Serial Plasma Growth Hormone Levels in 33 Cases of Severe Diabetic Ketoacidosis - Effects of Sodium Nicotinate[*]

Abstract

Plasma growth hormone levels were measured in 33 cases of severe ketoacidosis. Patients were treated at random by insulin alone or by insulin + Na nicotinate (schedule of insulinotherapy, fluid and electrolyte administrations being standardized). The overall mean initial level of HGH before treatment was high although low initial values were observed in four cases. A twofold increase occurred at the second hour of treatment, associated with a large decrease in glycemia (yet frankly above normal). After the second hour HGH values decreased.

Individual pattern varied widely and were not related to the severity of the ketoacidosis, or to age and sex. The individual ability to secrete HGH is clear in two patients with recurrent ketotic comas. The rise in plasma HGH was larger, and significantly more sustained in the nicotinate-insulin treated patients despite identical initial mean values in both groups. The fall in plasma FFA and glycerol levels was significantly faster with nicotinate. The fall in blood glucose was similar in both groups.

It is suggested that faster and deeper FFA decrease contributed to enhance the secondary HGH release observed in treated ketoacidosis.

Key words

Lipolysis - Nicotinic Acid - Human Growth Hormone - Free Fatty Acids - Diabetic Ketoacidosis

1 This study was supported by the University Paris-VI and the Fondation Nationale pour la Recherche Medicale Française

1 This study was supported by the University Paris-VI and the Fondation Nationale pour la Recherche Medicale Française