{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T20:47:40Z","timestamp":1761511660554},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2002,3,5]],"date-time":"2002-03-05T00:00:00Z","timestamp":1015286400000},"content-version":"vor","delay-in-days":32,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2002,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>objective<\/jats:bold> Hypercortisolism is associated with impaired glucose tolerance and insulin resistance. For many years hydrocortisone 30\u00a0mg was the standard total daily replacement dose in adult hypopituitarism. The use of this conventional dose has now been shown to result in mild biochemical hypercortisolism and might contribute to the increased cardiovascular risk reported in hypopituitarism. The use of lower doses of hydrocortisone replacement therapy might prevent some of the adverse metabolic effects seen with conventional doses.<\/jats:p><jats:p><jats:bold>patients<\/jats:bold> In a randomized crossover study we assessed peripheral and hepatic insulin action in 15 ACTH\u2010deficient patients with normal glucose tolerance on two occasions while receiving either a low\u2010dose oral hydrocortisone replacement (LOR) therapy (15\u00a0mg at 0800, 5\u00a0mg at 1700) or a physiological hydrocortisone infusion (PHI), which achieved physiological serum cortisol concentrations.<\/jats:p><jats:p><jats:bold>results<\/jats:bold> Exogenous glucose infusion rates required to maintain euglycaemia were similar for the LOR and the PHI protocols (26\u00b72\u00a0\u00b1\u00a00\u00b74 <jats:italic>vs.<\/jats:italic> 23\u00b78\u00a0\u00b1\u00a00\u00b76\u00a0\u00b5mol\/kg\/min, respectively). Endogenous glucose production was also similar (12\u00b70\u00a0\u00b1\u00a02\u00b75 <jats:italic>vs<\/jats:italic>. 11\u00b76\u00a0\u00b1\u00a02\u00b74\u00a0\u00b5mol\/kg\/min, respectively) and in the post\u2010absorptive state suppressed to a similar extent following insulin (4\u00b75\u00a0\u00b1\u00a02\u00b70 <jats:italic>vs<\/jats:italic>. 5\u00b71\u00a0\u00b1\u00a03\u00b71\u00a0\u00b5mol\/kg\/min).<\/jats:p><jats:p><jats:bold>conclusion<\/jats:bold> Hydrocortisone replacement therapy at a dose of 15\u00a0mg with breakfast, 5\u00a0mg with evening meal does not increase peripheral or hepatic insulin resistance when compared to a hydrocortisone infusion designed to simulate physiological serum cortisol concentrations.<\/jats:p>","DOI":"10.1046\/j.0300-0664.2001.01447.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T10:52:27Z","timestamp":1047379947000},"page":"195-201","source":"Crossref","is-referenced-by-count":20,"title":["Effects of low\u2010dose oral hydrocortisone replacement versus short\u2010term reproduction of physiological serum cortisol concentrations on insulin action in adult\u2010onset hypopituitarism"],"prefix":"10.1111","volume":"56","author":[{"given":"E. 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