THE HYPOGLYCEMIC AND EOSINOPENIC RESPONSE TO INSULIN: A TEST FOR PITUITARY-ADRENAL INSUFFICIENCY

Abstract

A study was made of adrenal response to either epinephrine or insulin as measured by decrease in eosinophiles. 8 of 22 control patients failed to show a significant decrease in eosinophiles after receiving epinephrine. Insulin was as effective as epinephrine in causing eosinopenia. A hypoglycemic level of 35 mg. % is associated with eosinopenia. 2 patients with Addison''s disease demonstrated insulin sensitivity and retarded blood glucose response to hypoglycemia. 2 other patients with Addison''s disease demonstrated no insulin hypersensitivity and had a normal blood glucose rise in response to hypoglycemia. There was no eosinophil drop in any of these 4 patients, despite hypoglycemia below 35 mg. %. One patient with hypopituitarism failed to have an eosinopenic response to hypoglycemia. 3 acromegalic patients showed insulin resistance. The blood sugar and eosinophil response to insulin hypoglycemia may be used as a test of adrenocortical insufficiency in man.