| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Articles in PresS, published online ahead of print December 11, 2001
Am J Physiol Endocrinol Metab, 10.1152/ajpendo.00447.2001
Submitted on October 4, 2001
Accepted on December 4, 2001
1 Division of Endocrinology, Diabetes and Metabolism, Washington University School of Medicine, St. Louis, MO, USA
* To whom correspondence should be addressed. E-mail: pcryer{at}imgate.wustl.edu.
We tested the hypothesis that increased endogenous cortisol secretion reduces autonomic neuroendocrine and neurogenic symptom responses to subsequent hypoglycemia. Twelve healthy young adults were studied on two separate occasions, once following infusions of a pharmacological dose of 
1-24 ACTH (100 µg/h) from 0930 to 1200h and 1330 to 1600h (which raised plasma cortisol levels to ~45 µg/dL) on Day 1 and once following saline infusions on Day 1. Hyperinsulinemic (2.0 mU.kg-1.min.) stepped hypoglycemic clamps (90, 75, 65, 55 and 45 mg/dL glucose steps) were performed on the morning of Day 2 on both occasions. These markedly elevated antecedent endogenous cortisol levels reduced the adrenomedullary (P = 0.004, final plasma epinephrine levels of 489 ± 64 v. 816 ± 13 pg/mL), sympathetic neural (P = 0.0022, final plasma norepinephrine levels of 244 ± 15 v. 342 ± 22 pg/mL), parasympathetic neural ( P = 0.0434, final plasma pancreatic polypeptide levels of 312 ± 37 v. 424 ± 56 pg/mL) and neurogenic (autonomic) symptom (P = 0.0097, final symptom score of 7.1 ± 1.5 v. 10.6 ± 1.6) responses to subsequent hypoglycemia. Growth hormone, but not glucagon or cortisol, responses were also reduced. The findings that increased endogenous cortisol secretion reduces autonomic neuroendocrine and neurogenic symptom responses to subsequent hypoglycemia are potentially relevant to cortisol mediation of hypoglycemia-associated autonomic failure, and thus a vicious cycle of recurrent iatrogenic hypoglycemia, in people with diabetes mellitus.
This article has been cited by other articles:
|
|
 |
|
  P. E. Cryer Exercise-Related Hypoglycemia-Associated Autonomic Failure in Diabetes Diabetes, September 1, 2009; 58(9): 1951 - 1952. [Full Text] [PDF]
|
|
|
|
 |
|
 B. Montalvan and M. Duclos Why glucocorticoids ought to be kept on the World Antidoping Agency's list of banned products Br. J. Sports Med., December 1, 2008; 42(12): 946 - 947. [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Gustavson, D. A. Sandoval, A. C. Ertl, S. Bao, S. R. Raj, and S. N. Davis Stimulation of both type I and type II corticosteroid receptors blunts counterregulatory responses to subsequent hypoglycemia in healthy man Am J Physiol Endocrinol Metab, March 1, 2008; 294(3): E506 - E512. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. C. Tkacs and H. J. Thompson From bedside to bench and back again: research issues in animal models of human disease. Biol Res Nurs, July 1, 2006; 8(1): 78 - 88. [Abstract] [PDF]
|
|
|
|
|
|
D. A. Sandoval, D. L. Aftab Guy, M. A. Richardson, A. C. Ertl, and S. N. Davis Acute, same-day effects of antecedent exercise on counterregulatory responses to subsequent hypoglycemia in type 1 diabetes mellitus Am J Physiol Endocrinol Metab, June 1, 2006; 290(6): E1331 - E1338. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. E. Cryer Mechanisms of Hypoglycemia-Associated Autonomic Failure and Its Component Syndromes in Diabetes Diabetes, December 1, 2005; 54(12): 3592 - 3601. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Sandoval, L. Ping, R. A. Neill, B. Gong, K. Walsh, and S. N. Davis Brain region-dependent effects of dexamethasone on counterregulatory responses to hypoglycemia in conscious rats Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2005; 288(2): R413 - R419. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Sandoval, D. L. A. Guy, M. A. Richardson, A. C. Ertl, and S. N. Davis Effects of Low and Moderate Antecedent Exercise on Counterregulatory Responses to Subsequent Hypoglycemia in Type 1 Diabetes Diabetes, July 1, 2004; 53(7): 1798 - 1806. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. E. Cryer Diverse Causes of Hypoglycemia-Associated Autonomic Failure in Diabetes N. Engl. J. Med., May 27, 2004; 350(22): 2272 - 2279. [Full Text] [PDF]
|
|
|
|
|
|
D. A. Sandoval, L. Ping, A. R. Neill, S. Morrey, and S. N. Davis Cortisol Acts Through Central Mechanisms to Blunt Counterregulatory Responses to Hypoglycemia in Conscious Rats Diabetes, September 1, 2003; 52(9): 2198 - 2204. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. E. Flanagan, T. Keshavarz, M. L. Evans, S. Flanagan, X. Fan, R. J. Jacob, and R. S. Sherwin Role of Corticotrophin-Releasing Hormone in the Impairment of Counterregulatory Responses to Hypoglycemia Diabetes, March 1, 2003; 52(3): 605 - 613. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Visit Other APS Journals Online |
