GLUCAGON AND DIABETES.

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Abstract
Clinical and biochemical variables were examined during 2 standardized, low-dose insulin regimens in 7 [human] subjects with diabetic ketoacidosis and 1 with hyperosmolar coma, in order to determine whether glucagon levels can be suppressed in ketoacidosis and whether hyperglucagonemia influences the clinical and biochemical responses to treatment. Glucagon concentrations were significantly elevated (36.6-697.0 pmol/l) at presentation in all subjects. After institution of insulin treatment (4-8 u[units]/h), glucose and glucagon levels decreased rapidly, and in 5 of the 8 subjects, glucagon levels reached undetectable concentrations (< 3.0 pmol/l) during the initial treatment period. Neither plasma glucagon concentrations at presentation, nor the rate of glucagon decline during insulin treatment, appeared to influence the rapidity of the glucose decline or the persistence of the ketoacidosis. Low-dose exogenous insulin suppresses glucagon secretion in diabetic ketoacidosis, and the changes in glucagon concentrations during treatment are unrelated to the clinical response.