To elucidate the details of carbohydrate metabolism in the course of acute myocardial infarction, baseline blood insulin and glucose levels and changes thereof in response to acute hydrocortisone loading were investigated in patients with acute transmural and large-focal myocardial infarction that had developed in the presence of essential hypertension (patients with diabetes mellitus were excluded from the study). Basal hypoinsulinemia was discovered on Day 1 of myocardial infarction in these patients. On Days 3-5 of infarction, blood insulin concentration was increased significantly. The pattern of hydrocortisone-induced changes in glucose level suggests glucocorticoid involvement in "urgent" glucose mobilization. The state of and associations between the two hormonal systems throughout acute myocardial infarction are discussed on the basis of changes in insulin and glucose levels under hydrocortisone load.
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