DER INSULINHYPOGLYKÄMIE-TEST ALS FUNKTIONSPRÜFUNG DES HYPOTHALAMUS-HYPOPHYSEN-NEBENNIERENRINDEN-SYSTEMS.

Abstract

ABSTRACT In 50 patients determinations of blood sugar and corticosteroids in plasma (11-OHCS) were carried out during insulin-induced hypoglycaemia. In 9 out of 11 patients with Cushing's syndrome (bilateral adrenal hyperplasia) the characteristic finding was a missing increase of 11-OHCS concentrations during hypoglycaemia. On the contrary, 5 patients with alimentary obesity and clinical signs of hypercorticism showed a normal or even increased adrenocortical response. The results obtained in 7 patients with uncomplicated central diabetes insipidus did not differ from those in normal subjects, while 2 further patients with diabetes insipidus, complicated with secondary adrenocortical insufficiency, failed to respond. Findings in 12 patients with anorexia nervosa are consistent with a normal function of the hypothalamo-pituitary-adrenal axis. According to plasma corticosteroid response during hypoglycaemia results obtained in 15 patients with disorders of hypothalamus and/or hypophysis may be divided into three groups. The significance of this classification with regard to replacement therapy is discussed. Observations show that plasma corticosteroid estimations during insulin-induced hypoglycaemia provide a simple and reliable method to ascertain the function of the hypothalamo-pituitary-adrenal axis (insulinhypoglycaemiatest).