Plasma cortisol following injection of 1-39 or 1-18 ACTH.

Forty units of 1-39 ACTH of animal origin or 0.4 mg of synthetic 1-18 ACTH administered at 8 A.M. via either the intramuscular route to 10 subjects with intact adrenocortical function produced comparable increases in plasma cortisol at 1, 2, and 6 hours. The increase in plasma cortisol lasted at least 6 hours but less than 12 hours after intravenous crystalline 1-39 ACTH and at least 16 hours but less than 24 hours after the same dose of 1-39 ACTH administered as a depot gel via the intramuscular route. However, neither intravenous nor the intramuscular injection of 1-39 ACTH produced increases that were still evident at 24 hours. Following either the intramuscular or intravenous injection of 0.4 mg of the synthetic 1-18 ACTH, the plasma cortisol increase was still evident at the 24th hour. Our findings indicate that the plasma cortisol responses to either 40 units of exogenous 1-39 ACTH of animal origin or to 0.4 mg of a synthetic 1-18 ACTH are most consistent in the first 6 hours following either intravenous or intramuscular injection.

Discrepancies between glycosuria and home estimates of blood glucose in insulin-treated diabetes mellitus.

Glycosuria can be a misleading indicator of blood or plasma glucose levels. Thus glycosuria may be present when blood glucose levels are within the normal fasting or postprandial range, and it may be absent when the blood glucose is distinctly above normal. In such patients the blood glucose must be measured, preferably by the patient, as a guide to insulin and other therapy. However, urine glucose tests are valid indicators in a minority of patients and are essential in all patients for the detection of acetone.