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  • Title: Desensitization of the platelet aggregation response to adrenaline during insulin-induced hypoglycaemia in man.
    Author: Trovati M, Anfossi G, Mularoni E, Massucco P, Cavalot F, Mattiello L, Emanuelli G.
    Journal: Diabet Med; 1990 Jun; 7(5):414-9. PubMed ID: 2142038.
    Abstract:
    The aim of the present study was to investigate the influence of insulin-induced hypoglycaemia on platelet sensitivity to adrenaline and non-adrenergic agonists in man. Twenty-five healthy male subjects volunteered for the study. To evaluate the effects on platelets of different insulin-adrenaline interrelationships, two experimental models were used. In the first, hypoglycaemia was induced by a 60-min IV infusion of human insulin at the rate of 64 mU m-2 min-1, whereas in the other the same insulin dose was administered as an IV bolus (3.84 U m-2). Throughout the studies, plasma glucose, insulin, and adrenaline were measured together with platelet sensitivity to adrenaline, ADP, platelet activating factor, collagen, and sodium arachidonate. In both studies, hypoglycaemia induced a reduction of platelet sensitivity to adrenaline (p = 0.006 in infusion and p = 0.045 in injection study). In particular, maximal aggregation to adrenaline fell from 47.9 +/- 9.9 (+/- SE) to 31.1 +/- 11.3% at the hypoglycaemic nadir in the infusion study, and from 64.6 +/- 8.2 to 34.6 +/- 10.3% at the hypoglycaemic nadir in the injection study. In the injection study an increase of platelet sensitivity to ADP (p = 0.05), platelet activating factor (p = 0.018), sodium arachidonate (p = 0.035), and collagen (p = 0.027) was also found, in agreement with observations already published using the infusion protocol. Thus, insulin-induced hypoglycaemia increases platelet sensitivity to non-adrenergic agonists and decreases platelet response to adrenaline.
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