Role of glucagon and other hormones in development of diabetic ketoacidosis.

Blood concentrations of pancreatic glucagon, cortisol, noradrenaline, adrenaline, and growth hormone have been measured during the first 41 hours of insulin deprivation in six insulin-dependent diabetics to assess the importance of these hormones in the pathogenesis of diabetic ketoacidosis. Plasma-glucagon showed an early small significant rise and thereafter a slow increase to a plateau during the remaining experimental period. Plasma-cortisol increased only at the end of the insulin-deprivation period, while plasma-catecholamines and serum-growth-hormone concentrations did not change. In the three of the six patients who developed significant ketosis, plasma-glucagon showed a close correlation with blood-ketones and plasma-free-fatty-acids while for the whole group the change in glucagon concentration correlated significantly with the rise in ketone-body concentration. It is suggested that the excess of glucagon in addition to the insulin lack may be an important factor in determining the degree of hyperglycaemia had hyperketonaemia in the early stages of insulin deprivation.