Skip to main content
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1976 Feb;57(2):522–525. doi: 10.1172/JCI108305

Glucagon response to hypoglycemia in sympathectomized man.

J P Palmer, D P Henry, J W Benson, D G Johnson, J W Ensinck
PMCID: PMC436678  PMID: 1254731

Abstract

Hypoglycemia stimulates immunoreactive glucagon (IRG) secretion and increases the activity of the sympathetic nervous system. To ascertain if the augmented alpha cell activity evoked by glucopenia is mediated by the adrenergic nervous system, the glucagon response to insulin-induced hypoglycemia of five subjects with neurologically complete cervical transections resulting from trauma, thereby disrupting their hypothalamic sympathetic outflow, was compared to six healthy volunteers. In addition to clinical neurological evaluation, completeness of sympathectomy was verified by failure to raise plasma norepinephrine levels during hypoglycemia compared to the two- and threefold increase observed in controls. Total IRG response (IRG area above basal 0-90 min) and peak IRG levels achieved were the same in the quadriplegics and the controls. Although the glucagon rise tended to be slower, and the peak levels attained occurred later in the quadriplegic patients than in the controls, this response was appropriate for their sugar decline, which was slower and reached the nadir later than in the control subjects. These observations that the glucagon release during insulin-induced hypoglycemia is normal in subjects whose hypothalamic sympathetic outflow has been interrupted provide strong evidence that the sympathetic nervous system does not mediate the glucagon response to hypoglycemia.

