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Elevation of lactate(within a physiological range)substantially diminished catecholamines,growth hormone,cortisol,and symptomatic responses to hypoglycemia and lowered the glucose level at which these responses began. Glucagon responses were unaffected.Lactate was also associated with a significant lowering of the glucose level at which brain function deteriorated,suggesting that brain function was protected during the hypoglycemia.The defect in counter-regulation is similar to that seen in hypoglycemia-prone patients.Initiation of the protective responses to hypoglycemia(except glucagon)can be delayed by supporting metabolism with an alternative metabolic fuel.Cerebral cortical dysfunction of severe hypoglycemia is also delayed.Our demonstration that higher brain function can be protected during hypoglycemia may have therapeutic potential. |
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