Regulation of the Cortisol Axis, Glucagon, and Growth Hormone by Glucose Is Altered in Prediabetes and Type 2 Diabetes
Authors' conclusion
Altered counter-regulatory hormonal responses to glucose variations are observed at different stages of T2D development and may contribute to its progression by promoting insulin resistance and dysglycemia.
Study context
- Population
- Individuals with or without T2D undergoing hypoglycemic and hyperglycemic clamps with repeated hormonal measurementsfull cohort n = 54
- Participants
- 19 / 17 / 18 / 17
- Exposure
- T2D vs matched ND; Prediabetes (PD) vs normoglycemia (NG)
- T2Dn = 19
- NDn = 17reference
- PDn = 18
- NGn = 17reference
- Outcome
- Counter-regulatory hormone responses to glucose variations
Methodological detailshyperinsulinemic-normoglycemic-hypoglycemic clamp, hyperglycemic clamp, group-matched (age, sex, BMI)
- Hyperinsulinemic-normoglycemic-hypoglycemic clamp
- Hyperglycemic clamp
- Group-matched (age, sex, BMI)
Main finding
As reported in the abstract
- T2D vs ND: P < 0.05
- PD vs NG: P < 0.05
- T2D vs PD: P < 0.05
Observational data: associations, not effects.
Further findings
Correlates of hormone responses, full cohort
- Augmented glucagon, cortisol and ACTH and attenuated growth hormone (GH) responses correlated with adiposity, dysglycemia and insulin resistance
- Insulin resistance strongest predictor of elevated hypoglycemic glucagon, cortisol and ACTH responses
- Fasting glucose strongest predictor of low GH during hypoglycemia; HbA1c of less suppressed glucagon during hyperglycemia
- Adiposity measures also strongly associated with the responses
- Multilinear regressions
Original publication
Regulation of the Cortisol Axis, Glucagon, and Growth Hormone by Glucose Is Altered in Prediabetes and Type 2 Diabetes. J Clin Endocrinol Metab. Published 14 September 2023. doi:10.
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