Hypoglycaemia induces a sustained pro-inflammatory response in people with type 1 diabetes and healthy controls

Aim: To determine the duration and the extension of the pro-inflammatory response to hypoglycaemia both in people with type 1 diabetes and healthy controls. Materials and Methods: Adults with type 1 diabetes (n = 47) and matched controls (n = 16) underwent a hyperinsulinaemic-euglycaemic hypoglycaemic (2.8 +/- 0.1 mmoL/L [49.9 +/- 2.3 mg/dL]) glucose clamp. During euglycaemia, hypoglycaemia, and 1, 3 and 7 days later, blood was drawn to determine immune cell phenotype, monocyte function and circulating inflammatory markers. Results: Hypoglycaemia increased lymphocyte and monocyte counts, which remained elevated for 1 week. The proportion of CD16(+) monocytes increased and the proportion of CD14(+) monocytes decreased. During hypoglycaemia, monocytes released more tumour necrosis factor-a and interleukin-1 beta, and less interleukin-10, after ex vivo stimulation. Hypoglycaemia increased the levels of 19 circulating inflammatory proteins, including high sensitive C-reactive protein, most of which remained elevated for 1 week. The epinephrine peak in response to hypoglycaemia was positively correlated with immune cell number and phenotype, but not with the proteomic response. Conclusions: Overall, despite differences in prior exposure to hypoglycaemia, the pattern of the inflammatory responses to hypoglycaemia did not differ between people with type 1 diabetes and healthy controls. In conclusion, hypoglycaemia induces a range of pro-inflammatory responses that are sustained for at least 1 week in people with type 1 diabetes and healthy controls.

Automated summary

The aim of this study was to determine the duration and extent of the inflammatory response to hypoglycemia in individuals with type 1 diabetes and healthy controls. The results showed that hypoglycemia increased the counts of lymphocytes and monocytes, which remained elevated for one week. In addition, hypoglycemia also led to an increase in the release of pro-inflammatory cytokines and an elevation of circulating inflammatory proteins, both of which lasted for at least one week.