Disturbed alpha-adrenergic modulation of insulin and growth hormone secretion in chronic alcoholics

The effect of alpha-adrenergic stimulation by IV adrenaline and propranolol infusion upon basal insulin and growth hormone secretion was studied in six chronic alcoholics during alcohol withdrawal, two alcoholics recently admitted to hospital with alcohol-induced hypoglycaemia and twelve healthy subjects. In all healthy subjects a decline in basal insulin (mean +/- SEM decremental area 166 +/- 19) and an increase in growth hormone (mean +/- SEM incremental area 527 +/- 164) was found. In the two alcoholics admitted to hospital with alcohol hypoglycaemia, no consistent change occurred in basal insulin and basal growth hormone concentrations during alpha-adrenergic stimulation. In the other alcoholics a decrease in basal insulin (mean +/- SEM decremental area 91 +/- 13.5) was found, but this decrease was significantly less (p less than 0.05) than in healthy subjects. Growth hormone did not change significantly in these alcoholics. It is concluded that disturbances in the alpha-adrenergic modulation of basal insulin and growth hormone secretions are common in alcoholics in a withdrawal state. The implication of this finding for the occurrence of alcohol-induced hypoglycaemic coma is discussed.