Hormonal and metabolic disturbances during acute and subacute myocardial infarction in man

Summary To investigate the cause of glucose intolerance (GIT), frequently seen during acute myocardial infarction (AMI), seventeen males without history of diabetes were studied with intravenous glucose tolerance tests within seventy-two hours after uncomplicated myocardial infarction and again three weeks later. Seventy percent (12/17) of the patients showed GIT during AMI. In 7 of these patients (41%) glucose tolerance (GT) remained abnormal after 3 weeks. In addition, all 7 showed markedly diminished insulin responses to glucose during both the acute and subacute phase. Therefore, their GIT was considered to be due to newly-recognized chemical diabetes. In the remaining patients in whom the initially depressed GT improved during SMI elevated serum levels of FF A, insulin, HGH and cortisol suggested the temporary presence of insulin antagonism. Increased adrenal medullary activity was not found to be a major factor inhibiting glucose tolerance.Supported in part by the Genesee Valley Heart Association, Rochester, New York and PHS Research Grant No. 5 MOI RR349.