We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Evaluation of the counter-regulatory responses to hypoglycaemia in patients with type 1 diabetes during opiate receptor blockade with naltrexone.
- Authors
Naik, Sarita; Belfort‐DeAguiar, Renata; Sejling, Anne‐Sophie; Szepietowska, Barbara; Sherwin, Robert S.
- Abstract
Aims Hypoglycaemia is the major limiting factor in achieving optimal glycaemic control in people with type 1 diabetes ( T1DM), especially intensively treated patients with impaired glucose counter-regulation during hypoglycaemia. Naloxone, an opiate receptor blocker, has been reported to enhance the acute counter-regulatory response to hypoglycaemia when administered intravenously in humans. The current study was undertaken to investigate the oral formulation of the long-acting opiate antagonist, naltrexone, and determine if it could have a similar effect, and thus might be useful therapeutically in treatment of T1DM patients with a high risk of hypoglycaemia. Materials and methods We performed a randomized, placebo-controlled, double-blinded, cross-over study in which 9 intensively treated subjects with T1DM underwent a 2-step euglycaemic-hypoglycaemic-hyperinsulinaemic clamp on 2 separate occasions. At 12 hours and at 1 hour before the clamp study, participants received 100 mg of naltrexone or placebo orally. Counter-regulatory hormonal responses were assessed at baseline and during each step of the hyperinsulinaemic-clamp. Results Glucose and insulin levels did not differ significantly between the naltrexone and placebo visits; nor did the glucose infusion rates required to keep glucose levels at target. During hypoglycaemia, naltrexone, in comparison with the placebo group, induced an increase in epinephrine levels ( P = .05). However, no statistically significant differences in glucagon, cortisol and growth hormone responses were observed. Conclusion In contrast to the intravenous opiate receptor blocker naloxone, overnight administration of the oral long-acting opiate receptor blocker, naltrexone, at a clinically used dose, had a limited effect on the counter-regulatory response to hypoglycaemia in intensively treated subjects with T1DM.
- Subjects
HYPOGLYCEMIA; TREATMENT of diabetes; TYPE 1 diabetes; NALOXONE; GLYCEMIC control; NALTREXONE; THERAPEUTICS
- Publication
Diabetes, Obesity & Metabolism, 2017, Vol 19, Issue 5, p615
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/dom.12855