Subnormal pancreatic polypeptide and epinephrine responses to insulin-induced hypoglycemia identify patients with insulin-dependent diabetes mellitus predisposed to develop overt autonomic neuropathy

F. P. Kennedy, V. L.W. Go, P. E. Cryer, G. B. Bolli, J. E. Gerich

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Sixteen patients with insulin-dependent diabetes mellitus with no current evidence of autonomic dysfunction underwent an insulin tolerance test during which plasma pancreatic polypeptide and epinephrine responses were determined. Compared to 11 age- and weight-matched nondiabetic volunteers, 9 diabetic subjects had subnormal plasma epinephrine responses (n = 6) or plasma epinephrine responses (n = 8). When autonomic function was reassessed 2 to 3 years later by standard cardiovascular reflex tests and clinical examination, 8 of 9 diabetic subjects with subnormal hormonal responses did (P < 0.01). Diminished pancreatic polypeptide and epinephrine responses to hypoglycemia developed either abnormal cardiovascular reflexes (6 of 9) or overt symptoms consistent with diabetic autonomic neuropathy (6 of 9), whereas none of the subjects with previously normal plasma pancreatic polypeptide and epinephrine responses to hypoglycemia can predict the development of overt autonomic neuropathy in patients with insulin-dependent diabetes mellitus; identification of patients with a predilection to develop autonomic neuropathy may permit earlier treatment.

Original languageEnglish
Pages (from-to)54-58
Number of pages5
JournalAnnals of internal medicine
Volume108
Issue number1
DOIs
StatePublished - 1988

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