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Alcohol Causes Hypoglycemia by Boosting Islet Blood Flow and Insulin Output

Posted: Tuesday, January 15, 2008

Ethanol intake is well known as a potential cause of hypoglycemia in diabetic patients and now new findings from an animal study shed light on the mechanisms involved. 

Lead author Dr. Ake Sjoholm, from the Karolinska Institute in Stockholm, states that, the findings show that alcohol produces "a massive redistribution of blood flow within the pancreas."

Using various techniques, Dr. Sjoholm along with Dr. Zhen Huang, also from the Karolinska Institute, showed that pancreatic islet blood flow is increased by about fourfold in rats after an injection of ethanol. Whole pancreatic blood flow, by contrast, was not affected.

"The magnitude of the alcohol effect on islet blood flow surprised us," Dr. Sjoholm said. Ethanol injection also amplified insulin secretion and resulted in hypoglycemia.

Further experiments showed that these effects were prevented by a nitric oxide synthase inhibitor and by atropine.
Summing up, the investigators write: "Our findings demonstrate that ethanol acutely exerts substantial influences on pancreatic microcirculation by evoking a massive redistribution of pancreatic blood flow from the exocrine into the endocrine part via mechanisms mediated by nitric oxide and vagal stimuli."

Practice Pearl: "Clinicians should advise their diabetic patients (or patients with liver problems) to be very careful with alcohol, especially if they are also treated with hypoglycemic sulfonylureas since these drugs may potentiate the alcohol effect," Dr. Sjoholm emphasized. 

Source: Diabetes In Control: Endocrinology Jan, 2008;149:232-236.

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