Maggs D G, Macdonald I A, Tattersall R B
Department of Physiology and Pharmacology, University of Nottingham, UK.
Diabetologia. 1994 Jul;37(7):689-96. doi: 10.1007/BF00417693.
In healthy subjects hypoglycaemia causes a fall in body temperature through increased sweating and limb blood flow, and despite increased metabolic heat production. We studied thermoregulatory responses to hyperinsulinaemic (100 mU.m-2.min-1) (a) hypoglycaemia (2.5 mmol/l) and (b) euglycaemia (4.5 mmol/l) in insulin-dependent diabetic men of short (< 5 years) and long (> 15 years) diabetes duration. Plasma noradrenaline (p < 0.0001), metabolic rate (p < 0.005), heart rate (p < 0.0001) and skin blood flow (p < 0.05) increased during hypoglycaemia and euglycaemia with a greater rise in noradrenaline during the former (p < 0.05). Plasma adrenaline (p < 0.005), forearm blood flow (p < 0.05) and systolic blood pressure (p < 0.02) increased and diastolic blood pressure decreased (p < 0.005) during hypoglycaemia, with greater changes in adrenaline (p < 0.05) and diastolic blood pressure in patients of short diabetes duration. Only two patients (diabetes duration < 2 years) sweated appropriately, while body temperature changed minimally in the two groups of patients. In summary, thermoregulatory responses to hypoglycaemia are impaired in IDDM due to attenuated sweating and adrenomedullary responses.
在健康受试者中，低血糖会导致体温下降，这是通过出汗增加和肢体血流增加实现的，尽管代谢产热也增加了。我们研究了胰岛素依赖型糖尿病男性患者（糖尿病病程短（<5年）和长（>15年））对高胰岛素血症（100 mU·m-2·min-1）（a）低血糖（2.5 mmol/l）和（b）正常血糖（4.5 mmol/l）的体温调节反应。低血糖和正常血糖期间，血浆去甲肾上腺素（p<0.0001）、代谢率（p<0.005）、心率（p<0.0001）和皮肤血流量（p<0.05）增加，前者期间去甲肾上腺素升高幅度更大（p<0.05）。低血糖期间，血浆肾上腺素（p<0.005）、前臂血流量（p<0.05）和收缩压（p<0.02）升高，舒张压降低（p<0.005），糖尿病病程短的患者肾上腺素（p<0.05）和舒张压变化更大。只有两名患者（糖尿病病程<2年）出汗正常，而两组患者体温变化极小。总之，由于出汗和肾上腺髓质反应减弱，胰岛素依赖型糖尿病患者对低血糖的体温调节反应受损。
