Serum growth hormone, insulin and blood sugar responses to oral glucose in protein energy malnutrition.

Blood sugar (BS), serum immunoreactive insulin (IRI) and growth hormone (GH) were measured in 5 normal children and 15 with varying grades of protein energy malnutrition (PEM) during a standard oral glucose tolerance test (OGTT). Impaired glucose tolerance was noted in grade III and IV PEM but not in grade II. Serum insulin responses were low but appropriate to blood glucose in grade II and grade III PEM and were lower (p less than 0.001) in Grade IV PEM subjects. Higher basal GH was observed in most cases of grade III and IV PEM (p less than 0.001) and the elevated GH was not suppressed following the oral glucose load. Further, a paradoxical rise in GH during OGTT was seen in 3 of the 5 subjects with grade-IV PEM.