Role for autonomic nervous system to increase pancreatic glucagon secretion during marked insulin-induced hypoglycemia in dogs

PJ Havel, RC Veith, BE Dunning, GJ Taborsky Jr - Diabetes, 1991 - Am Diabetes Assoc
PJ Havel, RC Veith, BE Dunning, GJ Taborsky Jr
Diabetes, 1991Am Diabetes Assoc
To determine the role of the autonomic nervous system (ANS) in mediating the glucagon
response to marked insulin-induced hypoglycemia in dogs, we measured arterial and
pancreatic venous glucagon responses to insulin-induced hypoglycemia during acute,
terminal experiments in halothane-anesthetized dogs in which the ANS was intact (control;
n= 9), pharmacologically blocked by the nicotinic ganglionic antagonist hexamethonium (n=
6), or surgically ablated by cervical vagotomy and cervical spinal cord section (n= 6). In …
To determine the role of the autonomic nervous system (ANS) in mediating the glucagon response to marked insulin-induced hypoglycemia in dogs, we measured arterial and pancreatic venous glucagon responses to insulin-induced hypoglycemia during acute, terminal experiments in halothane-anesthetized dogs in which the ANS was intact (control; n = 9), pharmacologically blocked by the nicotinic ganglionic antagonist hexamethonium (n = 6), or surgically ablated by cervical vagotomy and cervical spinal cord section (n = 6). In control dogs, insulin injection caused plasma glucose to fall by 4.4 ± 0.2 mM to a nadir of 1.7 ± 0.2 mM. Arterial epinephrine (EPI) levels increased by 13,980 ± 1860 pM (P < 0.005), confirming marked activation of the ANS. Pancreatic output of glucagon increased from 0.53 ± 0.12 to 2.04 ± 0.38 ng/min during hypoglycemia (change [Δ] + 1.51 ± 0.33 ng/min, P < 0.005). This increased arterial plasma glucagon from 27 ± 3 to 80 ± 15 ng/L (Δ + 52 ± 14 ng/L, P < 0.025). Hexamethonium markedly reduced the ANS response to insulin injection (ΔEPI + 2130 ± 600 pM, P < 0.025 vs. control) despite a similar fall of plasma glucose (Δ −4.1 ± 0.2 mM) and a lower nadir (0.6 ± 0.1 mM). Both the pancreatic glucagon response (delta glucagon output +0.45 ± 0.2 ng/min) and the arterial immunoreactive glucagon response (Δ + 5 ± 4 ng/L) were substantially reduced by hexamethonium (P < 0.025). Vagotomy plus spinal cord section totally abolished the arterial EPI response to insulin injection despite a larger fall of plasma glucose (Δ −5.4 ± 0.4 mM) and a lower nadir (0.9 ± 0.2 mM). Again, both the pancreatic glucagon response (Δglucagon output +0.27 ± 0.23 ng min) and the arterial glucagon response (Δ +5 ± 2 ng/L) were significantly reduced (both P < 0.025 vs. control). We conclude that autonomic activation contributes to the glucagon response to marked insulin-induced hypoglycemia in dogs.
Am Diabetes Assoc