THE CASE FOR CORTICAL STEROID HORMONE ACCELERATION OF NEOGLUCOGENESIS FROM FAT IN DIABETIC SUBJECTS. A SUMMARY OF FIVE YEARS' INVESTIGATIVE WORK*

PRODUCTION or accentuation of the diabetic state by adrenocorticotropin and by cortical steroids is well documented (1). In association with the diabetogenic effect of these hormones, one also observes a progressive degree of insulin resistance. The mechanism of these metabolic changes has never been satisfactorily explained. The possible explanations for such effects include the following: Inhibition of insulin production. Since corticotropin and cortical steroids accentuate the diabetes associated with total pancreatectomy, this is obviously an inadequate explanation. Insulin destruction. Unsatisfactory, as in “1”. Blockade of insulin effect, perhaps at the enzymatic level. On the basis of recent findings in our laboratory, this appears probable (2). As in “1” and “2,” however, such an hypothesis fails to explain the total diabetogenic effect of adrenal steroids.