Diminished Adrenal Cortical Function in Diabetes as Shown in Eosinophil Response to Stress of Surgery

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Abstract
The levels of circulating eosinophils as a measure of adrenal cortical response to the stress of surgery were followed in 25 diabetics and 13 non-diabetics. Ten of the 25 diabetics showed diminished adrenal cortical function as indicated by an eosinophil count on the 2d post-operative day which was depressed less than 50% of the preoperative level. Four-hour ACTH and cortisone tests were done on 5 of these 10 diabetics and confirmed the presence of reduced adrenal cortical reserve. The adrenal cortex was capable of responding normally to the initial stress of surgery, but its reserve capacity was insufficient to maintain the eosinopenia for 48 hours. There is a suggestion that the abnormal adrenal response can be correlated with the duration of the diabetes. The possibility is discussed that this decrease in the duration of the activity of the adrenal may be a compensatory change which results from the relative insulin deficiency of diabetes mellitus.