Huang Rong, Bao Yujie, Xiong Yuanli, Ma Jianhua, Ding Bo
Department of Endocrinology and Metabolism, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210012, China.
Department of Endocrinology and Metabolism, Nanjing Tongren Hospital, Southeast University School of Medicine, Nanjing, 211102, China.
Sci Rep. 2025 Apr 9;15(1):12099. doi: 10.1038/s41598-025-89543-7.
Obesity is associated with both high and low levels of hypoglycemia, and impairment of counterregulatory hormones may predispose individuals to hypoglycemia. This study aimed to explore differences in the responsiveness of insulin counterregulatory hormones to hypoglycemia between men with or without obesity who have been newly diagnosed with type 2 diabetes mellitus (T2DM). This study enrolled 25 men newly diagnosed with T2DM who were hospitalized in the Department of Endocrinology and Metabolism between January 2022 and December 2022. All participants were treated with intensive insulin pump therapy to achieve glycemic control within one week, then a hyperinsulinemic-hypoglycemic clamp was used to evaluate insulin counter-regulatory hormones for hypoglycemia. Based on the body mass index, 10 and 15 patients were included in the obese and nonobese groups, respectively. During the hyperinsulinemic-hypoglycemic clamp test, the obese group showed a significant lower multiple of adrenocorticotropic hormone elevation than the nonobese group (P = 0.040). Regarding the proportion of hormone response multiples reaching the target, those who reached the reaction multiple were lower in the obese group than those in the non-obese group, although the differences were not statistically significant (all P > 0.05). The responses of insulin counterregulatory hormones to hypoglycemia in men with obesity and newly diagnosed T2DM were significantly lower than those in men with T2DM but without obesity.
肥胖与低血糖水平的高低均有关联，且反调节激素受损可能使个体易患低血糖。本研究旨在探讨新诊断为2型糖尿病（T2DM）的肥胖男性与非肥胖男性之间胰岛素反调节激素对低血糖反应性的差异。本研究纳入了2022年1月至2022年12月期间在内分泌代谢科住院的25名新诊断为T2DM的男性。所有参与者均接受强化胰岛素泵治疗，以在一周内实现血糖控制，然后采用高胰岛素-低血糖钳夹试验来评估胰岛素反调节激素对低血糖的反应。根据体重指数，肥胖组和非肥胖组分别纳入10例和15例患者。在高胰岛素-低血糖钳夹试验期间，肥胖组促肾上腺皮质激素升高倍数显著低于非肥胖组（P = 0.040）。关于激素反应倍数达到目标的比例，肥胖组达到反应倍数的比例低于非肥胖组，尽管差异无统计学意义（所有P > 0.05）。肥胖且新诊断为T2DM的男性中胰岛素反调节激素对低血糖的反应显著低于无肥胖的T2DM男性。
