CoChat
Sign Up
Cited by 295Hyperglycemia and glycemic control in critically ill and hospitalized patientsPancreatic function and diabetesDiabetes Management and Research

Synergistic Interactions among Antiinsulin Hormones in the Pathogenesis of Stress Hyperglycemia in Humans*

SHAMOON, HARRY, HENDLER, ROSA, SHERWIN, ROBERT S.·1981·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem-52-6-1235
Open this paper in CoChat — free account

Abstract

We infused epinephrine, glucagon, and cortisol in combination into health overnight-fasted subjects in doses designed to simulate changes in severe stress. When all three hormones were infused simultaneously, glucose levels rose above 200 mg/dl in spite of a 100-200% increase in plasma insulin. In contrast, infusion of each hormone individually produced either a mild (less than 120 mg/dl) or a transient elevation in the plasma glucose concentration. With the combined hormone infusion, the increment in plasma glucose was 3-fold greater than the sum of the responses to the individual hormones (P less than 0.001). The marked hyperglycemia in this setting is a result of ongoing glucose overproduction which is stimulated by epinephrine and glucagon and sustained by cortisol. Furthermore, epinephrine (and possibly cortisol) inhibited glucose disposal despite concomitant hyperinsulinemia. In contrast to their effects on glucose regulation, the simultaneous infusion of epinephrine, glucagon, and cortisol failed to cause hyperketonemia. We conclude that the combined infusion of epinephrine, glucagon, and cortisol produces a greater than additive hyperglycemic response in normal humans. These data suggest that the clinical occurrence of fasting hyperglycemia in a setting of hypersecretion of multiple antiinsulin hormones (stress hyperglycemia) may result, at least in part, from synergistic interactions among these hormones.

Integrity signals

Registry

Crossref · 10.1210/jcem-52-6-1235

Cites

3 of 3 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
SHAMOON, H., HENDLER, R., & SHERWIN, R. S.
Affiliations
Yale University (US)
ORCID
SHAMOON, HARRY
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1981-06
Volume
52
Issue
6
Pages
1235-1241
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem-52-6-1235
OpenAlex
W2171532347
Cited by
295
References
3
Citations by year
2026: 3 · 2025: 14 · 2024: 11 · 2023: 4 · 2022: 6 · 2021: 8 · 2019: 1 · 2018: 5 · 2017: 1 · 2016: 6 · 2015: 7 · 2013: 5 · 2012: 6
FWCI
7.99
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
stress hyperglycemia, epinephrine, glucagon, cortisol, synergistic hormone interaction, glucose disposal, hyperinsulinemia, hyperketonemia, fasting hyperglycemia
MeSH terms
Adult, Blood Glucose, Drug Synergism, Epinephrine, Female, Glucagon, Humans, Hydrocortisone, Hyperglycemia, Insulin, Kinetics, Male

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 ›

Are you an author, or do you see a problem with this page? Request a review