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Contribution of cortisol to glucose counterregulation in humans
Abstract
To test the hypothesis that cortisol secretion plays a counterregulatory role in hypoglycemia in humans, four studies were performed in eight normal subjects. In all studies, insulin (15 mU.m-2.min-1) was infused subcutaneously (plasma insulin 27 +/- 1 microU/ml). In study 1, plasma glucose concentration and glucose fluxes [( 3-3H]glucose), substrate, and counterregulatory hormone concentrations were simply monitored, and plasma glucose decreased from 89 +/- 2 to 52 +/- 2 mg/dl for 12 h. In study 2, (pituitary-adrenal-pancreatic clamp), insulin and counterregulatory hormone secretion (except for catecholamines) was prevented by somatostatin (0.5 mg/h, iv) and metyrapone (0.5 g/4 h, per os), and glucagon, cortisol, and growth hormone were infused to reproduce the concentrations of study 1. In study 3 (lack of cortisol increase), the pituitary-adrenal-pancreatic clamp was performed with maintenance of plasma cortisol at basal levels, and glucose was infused, whenever needed, to reproduce plasma glucose concentration of study 2. Study 4 was identical to study 3, but exogenous glucose was not infused. Isolated lack of cortisol increase caused a approximately 22% decrease in hepatic glucose production (P less than 0.01) and a approximately 15% increase in peripheral glucose utilization (P less than 0.01), which resulted in greater hypoglycemia (37 +/- 2 vs. 52 +/- 2 mg/dl, P less than 0.01) despite compensatory increases in plasma epinephrine. Lack of cortisol response also reduce…
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“Cortisol has a key role in glucose homeostasis, particularly in the counter-regulatory mechanisms to prevent hypoglycaemia in times of biological stress.”
From Hypoglycaemia in adrenal insufficiency (2023) · cites this paper as [11]
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Metadata
- Authors
- De Feo, P., Perriello, G., Torlone, E., Ventura, M. M., Fanelli, C., Santeusanio, F., Brunetti, P., Gerich, J. E., & Bolli, G. B.
- Affiliations
- Istituto di Patologia Medica, Universita di Perugia, Italy.
- University of Perugia (IT)
- Venue
- American Journal of Physiology-Endocrinology and Metabolism
- Publisher
- American Physiological Society
- Published
- 1989-07-01
- Volume
- 257
- Issue
- 1
- Pages
- E35-E42
- ISSN
- 0193-1849 (ISSN-L)
- 1522-1555
- OpenAlex
- W1952942405
- Cited by
- 134
- References
- 21
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 4 · 2016: 6 · 2015: 1 · 2014: 5 · 2013: 9 · 2012: 1
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physiology-Endocrinology and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-20411)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Keywords
- cortisol, glucose counterregulation, hypoglycemia, hepatic glucose production, peripheral glucose utilization, lipolysis, epinephrine, somatostatin, metyrapone, glucagon, growth hormone, free fatty acids, beta-hydroxybutyrate, glycerol, insulin-induced hypoglycemia
- MeSH terms
- Adult, Alanine, Blood Glucose, C-Peptide, Epinephrine, Fatty Acids, Nonesterified, Female, Glucagon, Glycerol, Humans, Hydrocortisone, Hydroxybutyrates, Insulin, Kinetics, Lactates, Male, Portal Vein, Growth Hormone, Lactic Acid, 3-Hydroxybutyric Acid
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