Impaired overnight counterregulatory hormone responses to spontaneous hypoglycemia in children with type 1 diabetes

Nelly Mauras, Peter H. Chase, Rosanna Fiallo-Scharer, Jennifer H. Fisher, Barbara Tallant, Eva Tsalikian, Michael J. Tansey, Linda F. Larson, Julie Coffey, Tim Wysocki, Nelly Mauras, Larry A. Fox, Keisha Bird, Kelly L. Lofton, Bruce A. Buckingham, Darrell M. Wilson, Jennifer M. Block, Paula Clinton, Stuart A. Weinzimer, William V. Tamborlane & 22 others Elizabeth A. Doyle, Kristin Sikes, Roy W. Beck, Katrina J. Ruedy, Craig Kollman, Dongyuan Xing, Andrea Kalajian, Cynthia R. Stockdale, Michael W. Steffes, Jean M. Bucksa, Maren L. Nowicki, Carol A. Van Hale, Vicky Makky, Ravinder Singh, Gilman D. Grave, Barbara Linder, Karen K. Winer, Dorothy M. Becker, Christopher Cox, Christopher M. Ryan, Neil H. White, Perrin C. White

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

To assess the changes in counterregulatory hormones overnight after an afternoon of structured exercise or sedentary activity in children with type 1 diabetes mellitus (T1DM), the Diabetes Research in Children Network (DirecNet) studied 50 children (10 to <18 yr) with T1DM in five clinical research centers on two separate days (with and without an afternoon exercise session) using a crossover design. Glucose, epinephrine, norepinephrine, cortisol, growth hormone (GH), and glucagon concentrations were measured hourly overnight. Nocturnal hypoglycemia [plasma glucose concentrations ≤70 mg/dL (3.9 mmol/L)] occurred more frequently on the nights following exercise (56 vs. 36%; p = 0.008). Mean hourly concentrations of most hormones did not differ between sedentary or exercise nights or between nights with or without hypoglycemia. Spontaneous nocturnal hypoglycemia only stimulated small increases in plasma epinephrine and GH concentrations and failed to cause a rise in norepinephrine, cortisol, or glucagon levels in comparison with values during the hour before or after hypoglycemia or other times during those same nights. Counterregulatory hormone responses to spontaneous nocturnal hypoglycemia were markedly decreased regardless of whether there was antecedent afternoon exercise in children with T1DM. Sleep-induced impairments in counterregulatory hormone responses likely contribute to the increased risk of hypoglycemia during the entire overnight period in youth with T1DM.

Original languageEnglish (US)
Pages (from-to)199-205
Number of pages7
JournalPediatric Diabetes
Volume8
Issue number4
DOIs
StatePublished - Aug 1 2007

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Type 1 Diabetes Mellitus
Hypoglycemia
Hormones
Exercise
Glucagon
Epinephrine
Growth Hormone
Hydrocortisone
Norepinephrine
Glucose
Research
Cross-Over Studies
Sleep

Keywords

  • Epinephrine
  • GH
  • Hypoglycemia
  • Norepinephrine
  • T1DM

Cite this

Mauras, N., Chase, P. H., Fiallo-Scharer, R., Fisher, J. H., Tallant, B., Tsalikian, E., ... White, P. C. (2007). Impaired overnight counterregulatory hormone responses to spontaneous hypoglycemia in children with type 1 diabetes. Pediatric Diabetes, 8(4), 199-205. https://doi.org/10.1111/j.1399-5448.2007.00248.x

Impaired overnight counterregulatory hormone responses to spontaneous hypoglycemia in children with type 1 diabetes. / Mauras, Nelly; Chase, Peter H.; Fiallo-Scharer, Rosanna; Fisher, Jennifer H.; Tallant, Barbara; Tsalikian, Eva; Tansey, Michael J.; Larson, Linda F.; Coffey, Julie; Wysocki, Tim; Mauras, Nelly; Fox, Larry A.; Bird, Keisha; Lofton, Kelly L.; Buckingham, Bruce A.; Wilson, Darrell M.; Block, Jennifer M.; Clinton, Paula; Weinzimer, Stuart A.; Tamborlane, William V.; Doyle, Elizabeth A.; Sikes, Kristin; Beck, Roy W.; Ruedy, Katrina J.; Kollman, Craig; Xing, Dongyuan; Kalajian, Andrea; Stockdale, Cynthia R.; Steffes, Michael W.; Bucksa, Jean M.; Nowicki, Maren L.; Van Hale, Carol A.; Makky, Vicky; Singh, Ravinder; Grave, Gilman D.; Linder, Barbara; Winer, Karen K.; Becker, Dorothy M.; Cox, Christopher; Ryan, Christopher M.; White, Neil H.; White, Perrin C.

