{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T22:20:31Z","timestamp":1765318831081,"version":"3.46.0"},"reference-count":8,"publisher":"BMJ","issue":"6392","license":[{"start":{"date-parts":[[1983,8,27]],"date-time":"1983-08-27T00:00:00Z","timestamp":430790400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1983,8,27]]},"abstract":"<jats:p>The response of growth hormone, cortisol, and catecholamines to hypoglycaemia produced by a continuous intravenous infusion of insulin was investigated in 10 normal subjects and 15 patients with pituitary disease. The insulin infusion rate was started at 2 U\/hour for adolescents, 4 U\/hour for adults, and 6 U\/hour for patients with acromegaly. If required the rate was increased during the test depending on changes in blood glucose, measured by a Reflomat with low reading glucose oxidase strips. Stopping the infusion when the blood glucose concentration had fallen to 2.0 mmol\/l (36 mg\/100 ml) resulted in a maximum further fall of 0.7 mmol\/l (13 mg\/100 ml) and a subsequent spontaneous rise in blood glucose concentration. The rise was identical in normal subjects and in patients with hypopituitarism, further evidence that pituitary hormones--in contrast to glucagon and catecholamines--are relatively unimportant in the recovery from hypoglycaemia. The only patient who required intravenous glucose to restore normoglycaemia was a patient with longstanding insulin dependent diabetes. A comparison with the conventional bolus injection test showed that continuous intravenous insulin infusion was more reliable in producing adequate but not excessive hypoglycaemia and the hormone responses were equivalent. The continuous intravenous insulin infusion may offer particular advantages in the investigation of growth hormone deficiency.<\/jats:p>","DOI":"10.1136\/bmj.287.6392.571","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"571-574","source":"Crossref","is-referenced-by-count":1,"title":["Testing the anterior pituitary: hypoglycaemia produced by continuous intravenous insulin infusion."],"prefix":"10.1136","volume":"287","author":[{"given":"G H","family":"Newman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I A","family":"Macdonald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S P","family":"Allison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1983,8,27]]},"reference":[{"key":"ref_1","first-page":"429","article-title":"The plasma sugar, free fatty acid, cortisol and growth hormone response","volume":"45","year":"1966","unstructured":"Greenwood FC, Landon 1, Stamp TCB. The plasma sugar, free fatty acid, cortisol and growth hormone response to insulin. 7 Clin Invest 1966;45: 429-49."},{"key":"ref_2","article-title":"The physiological effects of insulin-induced hypoglycaemia in man: responses at differing levels of blood glucose","author":"Gale, E.A.M.; Bennett, T.; Macdonald, I.A.; Holst, J.J.; Matthews, J.A.","unstructured":"Gale EAM, Bennett T, Macdonald IA, Holst JJ, Matthews JA. The physiological effects of insulin-induced hypoglycaemia in man: responses at differing levels of blood glucose. Clin Sci (in press).","journal-title":"Clin Sci"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1113\/expphysiol.1981.sp002588","article-title":"The influence of intravenous glucose on body temperature","volume":"66","author":"Green, J.H.; Macdonald, I.A.","year":"1981","unstructured":"Green JH, Macdonald IA. The influence of intravenous glucose on body temperature. Q Exp Physiol 1981;66:465-73.","journal-title":"Q Exp Physiol"},{"key":"ref_4","first-page":"380","article-title":"Hormonal mechanisms of recovery from insulin-induced hypoglycaemia","volume":"236","author":"Gerich, J.; Davis, J.; Lorenzi, M.","year":"1979","unstructured":"Gerich J, Davis J, Lorenzi M, et al. Hormonal mechanisms of recovery from insulin-induced hypoglycaemia. Amy Physiol 1979;236:E380-5.","journal-title":"Amy Physiol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1126\/science.182.4108.171","article-title":"Lack of glucagon response to hypoglycaemia in diabetes","volume":"182","author":"Gerich, J.; Langlois, M.; Noacco, C.; Karam, J.; Forsham, P.H.","year":"1973","unstructured":"Gerich J, Langlois M, Noacco C, Karam J, Forsham PH. Lack of glucagon response to hypoglycaemia in diabetes. Science 1973;182:171-3.","journal-title":"Science"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1210\/jcem-51-4-877","article-title":"glucagon and growth hormone release in association with physiological decrements in the plasma glucose concentration in normal and diabetic man","volume":"51","author":"Santiago, J.V.; Clarke, W.L.; Shah, S.D.; Epinephrine, Cryer P.E.; norepinephrine","year":"1980","unstructured":"Santiago JV, Clarke WL, Shah SD, Cryer PE. Epinephrine, norepinephrine, glucagon and growth hormone release in association with physiological decrements in the plasma glucose concentration in normal and diabetic man. J Clin Endocrinol Metab 1980;51:877-83.","journal-title":"J Clin Endocrinol Metab"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1210\/jcem-30-5-619","article-title":"Hypoglycaemic threshold for human growth hormone release","volume":"30","author":"Glick, S.M.","year":"1970","unstructured":"Glick SM. Hypoglycaemic threshold for human growth hormone release. 7 Clin Endocrinol Metab 1970;30:619-23.","journal-title":"7 Clin Endocrinol Metab"},{"volume-title":"Accepted 8","year":"1983","key":"ref_8","unstructured":"(Accepted 8 june 1983)"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.287.6392.571","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.287.6392.571","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T22:18:55Z","timestamp":1765318735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.287.6392.571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1983,8,27]]},"references-count":8,"journal-issue":{"issue":"6392","published-online":{"date-parts":[[1983,8,27]]},"published-print":{"date-parts":[[1983,8,27]]}},"alternative-id":["10.1136\/bmj.287.6392.571"],"URL":"https:\/\/doi.org\/10.1136\/bmj.287.6392.571","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"type":"print","value":"0007-1447"},{"type":"electronic","value":"1468-5833"}],"subject":[],"published":{"date-parts":[[1983,8,27]]}}}