Role of cortisol in the pathogenesis of deficient counterregulation after antecedent hypoglycemia in normal humans
Open accessAbstract
The aim of this study was to determine the role of increased plasma cortisol levels in the pathogenesis of hypoglycemia-associated autonomic failure. Experiments were carried out on 16 lean, healthy, overnight fasted male subjects. One group (n = 8) underwent two separate, 2-d randomized experiments separated by at least 2 mo. On day 1 insulin was infused at a rate of 1.5 mU/kg per min and 2 h clamped hypoglycemia (53 +/- 2 mg/dl) or euglycemia (93 +/- 3 mg/dl) was obtained during morning and afternoon. The next morning subjects underwent a 2-h hyperinsulinemic (1.5 mU/kg per min) hypoglycemic (53 +/- 2 mg/dl) clamp study. In the other group (n = 8), day 1 consisted of morning and afternoon 2-h clamped hyperinsulinemic euglycemia with cortisol infused to stimulate levels of plasma cortisol occurring during clamped hypoglycemia (53 mg/dl). The next morning (day 2) subjects underwent a 2-h hyperinsulinemic hypoglycemic clamp identical to the first group. Despite equivalent day 2 plasma glucose and insulin levels, steady state epinephrine, norepinephrine, pancreatic polypeptide, glucagon, ACTH and muscle sympathetic nerve activity (MSNA) values were significantly (R < 0.01) blunted after day 1 cortisol infusion compared to antecedent euglycemia. Compared to day 1 cortisol, antecedent hypoglycemia produced similar blunted day 2 responses of epinephrine, norepinephrine, pancreatic polypeptide and MSNA compared to day 1 cortisol. Antecedent hypoglycemia, however, produced a more pronounced blunting of plasma glucagon, ACTH, and hepatic glucose production compared to day 1 cortisol. We conclude that in healthy overnight fasted men (a) antecedent physiologic increases of plasma cortisol can significantly blunt epinephrine, norepinephrine, glucagon, and MSNA responses to subsequent hypoglycemia and (b) these data suggest that increased plasma cortisol is the mechanism responsible for antecedent hypoglycemia causing hypoglycemia associated autonomic failure.
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Previous observations show that cortisol concentrations increase from baseline during hyperinsulinemic euglycemic clamp experiments in dogs and humans.
“The finding that supraphysiological hyperinsulinemia acutely stimulates HPA secretory activity during euglycemia agrees with previous observations that cortisol concentrations increase from baseline during hyperinsulinemic euglycemic clamp experiments in dogs (19) and in humans (20, 21).”
From Supraphysiological Hyperinsulinemia Acutely Increases Hypothalamic-Pituitary-Adrenal Secretory Activity in Humans (1999) · cites this paper as [20]
Recent antecedent hypoglycemic episodes cause a defective counterregulation by reducing epinephrine levels.
“The concept of hypoglycemia unawareness also includes that recent antecedent hypoglycemic episodes cause a defective counterregulation by reducing epinephrine levels.”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [30]
A prior elevation of cortisol levels and recurrent hypoglycemia lead to an attenuation of counterregulatory response to subsequent hypoglycemia.
“A prior elevation of cortisol levels and recurrent hypoglycemia lead to an attenuation of counterregulatory response to subsequent hypoglycemia.”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [30]
After recent antecedent hypoglycemia, epinephrine levels are significantly reduced.
“After recent antecedent hypoglycemia, epinephrine levels are significantly reduced ( Figure 2 ) [ 19 , 30 ].”
From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [30]
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Cites
THE PREPARATION OF 131I-LABELLED HUMAN GROWTH HORMONE OF HIGH SPECIFIC RADIOACTIVITY
Greenwood, F., Hunter, W., & GLOVER, J. S. (1963) · Biochemical Journal · doi:10.1042/bj0890114 · Cited by 10,178 · see citing works
Glucose clamp technique: a method for quantifying insulin secretion and resistance.
DeFronzo, R. A., Tobin, J. D., & Andres, R. (1979) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1979.237.3.e214 · Cited by 7,425 · see citing works
Preparation of Iodine-131 Labelled Human Growth Hormone of High Specific Activity
Hunter, W. M., & Greenwood, F. C. (1962) · Nature · doi:10.1038/194495a0 · Cited by 6,945 · see citing works
β-Endorphin and Adrenocorticotropin Are Selected Concomitantly by the Pituitary Gland
Guillemin, R., Vargo, T., Rossier, J., Minick, S., Ling, N., Rivier, C., Vale, W., & Bloom, F. (1977) · Science · doi:10.1126/science.197601 · Cited by 1,419 · see citing works
Hyperinsulinemia produces both sympathetic neural activation and vasodilation in normal humans.
