamp 1 and clamp 3 of the preinduction protocol when epinephrine is used to define HAAF. (A) The response of the 28 healthy volunteers with complete epinephrine datasets is shown on the left. The middle graph shows the responses of the 21 who developed HAAF, as defined by a 20% reduction in epinephrine response during clamp 3 compared with clamp 1. The right graph shows the 7 who did not develop HAAF. (B) The response of the 19 volunteers with type 1 diabetes who had complete epinephrine datasets is shown on the left. The middle graph shows the responses of the 13 who developed HAAF, as defined by a 20% reduction in epinephrine response during clamp 3 compared with clamp 1. The right graph shows the 6 who did not develop HAAF. The boxes represent the average response ± standard error of the mean. The table shows the epinephrine responses in pg/mL for each subject group.

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  Figure 3.. Hypoglycemia-induced total symptom responses during clamp 1 and clamp 3 of the preinduction protocol when total symptoms are used to define HAAF. (A) The response of the 27 healthy volunteers with complete datasets for symptoms is shown on the left. The middle graph shows the responses of the 10 who developed HAAF, as defined by a 20% reduction in symptom response during clamp 3 compared with clamp 1. The right graph shows the 17 who did not develop HAAF. (B) The response of the 19 volunteers with type 1 diabetes who had complete datasets for symptoms is shown on the left. The middle graph shows the responses of the 10 who developed HAAF, as defined by a 20% reduction in symptom response during clamp 3 as compared to clamp 1. The right graph shows the 9 who did not develop HAAF. The boxes represent the average response ± standard error of the mean. The table shows symptom responses by subject group.

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  Figure 4.. Hypoglycemia-induced epinephrine responses during clamp 1 and clamp 3 of the preinduction protocol when total symptoms are used to define HAAF. (A) The response of the 26 healthy volunteers with complete epinephrine and symptom datasets is shown on the left. The middle graph shows the epinephrine responses of the 10 who developed symptom-based HAAF, as defined by a 20% reduction in symptoms during clamp 3 compared with clamp 1. The right graph shows the 16 who did not develop symptom-based HAAF. (B) The response of the 19 volunteers with type 1 diabetes with complete epinephrine and symptom datasets is shown on the left. The middle graph shows the epinephrine responses of the 10 who developed symptom-based HAAF, as defined by a 20% reduction in symptoms during clamp 3 compared with clamp 1. The right graph shows the 9 who did not develop symptom-based HAAF. The boxes represent the average response ± standard error of the mean. The table shows epinephrine responses in pg/mL by subject group.