Early posthypoglycemic insulin resistance in man is mainly an effect of b-adrenergic stimulation

The insulin effect following hypoglycemia was studied with the euglycemic clamp technique in seven healthy subjects. Following an initial euglycemic clamp hypoglycemia was induced and after glucose recovery a second clamp was performed. Glucose pro-duction (R.) and utilization (Rd) were studied with 13-3Hlglucose. Each subject was studied four times; during infusion of placebo, propranolol, somatostatin, and a control study where hypogly-cemia was prevented. Hypoglycemia induced an insulin resistance with a lower steady state glucose infusion rate following the hypoglycemia during placebo as compared to the control study (2.5±0.5 and 4.8±1.0 mg/kg min, respectively, P < 0.05). The insulin resis-tance was due to an attenuated insulin effect on both inhibition of R. (impaired by 37%) and stimulation of Rd (impaired by 61%). The insulin-antagonistic effect was completely prevented by propranolol but only partly by somatostatin. Thus, early posthypoglycemic insulin resistance (2.5-3.5 h after hypoglycemia) is a sustained effect mainly due to,-adren-ergic stimulation