Diabetogenic Action of Pituitary
CLINICIANS are becoming aware that knowledge of the various factors affecting carbohydrate metabolism is important to a better understanding and better control — perhaps eventually the cure —of diabetes in the human being. Although the faulty carbohydrate metabolism that characterizes diabetes mellitus most frequently is traceable to dysfunction of the pancreas and resultant deficiency of insulin, other factors also play important roles in carbohydrate metabolism and their action sometimes causes diabetes or affects an existing diabetes.
Pituitary hormones and other hormones related to pituitary and to adrenal function are parts only of a total complex having intimate connection with carbohydrate metabolism and with hyperglycemia. It appears that hyperglycemia, if sufficiently great or sufficiently long-lasting, in some people may precipitate lasting diabetes and eventually true insulin deficiency; very rarely, hyperglycemia may produce diabetes that is severe and temporary, as in the case reported by Del Greco and Scapellato.1 The purpose of this paper is to review from the clinical aspect, relationships of pituitary and adrenal factors related to carbohydrate metabolism, in order to reveal some of the complexities of that metabolism and perhaps to gain more insight into means of reversing diabetes.
The pituitary hormones that we think of as being responsible for the onset and persistence of some cases of diabetes in patients are: growth hormone, which operates in acromegaly; adrenocorticotropic hormone (ACTH) at fault in rare cases of pituitary tumor associated with Cushing's disease; and possibly another, “the Cori factor” that has bearing on hexokinase activity—it may. . .