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Influence of Small Increments of Epinephrine on Glucose Tolerance in Normal Humans

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Grant support: in part by grants AM 20495 and RR 125 from the National Institutes of Health. Dr. Sherwin is the recipient of a Research Development Award (AM 00334) from the National Institutes of Health.

▸Requests for reprints should be addressed to Robert S. Sherwin, M.D.; Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street; New Haven, CT 06510.

New Haven, Connecticut

© 1980 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1980;93(4):566-568. doi:10.7326/0003-4819-93-4-566
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To ascertain whether small elevations of epinephrine alter glucose tolerance, we infused epinephrine or saline into seven healthy volunteers for 5 hours. Two hours after starting the infusions, subjects ingested 100 g of glucose. Plasma epinephrine (basal 23 ± 4 pg/mL) rose during epinephrine infusion to levels (75 to 80 pg/mL) similar to those observed in nine outpatients presenting with mild viral illnesses (66 ± 8 pg/mL). Although epinephrine produced only a small (5 mg/dL) increase in plasma glucose before glucose ingestion, after oral glucose the levels of glucose increased by 30 to 60 mg/dL above saline control values (163 ± 14 mg/dL versus 108 ± 15 at 2 h,p < 0.005). This diabetogenic effect occurred despite two-fold higher insulin levels and normal suppression of plasma glucagon. We conclude that small physiologic increments of epinephrine, which cause minimal changes in fasting plasma glucose, produce a marked reduction in glucose tolerance. Our data suggest marked sensitivity to the insulin antagonistic effects of epinephrine and may provide a mechanism for stressinduced glucose intolerance.


epinephrine ; glucose





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