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GAIL K. ADLER, JOSEPH A. MAJZOUB, Influence of Infused Hypertonic Saline on the Response to Insulin-Induced Hypoglycemia in Man, The Journal of Clinical Endocrinology & Metabolism, Volume 65, Issue 1, 1 July 1987, Pages 116–121, https://doi.org/10.1210/jcem-65-1-116
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We studied the influence of a hypertonic saline infusion on the counterregulatory response to insulin-induced hypoglycemia in nine normal men. When given hypertonic saline, the men had less hypoglycemia in response to insulin, both acutely and in the recovery phase (P < 0.01), and released 34% more glucagon (P < 0.05) than when they were water loaded. The total integrated ACTH, cortisol, epinephrine, norepinephrine, and GH responses to hypoglycemia were similar after saline and water loading. After the saline load, the mean plasma vasopressin level rose from 11.0 ± 2.2 (±sem) to 20.9 ± 2.9 pg/mL in response to insulin-induced hypoglycemia. In contrast, after the water load, vasopressin levels were undetectable (<2 pg/mL) and they increased only to 2.6 ± 0.4 pg/mL with hypoglycemia. There was a significant positive correlation between basal plasma vasopressin and nadir glucose concentrations and a significant negative correlation between basal plasma vasopressin and the integrated fall in glucose after insulin administration (P < 0.01 and P < 0.025, respectively). The difference in the glycemic response to insulin may be related to the high vasopressin levels after saline loading, which could, either directly and/or through enhanced glucagon release, increase he-patic glucose production and thus limit the hypoglycemic response to insulin.
