Endocrine and Metabolic Emergencies
The insulin response to oral glucose is time-dependent, typically higher and shorter in duration in the morning than in the evening. Identical meals produce higher plasma glucose increases in the evening than in the morning. Declining cort…
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The insulin response to oral glucose is time-dependent, typically higher and shorter in duration in the morning than in the evening. Identical meals produce higher plasma glucose increases in the evening than in the morning. Declining cortisol, altered insulin sensitivity and waning counter-regulatory reserve in the afternoon increase metabolic vulnerability and may explain the afternoon clustering of endocrine emergencies. Endocrine and metabolic emergencies peaked between 12:00 and 15:00, later than most other symptom categories.