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The contribution of hyperglycemic hormones to the pathogenesis of diabetes mellitus.

Changes in cortisol, growth hormone, and glucagon levels observed in diabetes mellitus appear to be secondary to insulin deficiency, and can be related to the severity of insulinopenia with its attendant metabolic sequelae. Similarly, disturbances in plasma concentrations of catecholamines in diabetes also appear to be secondary to insulin deficiency, although a primary disturbance in adrenergic function or receptors at the cellular level cannot be excluded. As "inappropriate" compensatory responses, these hormones may aggravate the diabetic syndrome, but their dysfunction is not the cause of diabetes and cannot be used to identify prediabetes. To date, the primary hormonal disturbance in insulin-dependent diabetes remains defective insulin secretion.