Affiliation:
1. Joslin Clinic and the Elliott P. Joslin Research Laboratory Divisions of the Joslin Diabetes Foundation, the Department of Medicine, New England Deaconess and Peter Bent Brigham Hospitals, and Harvard Medical School Boston, Mass
Abstract
The renin-angiotensin-aldosterone system was evaluated in two types of uncontrolled diabetes: a) diabetic ketoacidosis, and b) nonketotic hyperglycemia. In thirteen patients with ketoacidosis, mean plasma renin activity (PRA) was 58 ± 12 (S.E.M.) ng. per milliliter per hour and in four patients, plasma aldosterone was 82 ± 17 ng. per 100 ml. Corresponding values for upright saltdepleted subjects were 13 ± 2 and 62 ± 8. In eleven diabetics with nonketotic hyperglycemia (mean glucose 318 ± 19 mg. per cent), mean blood volume was 4,660 ml. and PRA 2.1 ± .7. After control of the diabetes (mean glucose 129 ± 13) blood volume was 4,553 ml. and PRA 3.3 ± 1 (N.S.).
The results suggest that: 1) diabetic ketoacidosis is a state of severe secondary aldosteronism, 2) no significant change in blood volume or PRA occurs during short periods of hyperglycemia, and 3) insulin is not necessary for renin release.
Publisher
American Diabetes Association
Subject
Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
37 articles.
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