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Adrenomedullary Hyperactivity in Type I Diabetic Patients Before and During Continuous Subcutaneous Insulin Treatment

Chair of Endocrinology and Metabolism, University of Modena Modena, Italy

Address requests for reprints to: Dr. G. Del Rio, Instituto Patologia Medica, Policlinico, Via del Pozzo 71, 41100 Modena, Italy.

Urinary norepinephrine (NE) and epinephrine (E) excretion was measured at 4-h intervals for 2 consecutive days in nine type I diabetic patients with no signs of autonomic neuropathy before and after 3 weeks of glycemic control with continuous insulin infusion (CSII). Twenty-four-hour urinary E excretion was significantly higher in the diabetic patients than in normal subjects both before and after the period of CSII treatment [mean, 198.9 ± 20.6 ±SE and 127.8 ± 24.4 vs, 46.6 ± 9.8 nmol/day; P < 0.05 for both]. The values in each of the 4-h periods before and in two of three of the periods after the 3-week period of CSII were significantly higher than those in normal subjects. Total urinary NE excretion was similar to that in the normal subjects at both times. The 24-h urinary NE/E ratio was significantly lower in diabetic patients even after they had achieved good metabolic control, compared with that in normal subjects (1.4 ± 0.2 vs, 11.6 ± 3.7; P < 0.03). These data demonstrate hyperactivity of the adrenal medulla in type I diabetic patients, which is only partially reversed by a short period of glycemic control.

Received March 14, 1988.

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