Serial Changes in Glucose Utilization and Insulin and Growth Hormone Secretion in Acute Cerebrovascular Disease

Serial studies were made of glucose utilization and insulin and growth hormone secretion following intravenous glucose tolerance tests given to 16 patients during recovery from acute cerebrovascular disease. Three groups of patients were identified based on the pattern of change of glucose utilization during the first month of convalescence. A small group showed a persistent defective insulin response to glucose and appeared to have had pre-existing unrecognized adult-onset diabetes mellitus. The two other groups showed either an immediate suppression of glucose utilization or delayed development of glucose intolerance associated with an increase in total insulin secretion. Both of these responses returned to normal by the end of the fourth week. Growth hormone secretion correlated with the severity of the stroke. Alterations in glucose metabolism and insulin secretion seem to occur in most patients following recovery from stroke and undoubtedly reflect transient hormonal or metabolic changes related to either acute stress or tissue injury, depending on the interval after the onset of the vascular episode.