The Concentration of Adrenaline-Like Substances in Blood during Insulin Hypoglycaemia

Abstract

Since the demonstration of increased sympathetic activities during insulin hypoglycaemia by Cannon, MacIver and Bliss (1924) the assumption has been current that hypoglycaemia also increases the concentration of circulating adrenaline, and repeated attempts have been made to verify this experimentally. Brandt and Katz (1933), using the perfused rabbit ear, the isolated rabbit ileum and the enucleated frog eye as test objects, found that human blood possessed adrenaline-like activities during hypoglycaemia, while control blood was inactive. Meythaler and Wossidlo (1935) reported that the blood of subjects injected with insulin caused an increased vasoconstriction of the perfused rabbit ear and, more recently, Meythaler, Lobenhofer and Haggenmiller (1951) found that the response varied according to the constitutional type of the subject. Heilbrunn and Liebert (1939), however, observed no uniform effects when they tested the blood of patients undergoing insulin shock therapy with the frog perfusion technique; while there was a rise of adrenaline-like activity in some patients, others showed a fall and some failed to show any definite pattern. The results of Tietz, Dornheggen and Goldman (1940) and of Tietz and Birnbaum (1942) who used Shaw's colorimetric method indicated little change in the first two hours after insulin injection, but in the later stages of hypoglycaemia there was a more consistent tendency towards an increase of concentration. The proportion of adrenaline in the chromogenic material estimated by Shaw's method increases during hypoglycaemia, according to Raab (1943). Kalaja (1942), with a fluorimetric method, also found an increase of the blood adrenaline level after insulin injection. On the other hand, Richter (quoted by Jones, 1939) who used the method of Shaw came to the conclusion that adrenaline was not present in significantly increased concentration in arterial blood during those stages of hypoglycaemia when the clinical picture suggested the possibility of adrenalinaemia.