NIHR Bristol Biomedical Research Centre, University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
School of Psychological Sciences, University of Bristol, Bristol, UK.
BMJ Open Diabetes Res Care. 2022 Nov;10(6). doi: 10.1136/bmjdrc-2022-003065.
Hypoglycemia elicits coordinated counter-regulatory neuroendocrine responses. The extent to which this process involves an increased drive to eat, together with greater preference for foods high in carbohydrate content, is unclear. Our objective was to examine this effect in children and adolescents (age 5-19 years) without diabetes and no prior known experience of hypoglycemic episodes.
We administered a computerised task designed to examine preference for high-carbohydrate foods (sweet and savory) to pediatric patients (n=26) undergoing an insulin tolerance test as part of the routine clinical assessment of pituitary hormone secretory capacity. The task was completed at baseline and three time points after intravenous infusion of insulin (approximately 7, 20 and 90 min).
Although all patients reached insulin-induced hypoglycemia (mean venous glucose at nadir=1.9 mmol/L), there was moderate evidence of no effect on preference for high-carbohydrate foods (moderate evidence for the null hypothesis) compared with euglycemia. Patients also did not display an increase in selection of foods of high compared with low energy density. Sensitivity of the task was demonstrated by decreased preference for sweet, high-carbohydrate foods after consumption of sweet food and drink.
Results support the view that acute hypoglycemia does not automatically prompt the choice of high-carbohydrate foods for rapid glucose restoration, and further stresses the importance that people and families with children vulnerable to hypoglycemic episodes ensure that 'rapidly absorbed glucose rescue therapy' is always available.
低血糖会引发协调的代偿性神经内分泌反应。目前尚不清楚这一过程在多大程度上涉及到进食欲望的增加，以及对高碳水化合物含量食物的更大偏好。我们的目的是在没有糖尿病且没有低血糖发作既往史的儿童和青少年（5-19 岁）中研究这种影响。
我们进行了一项计算机化任务，旨在检查儿童患者（n=26）对高碳水化合物食物（甜食和咸食）的偏好，这些患者正在接受胰岛素耐量试验，作为垂体激素分泌能力常规临床评估的一部分。该任务在基线和静脉输注胰岛素后三个时间点（大约 7、20 和 90 分钟）完成。
尽管所有患者均达到胰岛素诱导的低血糖（静脉血糖最低点平均值为 1.9mmol/L），但与正常血糖相比，对高碳水化合物食物的偏好几乎没有影响（对零假设的中等证据）。与低能量密度的食物相比，患者也没有显示出对高能量密度食物的选择增加。该任务的敏感性通过在食用甜食和饮料后对甜食和高碳水化合物食物的偏好降低得到证明。
结果支持这样一种观点，即急性低血糖不会自动促使人们选择高碳水化合物食物来快速恢复血糖，这进一步强调了易发生低血糖发作的儿童的患者及其家庭确保始终提供“快速吸收的葡萄糖抢救治疗”的重要性。
