ExtractForty-five children with newly diagnosed diabetes mellitus were evaluated in terms of endogenous release of insulin and growth hormone using glucose, tolbutamide, arginine and glucagon as stimuli. The mean concentration of insulin in the plasma obtained from fasting diabetic children was found to be 10.0 ^U/ml, a value significantly below the mean level of 15.3 jnUjml in the control group. Essentially no increase in the concentration of insulin in plasma resulted from stimulation with the above agents. The mean concentration of growth hormone in the plasma of fasting diabetics was found to be 3.8 m^g/ml, a value higher than but not significantly different from the value of 2.5 m^wg/ml in the contrast patients. Following the intravenous infusion of arginine, however, the mean concentration of growth hormone in the plasma of diabetic children rose to 20.8 m/^g/ml, a level significantly higher than the mean peak value of 7.4 m/^g/ml in the nondiabetics. Although no change in the concentration of growth hormone followed glucagon injection in the nondiabetic children, a prompt, significant elevation to 9.4 m^g/ml occurred in the diabetics. Glucagon administration has not previously been reported to stimulate the release of growth hormone. SpeculationInsulin deficiency alone will not adequately explain the variability in clinical symptomatology and metabolic derangement seen in children with newly diagnosed diabetes mellitus. These data suggest that growth hormone may play an important role. The finding that glucagon administration stimulates release of growth hormone in the juvenile diabetic may indicate the presence of a previously unrecognized interrelation between glucagon-growth hormone and insulin.

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