Full text

PDF
524

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blackard W. G., Nelson N. C., Andrews S. S. Portal and peripheral vein immunoreactive glucagon concentrations after arginine or glucose infusions. Diabetes. 1974 Mar;23(3):199–202. doi: 10.2337/diab.23.3.199. [DOI] [PubMed] [Google Scholar]
  2. Brodows R. G., Pi-Sunyer F. X., Campbell R. G. Insulin secretion in adrenergic insufficiency in man. J Clin Endocrinol Metab. 1974 Jun;38(6):1103–1108. doi: 10.1210/jcem-38-6-1103. [DOI] [PubMed] [Google Scholar]
  3. Brodows R. G., Pi-Sunyer F. X., Campbell R. G. Neural control of counter-regulatory events during glucopenia in man. J Clin Invest. 1973 Aug;52(8):1841–1844. doi: 10.1172/JCI107366. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Christensen N. J., Iversen J. Release of large amounts of noradrenaline from the isolated perfused canine pancreas during glucose deprivation. Diabetologia. 1973 Oct;9(5):396–399. doi: 10.1007/BF01239435. [DOI] [PubMed] [Google Scholar]
  5. Christensen N. J. Plasma norepinephrine and epinephrine in untreated diabetics, during fasting and after insulin administration. Diabetes. 1974 Jan;23(1):1–8. doi: 10.2337/diab.23.1.1. [DOI] [PubMed] [Google Scholar]
  6. FRENCH E. B., KILPATRICK R. The role of adrenaline in hypoglycaemic reactions in man. Clin Sci. 1955 Nov;14(4):639–651. [PubMed] [Google Scholar]
  7. Felig P., Wahren J., Hendler R., Ahlborg G. Plasma glucagon levels in exercising man. N Engl J Med. 1972 Jul 27;287(4):184–185. doi: 10.1056/NEJM197207272870412. [DOI] [PubMed] [Google Scholar]
  8. Frohman L. A., Bernardis L. L. Effect of hypothalamic stimulation on plasma glucose, insulin, and glucagon levels. Am J Physiol. 1971 Dec;221(6):1596–1603. doi: 10.1152/ajplegacy.1971.221.6.1596. [DOI] [PubMed] [Google Scholar]
  9. Gerich J. E., Karam J. H., Forsham P. H. Stimulation of glucagon secretion by epinephrine in man. J Clin Endocrinol Metab. 1973 Sep;37(3):479–481. doi: 10.1210/jcem-37-3-479. [DOI] [PubMed] [Google Scholar]
  10. Gerich J. E., Langlois M., Noacco C., Schneider V., Forsham P. H. Adrenergic modulation of pancreatic glucagon secretion in man. J Clin Invest. 1974 May;53(5):1441–1446. doi: 10.1172/JCI107692. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Henry D. P., Starman B. J., Johnson D. G., Williams R. H. A sensitive radioenzymatic assay for norepinephrine in tissues and plasma. Life Sci. 1975 Feb 1;16(3):375–384. doi: 10.1016/0024-3205(75)90258-1. [DOI] [PubMed] [Google Scholar]
  12. Iversen J. Adrenergic receptors and the secretion of glucagon and insulin from the isolated, perfused canine pancreas. J Clin Invest. 1973 Sep;52(9):2102–2116. doi: 10.1172/JCI107395. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Lindsey A., Santeusanio F., Braaten J., Faloona G. R., Unger R. H. Pancreatic alpha-cell function in trauma. JAMA. 1974 Feb 18;227(7):757–761. [PubMed] [Google Scholar]
  14. Lindsey C. A., Faloona G. R., Unger R. H. Plasma glucagon in nonketotic hyperosmolar coma. JAMA. 1974 Sep 23;229(13):1771–1773. [PubMed] [Google Scholar]
  15. Lipman R. L., Schnure J. J., Bradley E. M., Lecocq F. R. Impairment of peripheral glucose utilization in normal subjects by prolonged bed rest. J Lab Clin Med. 1970 Aug;76(2):221–230. [PubMed] [Google Scholar]
  16. Luft R., Cerasi E., Madison L. L., von Euler U. S., Della Casa L., Roovete A. Effect of a small decrease in blood-glucose on plasma-growth-hormone and urinary excretion of catecholamines in man. Lancet. 1966 Jul 30;2(7457):254–256. doi: 10.1016/s0140-6736(66)92542-6. [DOI] [PubMed] [Google Scholar]
  17. Luyckx A. S., Lefebvre P. J. Mechanisms involved in the exercise-induced increase in glucagon secretion in rats. Diabetes. 1974 Feb;23(2):81–93. doi: 10.2337/diab.23.2.81. [DOI] [PubMed] [Google Scholar]
  18. Marliss E. B., Girardier L., Seydoux J., Wollheim C. B., Kanazawa Y., Orci L., Renold A. E., Porte D., Jr Glucagon release induced by pancreatic nerve stimulation in the dog. J Clin Invest. 1973 May;52(5):1246–1259. doi: 10.1172/JCI107292. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Marliss E. B., Wollheim C. B., Blondel B., Orci L., Lambert A. E., Stauffacher W., Like A. A., Renold A. E. Insulin and glucagon release from monolayer cell cultures of pancreas from newborn rats. Eur J Clin Invest. 1973 Jan;3(1):16–26. doi: 10.1111/j.1365-2362.1973.tb00324.x. [DOI] [PubMed] [Google Scholar]
  20. Müller W. A., Faloona G. R., Unger R. H. Hyperglucagonemia in diabetic ketoacidosis. Its prevalence and significance. Am J Med. 1973 Jan;54(1):52–57. doi: 10.1016/0002-9343(73)90083-1. [DOI] [PubMed] [Google Scholar]
  21. Palmer J. P., Walter R. M., Ensinck J. W. Arginine-stimulated acute phase of insulin and glucagon secretion. I. in normal man. Diabetes. 1975 Aug;24(8):735–740. doi: 10.2337/diab.24.8.735. [DOI] [PubMed] [Google Scholar]
  22. Porte D., Jr Beta adrenergic stimulation of insulin release in man. Diabetes. 1967 Mar;16(3):150–155. doi: 10.2337/diab.16.3.150. [DOI] [PubMed] [Google Scholar]
  23. Porte D., Jr, Graber A. L., Kuzuya T., Williams R. H. The effect of epinephrine on immunoreactive insulin levels in man. J Clin Invest. 1966 Feb;45(2):228–236. doi: 10.1172/JCI105335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Rocha D. M., Santeusanio F., Faloona G. R., Unger R. H. Abnormal pancreatic alpha-cell function in bacterial infections. N Engl J Med. 1973 Apr 5;288(14):700–703. doi: 10.1056/NEJM197304052881402. [DOI] [PubMed] [Google Scholar]
  25. Walter R. M., Dudl R. J., Palmer J. P., Ensinck J. W. The effect of adrenergic blockade on the glucagon responses to starvation and hypoglycemia in man. J Clin Invest. 1974 Nov;54(5):1214–1220. doi: 10.1172/JCI107864. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Weir G. C., Knowlton S. D., Martin D. B. Glucagon secretion from the perfused rat pancreas. Studies with glucose and catecholamines. J Clin Invest. 1974 Dec;54(6):1403–1412. doi: 10.1172/JCI107887. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Willerson J. T., Hutcheson D. R., Leshin S. J., Faloona G. R., Unger R. H. Serum glucagon and insulin levels and their relationship to blood glucose values in patients with acute myocardial infarction and acute coronary insufficiency. Am J Med. 1974 Nov;57(5):747–752. doi: 10.1016/0002-9343(74)90848-1. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES