Epinephrine and Blood Glucose: Understanding the Effects of Adrenaline
Epinephrine (adrenaline) elevates blood glucose via multiple mechanisms:
- Glycogenolysis: Binds β₂-adrenergic receptors on hepatocytes → cAMP → PKA → phosphorylase kinase → glycogen phosphorylase activation → glucose release.
- Gluconeogenesis: Increases substrate delivery (lactate, alanine, glycerol) and enzyme activity.
- Inhibits insulin secretion (α₂-adrenergic) and promotes glucagon release.
- Peripheral insulin resistance – reduces glucose uptake in muscle/adipose.
Clinical Relevance
- Acute stress – "fight or flight" mobilizes fuel.
- Hypoglycemia counter-regulation – key defense in diabetes.
- Pheochromocytoma – chronic catecholamine excess → hyperglycemia, diabetes.
- Beta-agonist therapy (albuterol) – transient hyperglycemia.
Chronic Excess Risks
Hypertension, tachycardia, arrhythmia, metabolic syndrome, cardiovascular disease.
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