Chemical Diabetes in Childhood: Integrated Concentrations of Glucose, Insulin, and Growth Hormone

Children and adolescents with varying degrees of glucose intolerance were studied with constant, blood withdrawal methods, and concentrations of glucose, insulin, and growth hormone were evaluated during a normal twenty-four-hour routine. Integrated concentrations of glucose and insulin in children with chemical diabetes were normal despite abnormal oral glucose–tolerance tests. All but two insulin–dependent diabetics had elevated integrated concentrations of growth hormone, as did some but not all chemical diabetics. Three of four mildly ketoacidotic individuals with newly diagnosed diabetes, who were studied before insulin therapy, had normal growth hormone–integrated concentrations. These data differentiate pharmacologic and physiologic assessments of carbohydrate homeostasis, and they support the concept that elevated growth hormone concentrations may not be a direct result of poor diabetic control.