Naltrexone for treatment of impaired awareness of hypoglycemia in type 1 diabetes: A randomized clinical trial

Amir Moheet, Silvia Mangia, Anjali Kumar, Nolawit Tesfaye, Lynn E Eberly, Yun Bai, Kristine Kubisiak, Elizabeth R Seaquist

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12 Scopus citations


Aims Impaired awareness of hypoglycemia (IAH) is a limiting factor in the treatment of type 1 diabetes (T1D) and is a challenging condition to reverse. The objective of this study was to test the hypothesis that naltrexone therapy in subjects with T1D and IAH will improve counterregulatory hormone response and recognition of hypoglycemia symptoms during hypoglycemia. Methods We performed a pilot randomized double blind trial of 4 weeks of naltrexone therapy (n = 10) or placebo (n = 12) given orally in subjects with T1D and IAH. Outcome measures included hypoglycemia symptom scores, counterregulatory hormone levels and thalamic activation as measured by cerebral blood flow using MRI during experimental hypoglycemia in all subjects before and after 4 weeks of intervention. Results After 4 weeks of therapy with naltrexone or placebo, no significant differences in response to hypoglycemia were seen in any outcomes of interest within each group. Conclusions In this small study, short-term treatment with naltrexone did not improve recognition of hypoglycemia symptoms or counterregulatory hormone response during experimental hypoglycemia in subjects with T1D and IAH. Whether this lack of effect is related to the small sample size or due to the dose, the advanced stage of study population or the drug itself should be the subject of future investigation.

Original languageEnglish (US)
Pages (from-to)1277-1282
Number of pages6
JournalJournal of Diabetes and Its Complications
Issue number8
StatePublished - Nov 2015

Bibliographical note

Funding Information:
This study was supported by a grant to E.S. from the American Diabetes Association , which provided support for E.S., L.E. and S.M.; A.M. and S.M. were supported by Clinical and Translational Science Award 5KL2TR113 . Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.


  • HAAF
  • Hypoglycemia
  • Impaired awareness of hypoglycemia
  • Naltrexone
  • Opioid antagonists
  • Type 1 diabetes


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