Name 4 hormone producing hyperglycaemia
Four hormones that produce hyperglycaemia (counter-regulatory or diabetogenic hormones):
-
Glucagon - secreted by pancreatic alpha cells; stimulates glycogenolysis and gluconeogenesis in the liver, directly raising blood glucose.
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Cortisol - secreted by the adrenal cortex; promotes gluconeogenesis, inhibits peripheral glucose uptake, and antagonizes insulin action.
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Epinephrine (Adrenaline) - secreted by the adrenal medulla; stimulates glycogenolysis in liver and muscle, inhibits insulin secretion, and promotes lipolysis.
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Growth Hormone (GH) - secreted by the anterior pituitary; reduces glucose uptake by peripheral tissues and stimulates gluconeogenesis (hence termed a "diabetogenic" hormone).
Memory aid: "ACEG" - Adrenaline, Cortisol, (Growth hormone), (gluCaGon) - or simply remember the "4 Gs rule": Glucagon, Glucocorticoids, Growth hormone, Adrenaline (the odd one out!).
Mechanism summary:
| Hormone | Source | Main mechanism |
|---|---|---|
| Glucagon | Pancreatic α-cells | Glycogenolysis + gluconeogenesis |
| Cortisol | Adrenal cortex | Gluconeogenesis + insulin resistance |
| Epinephrine | Adrenal medulla | Glycogenolysis + inhibits insulin |
| Growth Hormone | Anterior pituitary | Anti-insulin effect on tissues |
These four are the classic counter-regulatory hormones that oppose insulin and are tested frequently in physiology and endocrinology exams. Thyroid hormones (T3/T4) are sometimes added as a 5th, as hyperthyroidism can also cause hyperglycaemia.
Thyroid?
Yes, thyroid hormones (T3/T4) can cause hyperglycaemia through several mechanisms:
How Thyroid Hormones Raise Blood Glucose
| Mechanism | Detail |
|---|---|
| Increased glycogenolysis | T3/T4 enhance breakdown of glycogen in the liver |
| Increased gluconeogenesis | Stimulate hepatic glucose production |
| Increased GI glucose absorption | Accelerate intestinal absorption of glucose after meals |
| Increased insulin degradation | Faster clearance of insulin, reducing its effect |
| Potentiate catecholamine action | Thyroid hormones upregulate adrenergic receptors, amplifying epinephrine's hyperglycaemic effect |
| Increased lipolysis | Provides more gluconeogenic substrates (glycerol, fatty acids) |
Clinical Context
- Hyperthyroidism can unmask or worsen diabetes mellitus - patients with borderline glucose tolerance may become overtly diabetic.
- Thyroid hormones are considered weakly diabetogenic compared to cortisol or GH.
- Conversely, hypothyroidism tends to cause hypoglycaemia (reduced glycogenolysis, reduced glucose absorption).
So the Full List of Hyperglycaemic Hormones:
- Glucagon
- Cortisol
- Epinephrine
- Growth Hormone
- Thyroid hormones (T3/T4) - the "5th" counter-regulatory hormone
Thyroid hormones are included in many textbooks as part of the extended list, though the core four (glucagon, cortisol, epinephrine, GH) are the ones most consistently tested in exams.
How hans Selye group adrenocotical hormone
Hans Selye classified adrenocortical hormones into 3 groups based on their predominant biological activity:
Selye's Classification of Adrenocortical Hormones
1. Glucocorticoids
- Primary effect: Carbohydrate/protein/fat metabolism
- Key hormone: Cortisol (hydrocortisone), Corticosterone
- Actions: Gluconeogenesis, anti-inflammatory, immunosuppression, hyperglycaemia
- Regulated by ACTH
2. Mineralocorticoids
- Primary effect: Electrolyte and water balance
- Key hormone: Aldosterone, Deoxycorticosterone (DOC)
- Actions: Na⁺ retention, K⁺ excretion, water retention, raises BP
- Regulated mainly by Renin-Angiotensin system
3. Sex Corticoids (Androgens)
- Primary effect: Sexual characteristics
- Key hormones: Dehydroepiandrosterone (DHEA), Androstenedione
- Actions: Weak androgenic effects, contribute to pubic/axillary hair in females
- Excess causes virilization in females (e.g., in CAH)
Summary Table
| Group | Key Hormone | Main Action | Zone of Cortex |
|---|---|---|---|
| Glucocorticoids | Cortisol | Metabolism, anti-inflammatory | Zona Fasciculata |
| Mineralocorticoids | Aldosterone | Na⁺/K⁺/water balance | Zona Glomerulosa |
| Sex Corticoids | DHEA | Androgens | Zona Reticularis |
Important Note by Selye:
Selye observed that no hormone is purely glucocorticoid or mineralocorticoid - there is overlap. For example:
- Cortisol has some mineralocorticoid activity
- Aldosterone has some glucocorticoid activity
This "overlap" concept was central to his classification framework and his broader work on stress response (General Adaptation Syndrome - GAS).
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