Hypoglycaemia, hypothermia and shivering in man.

1. The present experiments were designed to elucidate the reasons for the fall in central body temperature during hypoglycaemia. 2. The first experiment was carried out at a room temperature of 25 degrees C on 11 male subjects. Hypoglycaemia was induced by infusion of insulin. Heat production (calculated from respiratory gas exchange) rose from a baseline of 5.10 +/- 0.13 kJ/min (mean +/- SEM) to a peak of 6.25 +/- 0.21 kJ/min (P less than 0.001), but core temperature fell concurrently by 0.51 +/- 0.08 degrees C and skin temperature fell by 1.1 +/- 0.2 degrees C. The net heat loss was due to peripheral vasodilatation and sweating. 3. To determine the effect of insulin-induced hypoglycaemia on thermoregulation in a cool environment, the experiment was repeated at a room temperature of 18-19 degrees C on five of the subjects who had air blown over them until shivering was sustained. During this time heat production rose to 10.13 +/- 1.67 kJ/min, but core temperature remained constant. Shivering stopped as plasma glucose fell below 2.5 mmol/l during insulin infusion and the subjects said they no longer felt cold. 4. During hypoglycaemia in the cold peripheral vasodilatation and sweating occurred, skin temperature fell by up to 0.8 degrees C and core temperature fell below 35 degrees C, so subjects had to be rewarmed. 5. Recovery of plasma glucose after hypoglycaemia in the cold was impaired at low body temperatures, but shivering was restored within seconds when glucose was given intravenously.

[1]  S. Welle,et al.  Thermoregulatory and related responses to 2-deoxy-D-glucose administration in humans. , 1980, The American journal of physiology.

[2]  J. Weiner,et al.  A PHYSIOLOGICAL BODY-COOLING UNIT FOR TREATMENT OF HEAT STROKE , 1980, The Lancet.

[3]  K. Lindros,et al.  Ethanol‐induced hypoglycaemia in man: its suppression by the alcohol dehydrogenase inhibitor 4‐methylpyrazole , 1977, European journal of clinical investigation.

[4]  E. B. French,et al.  Studies of the peripheral vasodilator response to acute insulin-induced hypoglycaemia in man. , 1974, Clinical science and molecular medicine.

[5]  W R Keatinge,et al.  Failure of thermoregulation in the cold during hypoglycaemia induced by exercise and ethanol , 1973, The Journal of physiology.

[6]  R H Fox,et al.  A new method for monitoring deep body temperature from the skin surface. , 1973, Clinical science.

[7]  I. Roddie,et al.  The role of circulating catecholamines in sweat production in man , 1972, The Journal of physiology.

[8]  B. Metzger,et al.  The hypothermia of hypoglycemia. Studies with 2-deoxy-D-glucose in normal human subjects and mice. , 1972, The New England journal of medicine.

[9]  R. Needham,et al.  Bradykinin in forearm venous blood during sweating. , 1971, The Journal of physiology.

[10]  B. Wharton.  Hypoglycaemia in children with kwashiorkor. , 1970, Lancet.

[11]  N. Freinkel,et al.  ALCOHOL HYPOGLYCEMIA. I. CARBOHYDRATE METABOLISM OF PATIENTS WITH CLINICAL ALCOHOL HYPOGLYCEMIA AND THE EXPERIMENTAL REPRODUCTION OF THE SYNDROME WITH PURE ETHANOL. , 1963, The Journal of clinical investigation.

[12]  M. Allwood,et al.  Muscle and skin blood flow in the human forearm during insulin hypoglycaemia , 1959, The Journal of physiology.

[13]  R. H. Fox,et al.  Bradykinin formation in human skin as a factor in heat vasodilatation , 1958, The Journal of physiology.

[14]  M. Allwood,et al.  The effect of insulin hypoglycaemia on blood flow in intact and sympathectomized extremities in man , 1957, The Journal of physiology.

[15]  R. J. Whitney,et al.  The measurement of volume changes in human limbs , 1953, The Journal of physiology.

[16]  H. Sheehan,et al.  Treatment of Hypopituitary Coma , 1952, British medical journal.

[17]  J. B. Weir.  New methods for calculating metabolic rate with special reference to protein metabolism , 1949, The Journal of physiology.

[18]  E. Gellhorn.  EFFECTS OF HYPOGLYCEMIA AND ANOXIA ON THE CENTRAL NERVOUS SYSTEM: A BASIS FOR A RATIONAL THERAPY OF SCHIZOPHRENIA , 1938 .

[19]  E. Gellhorn.  OXYGEN DEFICIENCY, CARBON DIOXIDE AND TEMPERATURE REGULATION , 1937 .

[20]  E. Wiechmann.  DIFFICULTIES IN THE DIAGNOSIS OF INSULIN COMA , 1929 .

[21]  S. Dworkin,et al.  ARTIFICIAL HIBERNATION IN THE WOODCHUCK (ARCTOMYS MONAX) , 1927 .

[22]  S. Dworkin,et al.  THE ACTION OF INSULIN ON THE DOMESTIC FOWL , 1926 .

[23]  G. S. Eadie,et al.  THE EFFECT OF INSULIN ON THE RESPIRATORY EXCHANGE OF NORMAL ANIMALS , 1924 .