Hourly measurement of blood glucose, serum growth hormone, and 3-hourly measurements of plasma cortisol were made over a period of 24 hours in nine patients of whom six appeared to be brittle diabetics. Throughout the period great variations in serum growth-hormone level were noted inthe majority of patients. Although hypoglycaemic episodes were associated with rises of serum growth-hormone level, it was felt that these growth-hormone peaks were not the cause of any subsequent hyperglycaemia. Plasma cortisol levels did not rise during these hypoglycaemic episodes. Increased stability in these brittle patients depends especially on the prevention of hypoglycaemia and the use of bi-daily insulin injections and adjustment of diet.
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