Mechanisms of Hypoglycemia Associated Autonomic Dysfunction, Q4-Atomoxetine

The purpose of this study is to see if the drug atomoxetine (Strattera) has effects on the
body's ability to defend itself against low blood sugar. Normally, when blood sugar levels
drop below normal, the body creates a series of responses, which increase the sugar inside
the body to bring blood sugar levels back to normal. The hormone epinephrine is a key defense
against low blood sugar in people with diabetes. Atomoxetine has been shown to increase this
hormone level. Thus, any approaches to increase levels of this key defense during low blood
sugar may have great value.

Inclusion Criteria:

- Healthy individuals aged 18-50 years

- Type 1 Diabetes individuals aged 18-50 years

- BMI <40 kg/m2

- Females of childbearing potential with negative urine pregnancy test

- Volunteers over 40 years of age, a cardiac stress test with no clinically significant
conduction or ischemic changes

Exclusion Criteria:

The following groups of subjects will be excluded from the study:

- Pregnant women

- Subjects unable to give voluntary informed consent

- Subjects on anticoagulant drugs or with known bleeding diatheses

- Subjects with uncontrolled hypertension, heart disease, cerebrovascular incidents

- Subjects taking MAOIs

- Subjects with narrow angle glaucoma

- Subjects with diagnosed psychiatric disorders

- Subjects with allergy to atomoxetine, heparin, or lidocaine

Physical Exam Exclusion Criteria:

- Uncontrolled severe hypertension (i.e., blood pressure greater than 150/95)

- Clinically significant Cardiac Abnormalities (e.g. Heart Failure, Arrhythmias,
ischemic tachycardia, S-T segment deviations, etc.) from history or from cardiac
stress testing in subjects > 40 years old.

- Pneumonia

- Hepatic Failure/Jaundice

- Renal Failure

- Acute Cerebrovascular/ Neurological deficit

- Fever greater than 38.0 C

Screening Laboratory Tests Exclusion Criteria Blood values as defined in protocol