Comparative Evaluation of Responsiveness of Insulin Counter-Regulatory Hormones and Insulin Resistance to Hypoglycemia in Newly Diagnosed Type 1 Diabetes Mellitus Man

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Aim: The mechanisms governing dynamic regulation of counterregulatory hormones in type 1 diabetes (T1DM) remain incompletely understood. To eliminate potential confounding effects of female sex hormones and menstrual cycle variations on insulin sensitivity and counter-regulatory hormone secretion, this study investigated the correlation between counter-regulatory hormone levels and insulin resistance in male patients with T1DM. Research Design and Methods: From March 2022 to December 2022, 34 male patients with newly diagnosed T1DM and 8 male normal people without DM were included. Counter-regulatory hormone levels and clinical characteristics were collected. All the included T1DM subjects were treated with intensive insulin therapy by insulin pump for 1 week to achieve glycemic control, followed by using the hyperinsulinemic-hypoglycemic clamp to determine the steady-state glucose infusion rate, an indicator of insulin sensitivity. The chemiluminescent immunometric assay was also used to measure circulating counter-regulatory hormones, such as glucagon (GCG), insulin-like growth factor-1 (IGF-1), adrenocorticotropic hormone (ACTH), growth hormone (GH), and cortisol (Cor) at 0min and 30min during hyperinsulinemic-hypoglycemic test. Correlation analysis was conducted to investigate the relationship between insulin-stimulated glucose disposal rates (M value) and counter-regulatory hormone levels. Results: The T1DM group exhibited lower fasting C-peptide levels than the normal group (p<0.050). During the hypoglycemic clamp test and in the hypoglycemic state, the T1DM group showed a greater magnitude of increase in Cor and GH levels than the control group, whereas GCG displayed an opposite trend. Moreover, the M value was negatively correlated with ACTH, COR, and GH, and positively correlated with IGF-1 in male patients with newly diagnosed T1DM. Conclusion: The current study demonstrates that inhibiting the upregulation of insulin counter-regulatory hormone levels contributes to impaired insulin regurgitator response during hypoglycaemia in newly man diagnosed T1DM patients. This study provides insight into the glycaemic control benefits of insulin counter-regulatory hormones, and insulin counter-regulatory hormone levels may serve as a potential biomarker for assessing the blood glucose control risk of T1DM. Trial Registration: This trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT05290207).

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