Insulin deficiency associated with hypoglycemia and good glucose tolerance in hypopituitarism. Report of a case with acromegaly developing pituitary apoplexy.

. A female patient with active acromegaly and latent insulin-deficient diabetes suffered pituitary apoplexy after which the markedly elevated plasma growth hormone decreased to non-detectable levels and did not respond to hypo-glycemia. Simultaneously the clinical signs of acromegaly progressively subsided and the adrenocortical function became subnormal. However, in spite of an almost total absence of insulin secretion the fasting blood glucose decreased to slightly hypoglycemic range and the previously diabetic glucose tolerance was improved in spite of blunted insulin response. Adequate cortisone substitution did not influence either glucose tolerance or insulin secretion. These findings suggest that in the absence of growth hormone glucose assimilation may be rapid in spite of nearly complete lack of insulin.