Plasma immunoreactive insulin and somatotropin in delirium tremens and alcoholic hallucinosis.

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Abstract
A 2-phase glucose tolerance test was administered, on day 1 following hospitalization, to 11 patients with acute alcoholic hallucinosis (AH) and to 11 with chronic alcoholic hallucinosis (CH), and on days 1 and 7 to 31 patients with delirium tremens (DT); 30 additional patients with DT were given a glucose-insulin tolerance test. All the patients were nondiabetic men, their liver function tests were similar, and the mean age of the individual groups ranged from 41-48. Two kinds of responses to the glucose load could be discerned among the DT patients; 25(group I) had on day 1 a diabetoid hyperglycemic response with a monophasic pattern of immunoreactive insulin (IRI) that peaked at 2 h, and a normal somototropin response; on day 7 both glycemic and insulinemic responses were normal, and the somatotropin curve was shaped inversely to the IRI curve. On both days 1 and 7 group II (6 DT patients) had a normal glycemic response, a biphasic IRI curve and a somatotropic curve inversely shaped to the IRI curve. In contrast to group I, the IRI levels in group II were significantly higher during recovery than during the delirium. The AH patients had a monophasic hyperglycemic curve peaking at 2 h and IRI and somototropin responses similar to that of the group I patients on day 1. The CH patients had a normal glycemic response and low IRI levels nonresponsive to glucose; somototropin levels increased after glucose. In 23 of the 30 DT patients given the insulin test, the sensitivity to insulin was low on day 1 and normal on day 7; in the rest the response was low on both days. The blood glucose levels were in the lower basal range and the ammonia levels normal in all the groups studied.