Journal article
Prevention of Human Diabetic Ketoacidosis by Somatostatin: Evidence for an Essential Role of Glucagon
The New England journal of medicine, Vol.292(19), pp.985-989
05/08/1975
DOI: 10.1056/NEJM197505082921901
PMID: 804137
Abstract
To evaluate the role of glucagon in the pathogenesis of diabetic ketoacidosis in man, we studied the effect of suppression of glucagon secretion by somatostatin on changes in plasma β-hydroxybutyrate and glucose concentrations (as well as changes in their precursors) after acute withdrawal of insulin from seven patients with juvenile-type diabetes.
Suppression of glucagon secretion prevented the development of ketoacidosis for 18 hours after acute insulin withdrawal, whereas in control studies mild ketoacidosis occurred 10 hours after insulin was stopped. Plasma β-hydroxybutyrate, glucose, free fatty acid, and glycerol levels were all markedly lower during suppression of glucagon secretion (p < 0.001), whereas plasma alanine levels were higher (P<0.001).
These studies indicate that insulin lack per se does not lead to fulminant diabetic ketoacidosis in man and that glucagon, by means of its gluconeogenic, ketogenic, and lipolytic actions, is a prerequisite to the development of this condition. (N Engl J Med 292:985–989,1975)
HUMAN diabetic ketoacidosis is characterized by overproduction of glucose and ketone bodies in the liver
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and by excessive mobilization of free fatty acids from adipose tissue.
2
These metabolic derangements are thought to result primarily from severe insulin deficiency.
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Nevertheless, elevated levels of pancreatic glucagon, a hormone with gluconeogenic,
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ketogenic,
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,
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and lipolytic
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actions in man, are found in this condition,
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suggesting that glucagon excess may also be an important factor.
Recent observations in our laboratory support this concept.
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In patients with juvenile-type diabetes previously kept normoglycemic with prolonged infusions of insulin, plasma glucagon levels rose progressively beginning within one hour after . . .
Details
- Title: Subtitle
- Prevention of Human Diabetic Ketoacidosis by Somatostatin: Evidence for an Essential Role of Glucagon
- Creators
- John E GerichMara LorenziDennis M BierVictor SchneiderEva TsalikianJohn H KaramPeter H Forsham
- Resource Type
- Journal article
- Publication Details
- The New England journal of medicine, Vol.292(19), pp.985-989
- Publisher
- Massachusetts Medical Society
- DOI
- 10.1056/NEJM197505082921901
- PMID
- 804137
- ISSN
- 0028-4793
- eISSN
- 1533-4406
- Language
- English
- Date published
- 05/08/1975
- Academic Unit
- Stead Family Department of Pediatrics; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984093216702771
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