Anderson, E. A., Hoffman, R. P., Balon, T. W., Sinkey, C. A., & Mark, A. L. (1991) · Journal of Clinical Investigation · doi:10.1172/jci115260 · Cited by 1,075 · see citing works
Gerich, J. E., Langlois, M., Noacco, C., Karam, J. H., & Forsham, P. H. (1973) · Science · doi:10.1126/science.182.4108.171 · Cited by 688 · see citing works
de Kloet, E. R., & Reul, J. M. H. M. (1987) · Psychoneuroendocrinology · doi:10.1016/0306-4530(87)90040-0 · Cited by 598 · see citing works
Lloyd, B. B., Burrin, J. M., Smythe, P., & Alberti, K. G. M. M. (1978) · Clinical Chemistry · doi:10.1093/clinchem/24.10.1724 · Cited by 579 · see citing works
Abumrad, N. N., Rabin, D. D., Diamond, M. P., & LACY, W. W. (1981) · Metabolism · doi:10.1016/0026-0495(81)90074-3 · Cited by 569 · see citing works
Radioimmunoassay of proteins with the use of Sephadex-coupled antibodies
WIDE, L. E., & Porath, J. O. (1966) · Biochimica et Biophysica Acta (BBA) - General Subjects · doi:10.1016/0304-4165(66)90032-8 · Cited by 555 · see citing works
Finegood, D. T., Bergman, R. N., & Vranić, M. (1987) · Diabetes · doi:10.2337/diab.36.8.914 · Cited by 546 · see citing works
Pancreatic Glucagon Secretion in Normal and Diabetic Subjects
Aguilar-Parada, E., Eisentraut, A. M., & Unger, R. H. (1969) · The American Journal of the Medical Sciences · doi:10.1097/00000441-196906000-00008 · Cited by 538 · see citing works
Heller, S. R., & Cryer, P. E. (1991) · Diabetes · doi:10.2337/diab.40.2.223 · Cited by 531 · see citing works
Dagogo-Jack, S. E., Craft, S., & Cryer, P. E. (1993) · Journal of Clinical Investigation · doi:10.1172/jci116302 · Cited by 471 · see citing works
A model of the kinetics of insulin in man
Sherwin, R. S., Kramer, K. J., Tobin, J. D., Insel, P. A., Liljenquist, J. E., Berman, M., & Andres, R. (1974) · Journal of Clinical Investigation · doi:10.1172/jci107697 · Cited by 460 · see citing works
Differences in Corticosterone and Dexamethasone Binding to Rat Brain and Pituitary<sup>1</sup>
DE KLOET, R., WALLACH, G., & McEWEN, B. S. (1975) · Endocrinology · doi:10.1210/endo-96-3-598 · Cited by 453 · see citing works
Radiochemical assay of long-chain fatty acids using 63Ni as tracer
Ho, R.-J. (1970) · Analytical Biochemistry · doi:10.1016/0003-2697(70)90337-4 · Cited by 380 · see citing works
Plasma noradrenaline correlates to sympathetic muscle nerve activity in normotensive man
WALLIN, B. G., SUNDLÖF, G., ERIKSSON, B., DOMINIAK, P., GROBECKER, H., & LINDBLAD, L. E. (1981) · Acta Physiologica Scandinavica · doi:10.1111/j.1748-1716.1981.tb06706.x · Cited by 316 · see citing works
Peripheral Sympathetic Neural Activity in Conscious Humans
Wallin, B. G., & Fagius, J. (1988) · Annual Review of Physiology · doi:10.1146/annurev.ph.50.030188.003025 · Cited by 293 · see citing works
The Adrenal Cortex and the Sympathetic Nervous System
RAMEY, E. R., & Goldstein, M. S. (1957) · Physiological Reviews · doi:10.1152/physrev.1957.37.2.155 · Cited by 265 · see citing works
Kerrigan, J. R., Veldhuis, J. D., Leyo, S. A., Iranmanesh, A., & Rogol, A. D. (1993) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.76.6.8501158 · Cited by 228 · see citing works
Cryer, P. E. (1992) · Diabetes · doi:10.2337/diab.41.3.255 · Cited by 222 · see citing works
Reversibility of unawareness of hypoglycemia in patients with insulinomas.
