Hypothalamic-pituitary-adrenal response to different tests in type 1 diabetes mellitus

Summary, in English

OBJECTIVE: To determine whether different tests of the adrenocorticotropic hormone (ACTH) reserve are influenced by diabetic state and metabolic control in newly diagnosed type 1 diabetic patients. DESIGN AND METHODS: We evaluated the ACTH reserve in 10 patients with uncomplicated type 1 diabetes during periods of poor and improved metabolic control and in 10 healthy subjects. The ACTH-cortisol secretion was assessed by a diurnal profile, an intravenous corticotropin-releasing hormone (CRH) test and an insulin tolerance test (ITT). RESULTS: The diurnal profiles were similar in all groups. CRH resulted in a diminished ACTH response during poor compared with improved metabolic control (mean+/-SD) (AUC 4950+/-4227 vs. 5847+/-3788 ng/L min, p<0.05). The response in the diabetic patients during improved metabolic control was of the same magnitude as in the control subjects (5934+/-1778 ng/L x min). ITT elicited a similar ACTH and cortisol response in the diabetic patients during poor and improved metabolic control as in the healthy control subjects. CONCLUSIONS: The ITT was uninfluenced by diabetic state and metabolic control and should therefore be considered the method of choice in evaluation of the ACTH reserve in patients with type 1 diabetes.

• Author: E G Almqvist; Leif Groop; P J Manhem
• Department/s: Translational Muscle Research
• Publishing year: 2001
• Language: English
• Pages: 557-565
• Publication/Series: Scandinavian Journal of Clinical & Laboratory Investigation
• Volume: 61
• Issue: 7
• Links: http://dx.doi.org/10.1080/003655101753218328
• Document type: Journal article
• Publisher: Informa Healthcare
• Topic: Endocrinology and Diabetes
• Keywords: Corticotropin-RELEASING; Acth; Hormone; Cortisol; Hypoglycaemia; Insulin; Pituitary-ADRENAL; Function; Tests
• Status: Published
• Research group: Genomics, Diabetes and Endocrinology
• ISBN/ISSN/Other: ISSN: 1502-7686