Establishment of reference values for standard dose short synacthen test (250 microgram), low dose short synacthen test (1 microgram) and insulin tolerance test for assessment of the hypothalamo-pituitary-adrenal axis in normal subjects.

Objective: To assess the integrity of the hypothalamo-pituitary-adrenal(HPA) axis, many authors have proposed the short synacthen test (ACTH1-24, Tetracosactrin) as a replacement for the insulin tolerance test (ITT). The aim of this study was to compare the plasma cortisol response obtained with both short synacthen tests (high dose (HDT, 250 microgram) and low dose (LDT, 1 microgram)) with the peak reached during the ITT in healthy volunteers, and to establish the plasma cortisol cut-off level in each test.

Subjects And Methods: Thirty healthy subjects (16 F, 14 M), mean age 34 years, underwent both short synacthen tests.

[The influence of clinical presentation and metabolic control of insulin dependent diabetes in the evolution of residual insulin secretion. A prospective study at five years].

Background: To study the influence of clinical, metabolic and immunological parameters during the first years of the evolution of insulin-dependent diabetes mellitus (IDDM) on the long-term residual insulin secretion (IS).

Patients And Methods: 186 IDDM subjects diagnosed from 1986 to 1993 were included; 135 subjects have completed a two year follow-up, and 57 have completed a five year follow-up. The influence of individual characteristics at diagnosis (age, sex, clinical presentation, islet-cell antibodies) and during the first two years of follow-up (IS, metabolic control) on IS at five years was evaluated by multiple linear regression.