Summary
Plasma adrenaline kinetics (clearance, extraction across the forearm, initial plasma disappearance rate, mean sojourn time, volume of distribution) were studied in sixteen Type 1 (insulin-dependent) diabetic patients during constant i.v. infusion of tritium labelled adrenaline. In patients with (n=8) and without (n=8) neuropathy forearm venous plasma noradrenaline and adrenaline concentrations as well as plasma clearance of adrenaline based on arterial sampling (1.7 vs 2.1 l/min) were not significantly different. The initial disappearance time (T1/2) after the infusion of the tritium labelled adrenaline had been stopped was significantly prolonged in Type 1 diabetic patients with neuropathy compared to those without (after 20 min infusion 2.7 vs 2.2 min, p<0.02, after 75 min infusion 3.7 vs 2.9 min, p<0.05). The corresponding values for the mean sojourn time of adrenaline in plasma were 6.5 vs 4.7 min (p<0.05) after 20 min infusion and 18 vs 10 min (p<0.05) after 75 min of infusion. The unchanged plasma clearance and the prolonged initial halftime and mean sojourn time of adrenaline in plasma suggest that adrenaline is distributed in a larger volume in Type 1 diabetic patients with neuropathy as compared to patients without neuropathy (estimated space of distribution 29 vs 201). Our results suggest that patients with diabetic neuropathy do not adjust the plasma adrenaline concentration to changes in adrenaline infusion rate as rapidly as those without neuropathy, i. e. the effect of an elevated adrenaline secretion rate may be prolonged in patients with diabetic autonomic neuropathy.
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References
Moorhouse IA, Carter SA, Doupe J (1966) Vascular responses in diabetic peripheral neuropathy. Br Med J 1: 883–888
Davies IB, Sudera D, Sagnella G (1982) Increased numbers of alpha receptors in sympathetic denervation supersensitivity in man. J Clin Invest 69: 779–784
Bannister R, Davies IB, Holly E (1979) Defective cardiovascular reflexes and supersensitivity to sympathornimetic drugs in autonomic failure. Brain 102: 163–176
Hilsted J, Richter EA, Madsbad S, Tronier B, Christensen NJ, Hildebrandt P, Damkjær M, Galbo H (1987) Metabolic and cardiovascular responses to epinephrine in diabetic autonomic neuropathy. N Engl J Med 317: 421–426
Hilsted J, Jensen SB (1979) A simple test for autonomic neuropathy in juvenile diabetics. Acta Med Scand 205: 385–387
Hilsted J, Christensen NJ, Madsbad S (1983) Whole body clearance of norepinephrine. The significance of arterial sampling and of surgical stress. J Clin Invest 71: 500–505
Christensen NJ, Vestergård P, Sørensen T, Rafaelsen OJ (1980) Cerebrospinal fluid adrenaline and noradrenaline in depressed patients. Actda Psychiatr Scand 61: 178–182
Kirkegaard P (1970) A fortran IV version of the sum of exponential least squares code EXPOSUM. Atomic Energy Commission, Risø, Denmark
Lassen NA, Perl W (1979) Tracer kinetic methods in medical physiology. 1st edn. Raven Press, New York
Hilsted J (1982) Pathophysiology in diabetic autonomic neuropathy: cardiovascular, hormonal and metabolic studies, Diabetes 31: 730–737
Christensen NJ (1972) Plasma catecholamines in long-term diabetics with and without neuropathy and in hypophysectomized subjects. J Clin Invest 51: 779–787
Dejgaard A, Hilsted J, Christensen NJ (1986) Noradrenaline and isoproterenol kinetics in diabetic patients with and without autonomie neuropathy. Diabetologia 29: 773–777
Cryer PE, Silverberg AB, Santiago JV, Shah SD (1978) Plasma catecholamines in diabetes. The syndromes of hypoadrenergic and hyperadrenergic postural hypotension. Am J Med 64: 407–416
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Dejgaard, A., Hilsted, J., Henriksen, J.H. et al. Plasma adrenaline kinetics in Type 1 (insulin-dependent) diabetic patients with and without autonomie neuropathy. Diabetologia 32, 810–813 (1989). https://doi.org/10.1007/BF00264912
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DOI: https://doi.org/10.1007/BF00264912