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Twenty-four-hour cortisol profiles demonstrate exaggerated nocturnal rise in diabetic children
T G Lebinger1, P Saenger, D K Fukushima
1Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10467.
Insights
Diabetic children show an exaggerated nocturnal rise in plasma cortisol, independent of blood glucose levels. This finding highlights altered stress hormone patterns in pediatric diabetes.
Area of Science:
- Pediatric Endocrinology
- Diabetology
- Endocrinology
Background:
- Children with insulin-dependent diabetes often exhibit altered physiological responses.
- Cortisol secretion follows a diurnal pattern, crucial for metabolic regulation.
- Understanding cortisol dynamics in pediatric diabetes is important for managing complications.
Purpose of the Study:
- To investigate the diurnal pattern and levels of plasma cortisol in children with insulin-dependent diabetes.
- To compare cortisol secretion in diabetic children with healthy controls.
- To determine the relationship between plasma glucose and cortisol levels in diabetic children.
Main Methods:
- Collected plasma cortisol every 20 minutes for 24 hours in 12 healthy and 8 diabetic children.
- Monitored plasma glucose every 20 minutes in diabetic children.
- Analyzed diurnal patterns and mean/peak cortisol levels between groups.
Main Results:
- Identical diurnal cortisol secretion patterns were observed in both groups.
- Mean 24-hour plasma cortisol was similar, but significantly elevated in diabetics from 0200 to 0920h.
- Diabetic children exhibited higher peak cortisol levels, unrelated to plasma glucose fluctuations.
Conclusions:
- Pediatric diabetes is associated with an exaggerated nocturnal rise in plasma cortisol.
- This cortisol elevation is not directly correlated with concurrent plasma glucose levels.
- Altered cortisol dynamics may represent a distinct feature of pediatric diabetes management.
Abstract:
Plasma cortisol was measured every 20 min for 24 h in 12 normal and 8 insulin-dependent, nonketotic, diabetic children treated with one daily injection of insulin. Plasma glucose was also measured every 20 min in the diabetic children. The diurnal pattern of cortisol secretion was identical. The mean 24-h plasma cortisol was similar in both groups, but significantly elevated in the diabetic children between 0200 and 0920 h. Peak cortisol levels were higher in the diabetic than in the normal children. No correlation was found between average plasma glucose and average plasma cortisol, or between the nocturnal change in plasma glucose and average nocturnal plasma cortisol in the diabetic subjects. These studies demonstrate an exaggeration of the normal nocturnal rise in plasma cortisol in diabetic children not related to the levels of plasma glucose.