Impaired Counterregulation of Glucose in a Patient with Hypothalamic Sarcoidosis

Hypoglycemia stimulates rapid increases in the secretion of several hormones, including catecholamines, glucagon, cortisol, and growth hormone, that act in concert to increase the plasma glucose concentration. The chief role of the central nervous system in triggering the release of such counterregulatory hormones during hypoglycemia is well recognized. The specific region of the hypothalamus responsible for this process is probably the ventromedial region, because bilateral lesions or perfusion of d-glucose into this region reduces the increases in plasma glucagon and catecholamines in response to hypoglycemia in rats. 1 , 2 We describe a patient with a hypothalamic sarcoid infiltrate who had complete . . .