Abstract
Plasma growth hormone levels were measured in 33 cases of severe ketoacidosis. Patients
were treated at random by insulin alone or by insulin + Na nicotinate (schedule of
insulinotherapy, fluid and electrolyte administrations being standardized). The overall
mean initial level of HGH before treatment was high although low initial values were
observed in four cases. A twofold increase occurred at the second hour of treatment,
associated with a large decrease in glycemia (yet frankly above normal). After the
second hour HGH values decreased.
Individual pattern varied widely and were not related to the severity of the ketoacidosis,
or to age and sex. The individual ability to secrete HGH is clear in two patients
with recurrent ketotic comas. The rise in plasma HGH was larger, and significantly
more sustained in the nicotinate-insulin treated patients despite identical initial
mean values in both groups. The fall in plasma FFA and glycerol levels was significantly
faster with nicotinate. The fall in blood glucose was similar in both groups.
It is suggested that faster and deeper FFA decrease contributed to enhance the secondary
HGH release observed in treated ketoacidosis.
Key words
Lipolysis - Nicotinic Acid - Human Growth Hormone - Free Fatty Acids - Diabetic Ketoacidosis
1 This study was supported by the University Paris-VI and the Fondation Nationale pour
la Recherche Medicale Française
