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Brain Behav Immun. 2018 Oct;73:41-50. doi: 10.1016/j.bbi.2018.05.003. Epub 2018 May 4.

The effect of insulin-induced hypoglycemia on inflammatory markers: A systematic review.

Author information

1
Servico de Endocrinologia do Hospital das Clinicas da Universidade Federal de Minas Gerais, Brazil. Electronic address: juliana.drummond@ebserh.gov.br.
2
Laboratorio Interdisciplinar de Investigacao Medica, Faculdade de Medicina, UFMG, Belo Horizonte, Brazil.
3
Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, USA.
4
Laboratorio Interdisciplinar de Investigacao Medica, Faculdade de Medicina, UFMG, Belo Horizonte, Brazil; Immunopsychiatry Laboratory & Neuropsychiatry Program, Department of Psychiatry & Behavioral Science, McGovern Medical School, University of Texas Health Science Center at Houston, USA.

Abstract

INTRODUCTION:

The effects of acute hypoglycemia on markers of inflammation have been investigated, but the results have been heterogeneous.

OBJECTIVE:

We aimed to perform a systematic review about the acute effects of insulin-induced hypoglycemia on inflammatory markers in patients with diabetes as well as non-diabetic subjects.

METHODS:

A systematic search of the literature using the electronic databases MEDLINE and SCOPUS was conducted through September 2017. Search terms included: "hypoglycemia"," insulin", "cytokines", and "inflammation". We included original studies assessing peripheral inflammatory markers during insulin-induced hypoglycemia in humans.

RESULTS:

Two hundred twenty-two citations were initially retrieved. Eleven studies were included in our systematic review. Acute hypoglycemia increases total leukocyte number and several pro-inflammatory markers. Elevation in pro-inflammatory markers in response to insulin-induced acute hypoglycemia appears to be of similar magnitude in non-diabetic subjects and in type-1 diabetic patients with intact awareness of hypoglycemia. Adrenaline rises in response to acute hypoglycemia correlates with the increase of pro-inflammatory markers.

CONCLUSION:

Acute hypoglycemia induces a pro-inflammatory state in both type-1 diabetic and non-diabetic subjects with no apparent significant difference between these two populations. Activation of the sympathetic nervous system is a likely mediator of these effects.

KEYWORDS:

Hypoglycemia; Inflammation; Insulin

PMID:
29733946
DOI:
10.1016/j.bbi.2018.05.003
[Indexed for MEDLINE]

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