Influence of Small Increments of Epinephrine on Glucose Tolerance in Normal Humans

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Abstract
To ascertain whether small elevations of epinephrine alter glucose tolerance, epinephrine or saline was infused into 7 healthy volunteers for 5 h. Two hours after starting the infusions, subjects ingested 100 g of glucose. Plasma epinephrine (basal 23 .+-. 4 pg/ml) rose during epinephrine infusion to levels (75 to 80 pg/ml) similar to those observed in 9 outpatients presenting with mild viral illnesses (66 .+-. 8 pg/ml). Although epinephrine produced only a small (5 mg/dl) increase in plasma glucose before glucose ingestion, after oral glucose the levels of glucose increased by 30 to 60 mg/dl above saline control values (163 .+-. 14 mg/dl vs. 108 .+-. 15 at 2 h, P < 0.005). This diabetogenic effect occurred despite 2-fold higher insulin levels and normal suppression of plasma glucagon. Small physiologic increments of epinephrine, which cause minimal changes in fasting plasma glucose apparently produce a marked reduction in glucose tolerance. The data suggest marked sensitivity to the insulin antagonistic effects of epinephrine and may provide a mechanism for stress-induced glucose intolerance.