Severe Insulin-Induced Hypoglycemia Associated with Deficiencies in the Release of Counterregulatory Hormones

A FALL in blood glucose to hypoglycemic levels usually triggers a prompt release of catecholamines, glucagon, growth hormone, and cortisol. These so-called counterregulatory hormones are believed to restore blood glucose to normal concentrations by increasing hepatic glucose production (in the cases of glucagon, epinephrine, and cortisol) or by decreasing peripheral use of glucose (in the cases of epinephrine and growth hormone). The relative contributions of the individual hormones in counteracting insulin-induced hypoglycemia, however, have not been established. In this paper, we report the case of an insulin-dependent diabetic patient who was capable of synthesizing and releasing all the counterregulatory hormones . . .