Glucagon response to insulin hypoglycemia was tested in diabetics with autonomic neuropathy (N=9), diabetics without neuropathy (N=8), and normals (N=9). With similar levels of hypoglycemia, growth hormone and plasma cortisol increased in all groups. The glucagon response in normals (121 ± 19 vs. 308 ± 30 pg./ml., mean ± S. E. M. of baseline vs. hypoglycemia peak) was significantly less in nonneuropathic diabetics than in normals (128 ± 13 vs. 209 ± 30) and absent in neuropathic diabetics (128 ± 23 vs. 115 ± 20). Arginine stimulation produced a glucagon response in the neuropathic diabetics (106 ± 16 vs. 523 ± 103). The data indicate that the capacity to release glucagon during hypoglycemia is lost in diabetic neuropathy while glucagon responsiveness to arginine is retained. Neuropathy in diabetes may contribute to metabolic instability.
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Original Contributions|
March 01 1977
Lack of Glucagon Response to Hypoglycemia in Diabetic Autonomic Neuropathy
Thomas D Maker, MD;
Thomas D Maker, MD
Department of Medicine, University of Minnesota School of Medicine
Minneapolis, Minnesota
St. Paul- Ramsey Hospital and Medical Center
St. Paul, Minnesota
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Robert J Tanenberg, MD;
Robert J Tanenberg, MD
Department of Medicine, University of Minnesota School of Medicine
Minneapolis, Minnesota
St. Paul- Ramsey Hospital and Medical Center
St. Paul, Minnesota
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Beryl Z Greenberg, MS;
Beryl Z Greenberg, MS
Department of Medicine, University of Minnesota School of Medicine
Minneapolis, Minnesota
St. Paul- Ramsey Hospital and Medical Center
St. Paul, Minnesota
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James E Hoffman, MD;
James E Hoffman, MD
Department of Medicine, University of Minnesota School of Medicine
Minneapolis, Minnesota
St. Paul- Ramsey Hospital and Medical Center
St. Paul, Minnesota
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Richard P Doe, MD, PhD;
Richard P Doe, MD, PhD
Department of Medicine, University of Minnesota School of Medicine
Minneapolis, Minnesota
St. Paul- Ramsey Hospital and Medical Center
St. Paul, Minnesota
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Frederick C Goetz, MD
Frederick C Goetz, MD
Department of Medicine, University of Minnesota School of Medicine
Minneapolis, Minnesota
St. Paul- Ramsey Hospital and Medical Center
St. Paul, Minnesota
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Address reprint requests to Thomas D. Maher, M. D., 188 Genesee St., Auburn, New York 13021.
Citation
Thomas D Maker, Robert J Tanenberg, Beryl Z Greenberg, James E Hoffman, Richard P Doe, Frederick C Goetz; Lack of Glucagon Response to Hypoglycemia in Diabetic Autonomic Neuropathy. Diabetes 1 March 1977; 26 (3): 196–200. https://doi.org/10.2337/diab.26.3.196
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