Relative Hyperglucagonemia in L-Asparaginase-and Prednisone-induced Glucose Intolerance in Management of Acute Lymphocytic Leukemia

Ten children with acute lymphocytic leukemia developed transient diabetes mellitus during treatment with L-asparaginase and prednisone. Serum glucose, plasma insulin, and plasma glucagon levels were measured when the patients were hyperglycemic. Six of the children were restudied several months later when there were no clinical or laboratory signs of glucose in tolerance. Hyperglycemia induced by L-asparaginase and prednisone was associated with depres sion of plasma insulin and, despite the inhibiting action of L-asparaginase on protein synthesis, a corresponding elevation of plasma glucagon. Thus patients with diabetes mellitus induced by L-asparaginase and prednisone have relative hyperglucagonemia similar to other patients with diabetes mellitus.