Atrial natriuretic peptide in diabetic patients before and after control of blood sugar level

Atrial natriuretic peptide (ANP) was examined in 20 diabetic patients: 10 patients referred from the emergency room with severe hyperglycemia, (Group A), and 10 patients with uncontrolled diabetes referred by the outpatient clinic (Group B). Seven patients from Group A reached the nadir of less than 10 pg/ml, and three reached 12-16 pg/ml; following equilibration of sugar level, mean ANP level rose to 51.4 pg/ml (SD +/- 5.6). In Group B mean ANP level before treatment was 19.2 pg/ml +/- 11.4, and after diabetes control reached 40.4 pg/ml (SD +/- 10.04). Findings demonstrate a significant decrease in ANP in the acute hypoglycemic state, and a return to normal levels when sugar is controlled and hypovolemia corrected. Patients with chronic hyperglycemia exhibit compensation of intravascular volume. It seems that the equilibration system functioning via ANP is highly sensitive as a result of acute changes in total body fluid, and becomes desensitized during chronic disequilibrium.