Mitrakou, A., Fanelli, C., Veneman, T., Perriello, G., Calderone, S., Platanisiotis, D., Rambotti, A., Raptis, S., Brunetti, P., Cryer, P., et al. (1993) · New England Journal of Medicine · doi:10.1056/nejm199309163291203 · Cited by 221 · see citing works
Effect of glucagon on glucose production during insulin deficiency in the dog.
Cherrington, A. D., LACY, W. W., & Chiasson, J. L. (1978) · Journal of Clinical Investigation · doi:10.1172/jci109174 · Cited by 213 · see citing works
Induction of Hypoglycemia Unawareness by Asymptomatic Nocturnal Hypoglycemia
Veneman, T. F., Mitrakou, A., Mokáň, M., Cryer, P., & Gerich, J. E. (1993) · Diabetes · doi:10.2337/diab.42.9.1233 · Cited by 211 · see citing works
Role of Brain in Counterregulation of Insulin-Induced Hypoglycemia in Dogs
Biggers, D. W., Myers, S. R., Neal, D. W., Stinson, R. L., Cooper, N. B., Jaspan, J. B., Williams, P. E., Cherrington, A. D., & Frizzell, R. T. (1989) · Diabetes · doi:10.2337/diab.38.1.7 · Cited by 192 · see citing works
Květňanský, R., Fukuhara, K., Pacák, K., Cizza, G., Goldstein, D. S., & Kopin, I. J. (1993) · Endocrinology · doi:10.1210/endo.133.3.8396019 · Cited by 184 · see citing works
Effect of Insulin on Utilization and Production of Circulating Glucose
Wall, J. S., Steele, R., de Bodo, R. C., & ALTSZULER, N. (1957) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1957.189.1.43 · Cited by 180 · see citing works
PATTERNS OF ACTH AND CORTISOL PULSATILITY OVER TWENTY‐FOUR HOURS IN NORMAL MALES AND FEMALES
Horrocks, P. M., Jones, A. F., RATCLIFFE, W. A., Holder, G., White, A. E., Holder, R. L., Ratcliffe, J. G., & LONDON, D. R. (1990) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1990.tb03758.x · Cited by 175 · see citing works
Mechanisms of dexamethasone-induced insulin resistance in healthy humans
Tappy, L., Randin, D., Vollenweider, P., Vollenweider, L., Paquot, N., Scherrer, U., Schneiter, P., NICOD, P. H., & Jéquier, E. (1994) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.79.4.7962275 · Cited by 166 · see citing works
Assay of plasma catecholamines by liquid chromatography with electrochemical detection
Causon, R. C., Carruthers, M. E., & Rodnight, R. (1981) · Analytical Biochemistry · doi:10.1016/0003-2697(81)90347-x · Cited by 163 · see citing works
Hypoglycemia-Associated Autonomic Failure in Insulin-Dependent Diabetes Mellitus
Cryer, P. E. (1997) · Advances in pharmacology · doi:10.1016/s1054-3589(08)60827-3 · Cited by 162 · see citing works
Adrenergic Modulation of Pancreatic Glucagon Secretion in Man
Gerich, J. E., Langlois, M., Noacco, C., Schneider, V. B., & Forsham, P. H. (1974) · Journal of Clinical Investigation · doi:10.1172/jci107692 · Cited by 144 · see citing works
Counterregulatory adaptation to recurrent hypoglycemia in normal humans
DAVIS, M. R., & SHAMOON, H. (1991) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-73-5-995 · Cited by 143 · see citing works
Heller, S. R., & Cryer, P. E. (1991) · Diabetes · doi:10.2337/diabetes.40.2.223 · Cited by 120 · see citing works
Glucagon response to hypoglycemia in sympathectomized man.
Palmer, J. P., Henry, D. P., Benson, J. W., Johnson, D. G., & Ensinck, J. W. (1976) · Journal of Clinical Investigation · doi:10.1172/jci108305 · Cited by 110 · see citing works
Intermittent Hypoglycemia Impairs Glucose Counterregulation
Widom, B., & Simonson, D. C. (1992) · Diabetes · doi:10.2337/diab.41.12.1597 · Cited by 109 · see citing works
Corticosteroid Receptor Types in Brain: Regulation and Putative Functiona
de Kloet, E. R., Ratka, A., Reul, J. M. H. M., Sutanto, W., & EEKELEN, J. A. M. V. (1987) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1987.tb24973.x · Cited by 102 · see citing works
Glucocorticoid suppression of the sympathetic nervous system and adrenal medulla
Brown, M. R., & Fisher, L. A. (1986) · Life Sciences · doi:10.1016/0024-3205(86)90289-4 · Cited by 101 · see citing works
Further defects in counterregulatory responses induced by recurrent hypoglycemia in IDDM.
