Trauma: Hormonal Factors with Special Reference to Diabetes Mellitus

Three aspects of the role of hormones in stress will be reviewed: 1) changes in hormone secretion during stress, 2) metabolic alterations as a consequence of these changes in hormone production, and 3) the significance of hormones as permissive factors in stress reactions. It is emphasized that body tissues in general ‐ except for the central nervous system ‐ can make use of free fatty acids as a source of energy. In order to provide the central nervous system with its requirement for glucose, the glucose uptake in other tissues is restrained by two hormonally controlled mechanisms: 1) depression of insulin secretion and 2) increase in the concentration of free fatty acids in plasma (which by direct means depresses glucose uptake). Thus, these hormonal interactions provide large amounts of metabolic fuel and distribute them in an effective manner, so that the body can meet stress. In diabetics, an increased secretion of stress hormones in connection with trauma is observed. The metabolic and therapeutic implications of this finding are discussed.