Carbohydrate Metabolism and Acute Myocardial Infarction: Circulating Glucose, Insulin, Cortisol and Growth Hormone Responses and Excretion of Catecholamines

¹ Department of Medicine, University of Colorado Medical Center, Denver

Carbohydrate metabolism was studied in ten patients during the first three weeks following acute myocardial infarction. All patients exhibited significant glucose intolerance over the three-week period and, therefore, a relative deficiency of insulin. Determination of insulin levels revealed that half of the patients secreted high levels and tended to be young and obese, while the other half who secreted normal amounts of insulin tended to be thin and elderly. Norepinephrine excretion was markedly increased in the first three days and returned to normal, while significant deviations in the glucose and insulin patterns persisted. Fasting serum cortisol and growth hormone concentrations remained normal. This suggests that abnormal peripheral utilization of insulin or production of abnormal insulin or relatively low levels of insulin is the cause of carbohydrate intolerance observed in post-myocardial infarction patients.