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October 14, 1968

Irreversible Hypoglycemia: A Complication of Alcohol and Insulin

Author Affiliations

From the Thorndike Memorial Laboratory; the Second and Fourth (Harvard) Medical Services, Boston City Hospital; and the Department of Medicine, Harvard Medical School.

JAMA. 1968;206(3):575-578. doi:10.1001/jama.1968.03150030031006

The glucose-lowering action of alcohol augments that of other hypoglycemic agents and may induce severe hypoglycemia with irreversible neurological changes. Five insulin-dependent diabetics were hospitalized with severe hypoglycemia after an alcohol debauch. Three of the five had permanent damage to the nervous system, while the other two patients died without recovery from initial coma. Infusion of alcohol during a standard insulin tolerance test in six healthy subjects inhibited the usual rebound of glucose after hypoglycemia. Alcohol interferes with hepatic glyconeogenesis and induces hypoglycemia whenever giyconeogenesis is required to maintain normal glucose levels. Diabetics receiving other hypoglycemic agents should be warned about the blood glucose-lowering action of alcohol.