The Effects of Exogenously Induced Hyperglucagonemia in Insulin-Treated Diabetics

Abstract

A recent report that the continuous intravenous infusion of glucagon failed to worsen hyperglycemia in two insulin-treated juvenile diabetics has raised doubts as to the importance of hyperglucagonemia in insulin-treated diabetics. To reexamine this, six juvenile type patients receiving a constant 28 to 50 U/day dose of regular insulin in five doses (before each of four meals and at 1:30 a. m.) were given glucagon subcutaneously for one or two days at 4-hour intervals (four patients) or 2-hour intervals (two patients), raising their mean plasma glucagon levels to an average of 590 ± 15 pg/ml. Mean plasma glucose concentration, measured at 2-hour intervals around the clock, rose from 231 ± 17 mg/dl on the control day to 285 ± 19 pg/ml (p <0.01) during glucagon administration. Glucose excretion rose significantly above the control value of 42 ± 7 gms per 24 hours to 145 ± 23 gms (p <0.01) and the excretion of urea nitrogen and ketones also increased significantly during glucagon administration (p <0.05; p <0.01, respectively). These data indicate that exogenous hyperglucagonemia can cause metabolic deterioration in insulin-treated diabetics.