Intuitively, I understand that ADH (Anti Diuretic Hormone) is responsible for maintaining osmolarity, and increased serum osmolarity is a stimulatory factor for its release-- ADH increases water reabsorbtion in the collecting ducts and DCT (Distal Convoluted tubule) of nephrons, thus decreasing the osmolarity back to normal.

But, apparently, (insulin induced) hypoglycemia also stimulates ADH secretion.

If it were hyperglycemia, it could be explained on the basis of increased osmolarity, as I have done above. I originally assumed it was a mistake in the standard book, but a quick Google search revealed several papers confirming what the book states. I still couldn't find an explanation though, most of these articles just state the observation.

Here are two of them:

  1. https://www.jci.org/articles/view/114626#:~:text=JCI%20-%20Insulin-induced%20hypoglycemia%20stimulates,blood%20of%20conscious%2C%20unrestrained%20rams.

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC296631/

Both of these also point out that Insulin Induced Hypoglycemia causes an increase in ACTH secretion. (I am not sure if that is relevant here, though.)

Also, does "insulin induced" hypoglycemia have an added significance over hypoglycemia?


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