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Endocrinology


Answer 4
  1. Glucagon. Glucagon is the first counterregulatory hormone to be secreted in response to hypoglycemia, both in disease-free individuals and in those with a new diagnosis of diabetes mellitus. Catecholamines follow a few minutes after glucagon secretion, whereas growth hormone and cortisol will take hours to be secreted. In patients with chronic diabetes mellitus, the problem of hypoglycemia unawareness with absent glucagon response exists, causing the patients to be heavily dependent on catecholamines to help them recover from hypoglycemia. In patients with more severe chronic diabetes, catecholamines also fail to respond, which explains why those patients need more time to recover from hypoglycemia and can present with more severe symptoms. Somatostatin is not considered to be a counterregulatory hormone in response to hypoglycemia.

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