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Hypothalamic-pituitary-adrenal response to different tests in type 1 diabetes mellitus

Almqvist, E G; Groop, Leif LU and Manhem, P J (2001) In Scandinavian Journal of Clinical & Laboratory Investigation 61(7). p.557-565
Abstract
OBJECTIVE: To determine whether different tests of the adrenocorticotropic hormone (ACTH) reserve are influenced by diabetic state and metabolic control in newly diagnosed type 1 diabetic patients. DESIGN AND METHODS: We evaluated the ACTH reserve in 10 patients with uncomplicated type 1 diabetes during periods of poor and improved metabolic control and in 10 healthy subjects. The ACTH-cortisol secretion was assessed by a diurnal profile, an intravenous corticotropin-releasing hormone (CRH) test and an insulin tolerance test (ITT). RESULTS: The diurnal profiles were similar in all groups. CRH resulted in a diminished ACTH response during poor compared with improved metabolic control (mean+/-SD) (AUC 4950+/-4227 vs. 5847+/-3788 ng/L min,... (More)
OBJECTIVE: To determine whether different tests of the adrenocorticotropic hormone (ACTH) reserve are influenced by diabetic state and metabolic control in newly diagnosed type 1 diabetic patients. DESIGN AND METHODS: We evaluated the ACTH reserve in 10 patients with uncomplicated type 1 diabetes during periods of poor and improved metabolic control and in 10 healthy subjects. The ACTH-cortisol secretion was assessed by a diurnal profile, an intravenous corticotropin-releasing hormone (CRH) test and an insulin tolerance test (ITT). RESULTS: The diurnal profiles were similar in all groups. CRH resulted in a diminished ACTH response during poor compared with improved metabolic control (mean+/-SD) (AUC 4950+/-4227 vs. 5847+/-3788 ng/L min, p<0.05). The response in the diabetic patients during improved metabolic control was of the same magnitude as in the control subjects (5934+/-1778 ng/L x min). ITT elicited a similar ACTH and cortisol response in the diabetic patients during poor and improved metabolic control as in the healthy control subjects. CONCLUSIONS: The ITT was uninfluenced by diabetic state and metabolic control and should therefore be considered the method of choice in evaluation of the ACTH reserve in patients with type 1 diabetes. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Corticotropin-RELEASING, Acth, Hormone, Cortisol, Hypoglycaemia, Insulin, Pituitary-ADRENAL, Function, Tests
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
61
issue
7
pages
557 - 565
publisher
Informa Healthcare
external identifiers
  • pmid:11763414
  • scopus:0035233634
ISSN
1502-7686
DOI
10.1080/003655101753218328
language
English
LU publication?
yes
id
42e56e70-8dbe-4a6a-be4b-0e98eb98c544 (old id 1122509)
date added to LUP
2008-06-23 14:56:13
date last changed
2018-01-07 09:51:50
@article{42e56e70-8dbe-4a6a-be4b-0e98eb98c544,
  abstract     = {OBJECTIVE: To determine whether different tests of the adrenocorticotropic hormone (ACTH) reserve are influenced by diabetic state and metabolic control in newly diagnosed type 1 diabetic patients. DESIGN AND METHODS: We evaluated the ACTH reserve in 10 patients with uncomplicated type 1 diabetes during periods of poor and improved metabolic control and in 10 healthy subjects. The ACTH-cortisol secretion was assessed by a diurnal profile, an intravenous corticotropin-releasing hormone (CRH) test and an insulin tolerance test (ITT). RESULTS: The diurnal profiles were similar in all groups. CRH resulted in a diminished ACTH response during poor compared with improved metabolic control (mean+/-SD) (AUC 4950+/-4227 vs. 5847+/-3788 ng/L min, p&lt;0.05). The response in the diabetic patients during improved metabolic control was of the same magnitude as in the control subjects (5934+/-1778 ng/L x min). ITT elicited a similar ACTH and cortisol response in the diabetic patients during poor and improved metabolic control as in the healthy control subjects. CONCLUSIONS: The ITT was uninfluenced by diabetic state and metabolic control and should therefore be considered the method of choice in evaluation of the ACTH reserve in patients with type 1 diabetes.},
  author       = {Almqvist, E G and Groop, Leif and Manhem, P J},
  issn         = {1502-7686},
  keyword      = {Corticotropin-RELEASING,Acth,Hormone,Cortisol,Hypoglycaemia,Insulin,Pituitary-ADRENAL,Function,Tests},
  language     = {eng},
  number       = {7},
  pages        = {557--565},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {Hypothalamic-pituitary-adrenal response to different tests in type 1 diabetes mellitus},
  url          = {http://dx.doi.org/10.1080/003655101753218328},
  volume       = {61},
  year         = {2001},
}