How are glucagon results interpreted?

Updated: Nov 13, 2018
  • Author: Cory Wilczynski, MD; Chief Editor: Eric B Staros, MD  more...
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Answer

Answer

Glucagon works along with insulin to balance glucose distribution in the serum for transport to body tissues. The serum level of glucose is the driving force through which these two hormones are either being activated or inhibited. Insulin stimulates glucose and amino acid uptake from the blood to tissues for functional use. This is why during a meal, glucose levels initially rise due to intake; in normal, healthy subjects, insulin’s job is to bring the levels back down to normal limits. The result of the lack of this hormone is especially seen in persons with diabetes after a meal in which glucose values elevate extremely high, unless endogenous insulin can inhibit glucagon’s effect for producing more glucose through the process of glycogenolysis. [3]

Normal levels of fasting glucose (80-100 mg/dL) mean that a balance exists and that both insulin and glucagon are adequately produced.

Pancreatic glucagon employs gluconeogenesis and glycogenolysis to regulate plasma glucose levels. Excess glucagon levels contribute to the development of hyperglycemia in type 1 and type 2 diabetes. In cases of hypoglycemia, however, increased glucagon secretion is the primary counterregulatory mechanism through which normal levels of plasma glucose are restored. Patients who have had type 1 diabetes for 1-5 years suffer impairment of the glucagon response, with this response becoming almost undetectable in those who have had the disease for 14-31 years. A syndrome of hypoglycemic autonomic failure can result when diabetes control intensifies and repeated episodes of hypoglycemia occur. [4]  In a state of hypoglycemia (blood glucose less than 70 mg/dL), a patient will experience autonomic dysfunction (shaking, palpitations, sweating, nervousness) and central nervous system dysfunction (confusion, unresponsiveness, seizures). Persistent hypoglycemia can be associated with an insulinoma, overmedication of insulin or oral hypoglycemia drugs, or prolonged fasting.


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