Effect of Fasting on Hypoglycemic Counterregulation in Type 1 Diabetes

Summary

Iatrogenic hypoglycemia is still considered to be the number one barrier to effective glycemic control in patients with type 1 diabetes (T1D). In a previous study, it was observed in people without diabetes that fasting can be detrimental to the hormonal and hepatic responses to insulin-induced hypoglycemia. In the experiments described herein, the impact fasting has on hypoglycemic counterregulation in people with T1D will be determined.

Eligibility

Inclusion Criteria:

* males and females of any race or ethnicity
* non-obese (BMI \< or = to 30)
* have a diagnosis of type 1 diabetes
* C-peptide negative

Exclusion Criteria:

* pregnant women
* cigarette smoking
* Taking inflammation-targeting steroids (e.g., prednisone).
* Taking medications targeting adrenergic signaling (e.g., beta-blockers, bronchodilators).
* Hematocrit less than 33%.
* Presence of HIV or hepatitis (due to their deleterious effects on the liver).
* The presence of cardiovascular or peripheral vascular disease.
* The presence of neuropathy, retinopathy or nephropathy.
* A detection of the presence of any other disease or condition by one of the study doctors, that would be expected to confound the responses to insulin-induced hypoglycemia or make participation in the study dangerous to the individual.

Conditions4

Locations1 site

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