Davis, M. R., Mellman, M., & Shamoon, H. (1992) · Diabetes · doi:10.2337/diab.41.10.1335 · Cited by 98 · see citing works
Bradbury, M. J., Akana, S. F., Cascio, C. S., Levin, N., Jacobson, L., & Dallman, M. F. (1991) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/0960-0760(91)90176-6 · Cited by 96 · see citing works
VAGAL CONTROL OF GLUCAGON RELEASE IN MAN
Bloom, S. R., Vaughan, N. J. A., & Russell, R. C. G. (1974) · The Lancet · doi:10.1016/s0140-6736(74)91875-3 · Cited by 85 · see citing works
Powell, A. M., Sherwin, R. S., & Shulman, G. I. (1993) · Journal of Clinical Investigation · doi:10.1172/jci116883 · Cited by 73 · see citing works
Sympathetic Outflow in Human Muscle Nerves Increases During Hypoglycemia
Fagius, J., Niklasson, F., & Berne, C. (1986) · Diabetes · doi:10.2337/diab.35.10.1124 · Cited by 71 · see citing works
Catecholamine-glucocorticoid interactions during surgical stress
Udelsman, R., Goldstein, D. S., Loriaux, D. L., & Chrousos, G. P. (1987) · Journal of Surgical Research · doi:10.1016/0022-4804(87)90128-4 · Cited by 68 · see citing works
Induction of hypoglycemia unawareness by asymptomatic nocturnal hypoglycemia
Veneman, T. F., Mitrakou, A., Mokán, M., et al. (1993) · Diabetes · doi:10.2337/diabetes.42.9.1233 · Cited by 60 · see citing works
Gans, R. O. B., Bilo, H. J. G., MAARSCHALKERWEERD, W. W. A. V., Heine, R. J., Nauta, J. J. P., & Donker, A. J. M. (1991) · Journal of Clinical Investigation · doi:10.1172/jci115333 · Cited by 57 · see citing works
Deficient Counterregulatory Hormone Responses during Hypoglycemia in a Patient with Insulinoma*
DAVIS, M. R., & Shamoon, H. (1991) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-72-4-788 · Cited by 56 · see citing works
Differential glucocorticoid effects on catecholamine responses to stress
Komesaroff, P. A., & Funder, J. W. (1994) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1994.266.1.e118 · Cited by 54 · see citing works
Predominance of renal and absence of hepatic metabolism of pancreatic polypeptide in the dog
Hagopian, W., Lever, E. G., Cohen, D., Emmanouel, D. S., Polonsky, K. S., Pugh, W., Moossa, A. R., & Jaspan, J. B. (1983) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1983.245.2.e171 · Cited by 54 · see citing works
Role of brain in counterregulation of insulin-induced hypoglycemia in dogs
Biggers, D. W., Myers, S. R., Neal, D. W., et al. (1989) · Diabetes · doi:10.2337/diabetes.38.1.7 · Cited by 50 · see citing works
Feo, P. D., Bolli, G. B., Perriello, G., Cosmo, S. D., Compagnucci, P., Angeletti, G., Santeusanio, F., Gerich, J. E., Motulese, M., & Brunetti, P. (1983) · Diabetes · doi:10.2337/diab.32.10.887 · Cited by 46 · see citing works
Powell, A. M., & Sherwin, R. S. (1993) · Cited by 34 · see citing works
Intermittent hypoglycemia impairs glucose counterregulation
Widom, B., & Simonson, D. C. (1992) · Diabetes · doi:10.2337/diabetes.41.12.1597 · Cited by 34 · see citing works
Changes of sympathetic nerve activity induced by 2-deoxy-D-glucose infusion in humans
Fagius, J., & Berne, C. (1989) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1989.256.6.e714 · Cited by 33 · see citing works
Evidence for Reversibility of Defective Counterregulation in a Patient with Insulinoma
Maran, A., Taylor, J., Macdonald, I. A., & Amiel, S. A. (1992) · Diabetic Medicine · doi:10.1111/j.1464-5491.1992.tb01889.x · Cited by 32 · see citing works
Further defects in counterregulatory responses induced by recurrent hypoglycemia in IDDM
Davis, M. R., Mellman, M. J., & Shamoon, H. (1992) · Diabetes · doi:10.2337/diabetes.41.10.1335 · Cited by 31 · see citing works
Indices of sympathetic vascular innervation in sympathectomized patients
Goldstein, D. S., Bonner, R. F., Zimlichman, R., Zahn, T. P., Cannon, R. O., Rosing, D. R., Stull, R., & Keiser, H. R. (1986) · Journal of the Autonomic Nervous System · doi:10.1016/0165-1838(86)90017-2 · Cited by 30 · see citing works
Nicholson, W. E., DeCherney, G. S., Jackson, R. V., et al. (1987) · Regulatory Peptides · doi:10.1016/0167-0115(87)90006-1 · Cited by 29 · see citing works