In: Pediatric Diabetes, Vol. 8, No. 4, 01.08.2007, p. 199-205.

Research output: Contribution to journalArticle

Mauras, N, Chase, PH, Fiallo-Scharer, R, Fisher, JH, Tallant, B, Tsalikian, E, Tansey, MJ, Larson, LF, Coffey, J, Wysocki, T, Mauras, N, Fox, LA, Bird, K, Lofton, KL, Buckingham, BA, Wilson, DM, Block, JM, Clinton, P, Weinzimer, SA, Tamborlane, WV, Doyle, EA, Sikes, K, Beck, RW, Ruedy, KJ, Kollman, C, Xing, D, Kalajian, A, Stockdale, CR, Steffes, MW, Bucksa, JM, Nowicki, ML, Van Hale, CA, Makky, V, Singh, R, Grave, GD, Linder, B, Winer, KK, Becker, DM, Cox, C, Ryan, CM, White, NH & White, PC 2007, 'Impaired overnight counterregulatory hormone responses to spontaneous hypoglycemia in children with type 1 diabetes', Pediatric Diabetes, vol. 8, no. 4, pp. 199-205. https://doi.org/10.1111/j.1399-5448.2007.00248.x
Mauras, Nelly ; Chase, Peter H. ; Fiallo-Scharer, Rosanna ; Fisher, Jennifer H. ; Tallant, Barbara ; Tsalikian, Eva ; Tansey, Michael J. ; Larson, Linda F. ; Coffey, Julie ; Wysocki, Tim ; Mauras, Nelly ; Fox, Larry A. ; Bird, Keisha ; Lofton, Kelly L. ; Buckingham, Bruce A. ; Wilson, Darrell M. ; Block, Jennifer M. ; Clinton, Paula ; Weinzimer, Stuart A. ; Tamborlane, William V. ; Doyle, Elizabeth A. ; Sikes, Kristin ; Beck, Roy W. ; Ruedy, Katrina J. ; Kollman, Craig ; Xing, Dongyuan ; Kalajian, Andrea ; Stockdale, Cynthia R. ; Steffes, Michael W. ; Bucksa, Jean M. ; Nowicki, Maren L. ; Van Hale, Carol A. ; Makky, Vicky ; Singh, Ravinder ; Grave, Gilman D. ; Linder, Barbara ; Winer, Karen K. ; Becker, Dorothy M. ; Cox, Christopher ; Ryan, Christopher M. ; White, Neil H. ; White, Perrin C. / Impaired overnight counterregulatory hormone responses to spontaneous hypoglycemia in children with type 1 diabetes. In: Pediatric Diabetes. 2007 ; Vol. 8, No. 4. pp. 199-205.
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abstract = "To assess the changes in counterregulatory hormones overnight after an afternoon of structured exercise or sedentary activity in children with type 1 diabetes mellitus (T1DM), the Diabetes Research in Children Network (DirecNet) studied 50 children (10 to <18 yr) with T1DM in five clinical research centers on two separate days (with and without an afternoon exercise session) using a crossover design. Glucose, epinephrine, norepinephrine, cortisol, growth hormone (GH), and glucagon concentrations were measured hourly overnight. Nocturnal hypoglycemia [plasma glucose concentrations ≤70 mg/dL (3.9 mmol/L)] occurred more frequently on the nights following exercise (56 vs. 36{\%}; p = 0.008). Mean hourly concentrations of most hormones did not differ between sedentary or exercise nights or between nights with or without hypoglycemia. Spontaneous nocturnal hypoglycemia only stimulated small increases in plasma epinephrine and GH concentrations and failed to cause a rise in norepinephrine, cortisol, or glucagon levels in comparison with values during the hour before or after hypoglycemia or other times during those same nights. Counterregulatory hormone responses to spontaneous nocturnal hypoglycemia were markedly decreased regardless of whether there was antecedent afternoon exercise in children with T1DM. Sleep-induced impairments in counterregulatory hormone responses likely contribute to the increased risk of hypoglycemia during the entire overnight period in youth with T1DM.",
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AU - Tallant, Barbara

AU - Tsalikian, Eva

AU - Tansey, Michael J.

AU - Larson, Linda F.

AU - Coffey, Julie

AU - Wysocki, Tim

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AU - Doyle, Elizabeth A.

AU - Sikes, Kristin

AU - Beck, Roy W.

AU - Ruedy, Katrina J.

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AU - Xing, Dongyuan

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AU - Stockdale, Cynthia R.

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AU - Bucksa, Jean M.

AU - Nowicki, Maren L.

AU - Van Hale, Carol A.

AU - Makky, Vicky

AU - Singh, Ravinder

AU - Grave, Gilman D.

AU - Linder, Barbara

AU - Winer, Karen K.

AU - Becker, Dorothy M.

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