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February 25, 1974

Hypoglycemia and Body Temperature

Author Affiliations

From the Veterans Administration Hospital, Little Rock, Ark.

JAMA. 1974;227(8):916-921. doi:10.1001/jama.1974.03230210028006

Among 36 recumbent nude men exposed for two hours in a thermoneutral environment, insulin-induced hypoglycemia reduced rectal and tympanic temperatures by 0 to 2 C (3.60 F). Twelve patients experienced rectal cooling below 36 C (96.2 F) (lowest, 34.9 C [94.8 F]); 17 experienced tympanic membrane cooling below this limit of normothermia. Cooling was due to reduction in heat production and to secretion of sweat, peripheral vasodilatation, and hyperventilation. Temperatures below 36 C (96.2 F) neither inhibited sweating nor stimulated shivering. Seven patients showed negligible cooling; they and three others did not sweat. Hypoglycemia was the same in those who cooled as in those who did not. Sweating and hyperventilation ceased while hypoglycemia persisted. Cooling may be greater during summer than during winter, perhaps because heatacclimatized sweat glands discharge more sweat. Published evidence establishes that hyperthermia occurs when hypoglycemia is complicated by infection, dehydration, or cerebral edema.