Table 1.
Summary of procedures used to reproduce the HAAF phenomenon in diabetic and nondiabetic humans.
| Subjects | Fasting condition | Insulin dose used to induce antecedent hypoglycaemia | Insulin dose used to induce subsequent hypoglycaemia | Depth and duration of antecedent hypoglycaemia | Method of glucose assay | Number of antecedent episodes | Plasma adrenaline in response to antecedent/subsequent hypoglycaemia (in pg/mL) and method of assay | Symptom scores during subsequent hypoglycaemia relative to that of antecedent hypoglycaemia |
|---|---|---|---|---|---|---|---|---|
| Type 1 diabetes patients [14–17] | Overnight fasted prior to all days of experiments [16, 17] Overnight fasted prior to subsequent episode [14, 15] |
1-2 mU/kg/min [14–17] | 1-2 mU/kg/min [14–17] | 2.2–3.3 mmol/L [14–17] 1.5–2 hrs [14, 16, 17] |
Glucose dehydrogenase method [15] Glucose oxidase method [14, 16, 17] |
1/day for 1 day [14, 16] 2/day for 1 day [17] 1/day for 4 days [15] |
380/200; p = 0.0060 [14] 187/75; p < 0.05 [17] 817/545; p < 0.05 [15] 300/200; p = 0.0397 [16] HPLC [15] RIA [14, 16, 17] |
Reduced neurogenic symptoms and neuroglycopenic symptoms p < 0.05–0.001 [14, 15] Not measured [17] No significant change [16] |
|
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| Type 2 diabetes patients [18] | Overnight fasted prior to all days of experiments [18] | 1-2 mU/kg/min [18] | 1-2 mU/kg/min [18] | 2.2–3.3 mmol/L [18] 1.5–2 hrs [18] |
Glucose oxidase method [18] | 2/day for 1 day [18] | No significant change in insulin treated patients p = 0.07 [18] RIA [18] |
Reduced neurogenic symptoms and neuroglycopenic symptoms p < 0.05–0.001 [18] |
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| Nondiabetic subjects [19–27] | Nonfasted [24] Overnight fasted prior to all days of experiments [19–25, 27] |
1-2 mU/kg/min [19–27] | 1-2 mU/kg/min [19–27] | 2.2–2.8 mmol/L [21–24] 2.9–3.3 mmol/L [19, 20, 23, 25, 27] 40 min–2 hrs [20, 21, 23–26] 3 hrs [22] |
Glucose oxidase method [20–23, 25, 27] HemoCue handheld device [24, 26] |
1/day for 1 day [19] 2/day for 1 day followed by 1/day on day 2 [21] 2/day for 1 day [22–27] 1/day for 1 day followed by interval interprandial hypoglycaemia [20] |
300–500/150–250; p < 0.05–0.001 [20–22, 25] 800–1000/350–500; p < 0.05–0.01 [19, 23, 26, 27] No significant change [24] HPLC [21, 22, 24, 26, 27] RIA [20, 23] |
Not measured [23, 25, 27] No significant change [22] Reduced neuroglycopenic symptoms p < 0.04; no significant change in neurogenic symptoms [24] Reduced neurogenic symptoms and neuroglycopenic symptoms; p < 0.05–0.001 [19–21] |
RIA: radioimmunoassay; HPLC: high-performance liquid chromatography.