Hypoqlycemia Increases Muscle Sympathetic Nerve Activity in IDDM and Control Subjects
Hoffman, R. P., Sinkey, C. A., & Anderson, E. A. (1994) · Diabetes Care · doi:10.2337/diacare.17.7.673 · Cited by 29 · see citing works
Plasma catecholamines in rats exposed to cold: Effects of ganglionic and adrenoreceptor blockade
Picotti, G. B., Carruba, M. O., Ravazzani, C., Cesura, A. M., Galva, M. D., & Prada, M. D. (1981) · European Journal of Pharmacology · doi:10.1016/0014-2999(81)90478-7 · Cited by 29 · see citing works
Sympathetic outflow in human muscle nerves increases during hypoglycemia
Fagius, J., Niklasson, F., & Berne, C. (1986) · Diabetes · doi:10.2337/diabetes.35.10.1124 · Cited by 20 · see citing works
Differential effect of glucocorticoids on abdominal pain induced by morphine
Roberts‐Thomson, I. C., Jonsson, J. R., Pannall, P. R., Taylor, W. B., & Frewin, D. B. (1991) · Pain · doi:10.1016/0304-3959(91)90067-8 · Cited by 9 · see citing works
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The selfish brain: Competition for energy resources
Peters, A., Schweiger, U., Pellerin, L., Hubold, C., Oltmanns, K. M., Conrad, M., Schultes, B., Born, J., & Fehm, H. L. (2004) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2004.03.002 · Cited by 489 · see citing works
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Cryer, P. E. (2004) · New England Journal of Medicine · doi:10.1056/nejmra031354 · Cited by 411 · see citing works
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Mosqueda-Garcia, R., Furlan, R., Fernandez-Violante, R., Desai, T., Snell, M., Jarai, Z., Ananthram, V, Robertson, R. M., & Robertson, D. (1997) · Journal of Clinical Investigation · doi:10.1172/jci119463 · Cited by 255 · see citing works
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Tesfaye, N., & Seaquist, E. R. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2010.05820.x · Cited by 164 · see citing works
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Taborsky, G. J., & Mundinger, T. O. (2012) · Endocrinology · doi:10.1210/en.2011-2040 · Cited by 140 · see citing works
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Fritsche, A., Stefan, N., Häring, H., Gerich, J., & Stumvoll, M. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-9_part_1-200105010-00009 · Cited by 98 · see citing works
Davis, S. N., Mann, S., Galassetti, P., Neill, R. A., Tate, D., Ertl, A. C., & Costa, F. (2000) · Diabetes · doi:10.2337/diabetes.49.11.1897 · Cited by 100 · see citing works
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Fruehwald-Schultes, B., Kern, W., Bong, W., Wellhoener, P., Kerner, W., Born, J., Fehm, H. L., & Peters, A. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.9.5953 · Cited by 75 · see citing works
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- Authors
- Davis, S. N., Shavers, C., Costa, F., & Mosqueda-Garcia, R.
- Affiliations
- Vanderbilt University (US)
- ORCID
- Davis, S N
- Venue
- Journal of Clinical Investigation
- Published
- 1996-08-01
- Volume
- 98
- Issue
- 3
- Pages
- 680-691
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC507477
- OpenAlex
- W2073955935
- Cited by
- 173
- References
- 63
- Citations by year
- 2026: 3 · 2024: 1 · 2023: 1 · 2022: 5 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 5 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 7 · 2012: 3
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01dk045369-05, 3p60am020593-07s1)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK 45369)
- National Center for Research Resources (M01RR000095, M01-RR-00095)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- cortisol, hypoglycemia-associated autonomic failure, epinephrine, norepinephrine, glucagon, ACTH, pancreatic polypeptide, muscle sympathetic nerve activity, hepatic glucose production, hyperinsulinemic hypoglycemic clamp
- MeSH terms
- Adrenocorticotropic Hormone, Adult, Autonomic Nervous System Diseases, Glucagon, Glucose, Humans, Hydrocortisone, Hypoglycemia, Insulin, Male, Muscles
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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