Treatment of insulin reactions in diabetics
R. G. Brodows, C. Williams and J. M. Amatruda
Using a modification of the glucose clamp technique, we have studied the
efficacy of commonly used foods to correct hypoglycemia in
insulin-dependent diabetics. After lowering the plasma glucose level to 55
mg/dL at a steady-state plasma free insulin concentration of about 50
microU/mL, patients were fed 20 g of carbohydrate as milk, orange juice, or
D-glucose or 40 g of carbohydrate as orange juice. The data indicate that
20 g of carbohydrate as D-glucose corrects hypoglycemia without rebound
hyperglycemia. In an outpatient setting, this treatment also proved
effective in spontaneous episodes of hypoglycemia. We conclude that (1) the
D-glucose content of the ingested carbohydrate is an important determinant
of the glycemic response, and (2) at times of moderately severe
hypoglycemia, ingestion of 20 g of D-glucose provides an effective glycemic
response for periods of at least 40 minutes. In view of these data, a table
is provided listing some common sources of 20 g of D-glucose.
