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已发表论文
新诊断1型糖尿病男性患者低血糖状态下胰岛素反调节激素反应性与胰岛素抵抗的比较评估
Authors Zhou Y, Zhou J, Ma J , Yan R, Yuan L, Huang R, Shen Y, Ding B
Received 22 July 2025
Accepted for publication 10 November 2025
Published 21 November 2025 Volume 2025:18 Pages 4309—4317
DOI https://doi.org/10.2147/DMSO.S554306
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Ernesto Maddaloni
Yunting Zhou,1,* Junming Zhou,2,* Jianhua Ma,1,* Rengna Yan,1 Lu Yuan,1 Rong Huang,1 Yun Shen,1 Bo Ding1
1Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China; 2Department of Healthcare, Jinling Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yun Shen, Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China, Email xiaoqianjin0721@aliyun.cn Bo Ding, Department of Endocrinology and Metabolism, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210012, People’s Republic of China, Fax +862552887091, Email dingbonanjing@sina.com
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).
Keywords: counter-regulatory hormone levels, insulin resistance, hyperinsulinemic-hypoglycemic clamp, type 1 diabetes mellitus, insulin-stimulated glucose disposal rates
1Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, People’s Republic of China; 2Department of Healthcare, Jinling Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yun Shen, Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China, Email xiaoqianjin0721@aliyun.cn Bo Ding, Department of Endocrinology and Metabolism, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210012, People’s Republic of China, Fax +862552887091, Email dingbonanjing@sina.com
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).
Keywords: counter-regulatory hormone levels, insulin resistance, hyperinsulinemic-hypoglycemic clamp, type 1 diabetes mellitus, insulin-stimulated glucose disposal rates