BETA ADRENERGIC BLOCKADE AND JUVENILE DIABETES - ACUTE STUDIES AND LONG-TERM THERAPEUTIC TRIAL - EVIDENCE FOR ROLE OF CATECHOLAMINES IN MEDIATING DIABETIC DECOMPENSATION FOLLOWING EMOTIONAL AROUSAL

In comparison with normal children, the diabetic child has a significantly more rapid increase of blood ketones following injection of epinephrine. Beta adrenergic blockade with MJ 1999 removes this ketone responsiveness, presumably by interfering with free fatty acid release from adipose tissue triglyceride, and perhaps from hepatic, stores. Two diabetic preadolescent girls, who were virtually incapacitated because of repeated hospitalizations for severe diabetic ketoacidosis, were studied. A specific stress interview with one child produced marked changes in blood glucose and plasma free fatty acid concentrations, associated with significant increases in plasma concentrations of corticoids and growth hormone as well as in urinary excretion of epinephrine. Beta adrenergic blockade prior to a repeat stress interview blocked the metabolic changes without interfering with the hormonal response to stress. During a therapeutic trial with MJ 1999 for the past 12 months, the need for hospitalization for each of these children has been markedly decreased. © 1969 The C. V. Mosby Company.