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Published online March 10, 2008
Diabetes Care 31:1222-1223, 2008
DOI: 10.2337/dc07-2243
© 2008 by the American Diabetes Association
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Pathophysiology/Complications
Original Research

Hypoglycemia Increases Serum Interleukin-6 Levels in Healthy Men and Women

Sarah Dotson, BA1, Roy Freeman, MD2, Hannah J. Failing, BA1 and Gail K. Adler, MD, PHD1

1 Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
2 Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

Corresponding author: Gail K. Adler, MD, PhD, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, 221 Longwood Ave., Boston, MA 02115. E-mail: gadler{at}partners.org

OBJECTIVE—Inflammation may have a major role in the pathogenesis and prognosis of critical illness. Hyperglycemia increases levels of the inflammatory cytokine interleukin-6 (IL-6) and is associated with increased risks of morbidity and mortality. Because hypoglycemia is also associated with adverse outcomes, we tested the hypothesis that hypoglycemia increases IL-6.

RESEARCH DESIGN AND METHODS—Seventeen healthy men and women participated in hypoglycemic and euglycemic-hyperinsulinemic clamp studies (target blood glucose levels 2.7 and 5.0 mmol/l, respectively), separated by 1–3 months. IL-6, ACTH, and cortisol were measured at baseline and at 45, 75, 105, and 135 min after initiation of the insulin infusion.

RESULTS—IL-6, ACTH, and cortisol levels increased significantly (P < 0.0001) during hypoglycemia but not euglycemia. IL-6 increased from mean ± SEM 1.0 ± 0.2 pg/ml at baseline to 2.6 ± 0.2 pg/ml after 135 min of hypoglycemia, whereas IL-6 levels were unchanged during euglycemia.

CONCLUSIONS—Hypoglycemia increases IL-6 levels in healthy individuals.

Abbreviations: HOMA, homeostasis model assessment • ICU, intensive care unit • IL-6, interleukin-6


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