EFFECT OF METABOLIC CONTROL ON URINARY-EXCRETION AND PLASMA-LEVELS OF CATECHOLAMINES IN DIABETICS

Urinary excretion and plasma levels of catecholamines were determined in 20 normal and 39 diabetic subjects to evaluate the sympathetic activity. Diabetic patients were divided into 4 groups according to the metabolic control. Sympathetic activity showed no differences between normal and subjects with chemical diabetes (group I, n=5). In insulin-treated diabetics in good metabolic control (group II, n=11) only urinary excretion of free norepinephrine was significantly higher than normals (p<.05). In insulin-treated diabetics in poor metabolic control (group III, n=16) urinary excretion and plasma levels of norepinephrine showed a marked increase over groups I and II (p<.001). In insulin-treated diabetics with ketosis (group IV, n=7) urinary excretion and plasma levels of both norepinephrine and epinephrine showed the highest values (p<.001 <.1). <.01). Finally, in groups III and IV, after achieving improved metabolic control, a significant decrease of urinary excretion and plasma levels of caatecholamines was observed. The results confirm that there is an increased rate of catecholamine release in poorly controlled diabetics and suggest a close correlation between sympathetic activity and metabolic derangement in diabetes.