Urinary cyclic 3',5'-adenosine monophosphate (cAMP) in diabetic subjects with and without symptomatic hypoglycemia and in normal subjects with insulin-induced hypoglycemia.

Urinary cAMP was investigated in diabetic subjects. It was found normal in patients on oral antidiabetics and on insulin in good or poor control. Patients with insulin-induced symptomatic hypoglycemia, however, excreted increased amounts of cAMP in the urine. To demonstrate the significance of hypoglycemia we induced hypoglycemia by i.v.-injection of 0.15 U insulin/kg body weight in six normal subjects. An increase of urinary cAMP was found even during the first 15 minutes with maximal hypoglycemia. Determination of urinary cAMP seems to be helpful in the diagnosis of unrecognized hypoglycemia and counterregulation.