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Does Ethanol Cause Hypoglycaemia in Overnight Fasted Patients with Type 1 Diabetes?
Author(s) -
Moriarty K.T.,
Maggs D.G.,
Macdonald I.A.,
Tattersall R.B.
Publication year - 1993
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1993.tb01998.x
Subject(s) - medicine , diabetes mellitus , ethanol , endocrinology , saline , bolus (digestion) , hypoglycemia , insulin , type 1 diabetes , type 2 diabetes , chemistry , biochemistry
Drinking ethanol is widely believed to predispose to hypoglycaemia in patients with Type 1 diabetes, the suggested mechanism being suppression of hepatic gluconeogenesis. The hypoglycaemic effect of ethanol was investigated by measuring steady‐state glucose infusion rate during a hypoinsulinaemic (mean plasma insulin 14 ± 1.3 (SEM) mU I ‐1 ), euglycaemic (blood glucose 5 mmol I ‐1 ) clamp. Nine patients with Type 1 diabetes fasted overnight and then had, in single‐blind fashion, ethanol 0.5 g kg ‐1 by intravenous bolus followed by 0.25 g kg ‐1 h ‐1 or matched volumes of saline. After 1 h of ethanol or saline, all infusions were stopped and blood glucose monitored for a further 90 min. A 60‐min ethanol infusion leading to a steady‐state blood concentration of 26.2 ± 1.4 mmol I ‐1 (120.7 mg %) did not alter the glucose infusion rate needed to maintain euglycaemia (1.22 ± 0.12 mg kg ‐1 min ‐1 before and 1.23 ± 0.12 during ethanol infusion), the initial rate of fall of blood glucose (ethanol 0.039 mmol I ‐1 min ‐1 vs control (0.033), the lowest blood glucose (4.43 mmol I ‐1 vs 4.31), or the rate of blood glucose recovery (ethanol 0.050 mmol I ‐1 min ‐1 vs control 0.054). We conclude that a moderate amount of ethanol, administered intravenously under controlled conditions, does not lead to hypoglycaemia in patients with Type 1 diabetes who have fasted overnight.