Interpretation

Elevated glucagon concentrations in the absence of hypoglycemia may indicate the presence of a glucagon-secreting tumor. Successful treatment of a glucagon-secreting tumor is associated with normalization of glucagon levels.

Inappropriate elevations in glucagon concentrations in patients who are hyperglycemic and have type I diabetes indicate that paradoxical glucagon release may contribute to disease severity. This can be observed if insulin treatment is inadequate and patients are ketotic. However, glucagon measurement plays little, if any, role in the diagnostic workup of diabetic ketoacidosis.

In patients with diabetes, low glucagon concentrations (undetectable or in the lower quartile of the normal range) in the presence of hypoglycemia indicate impairment of hypoglycemic counter regulation. These patients may be particularly prone to recurrent hypoglycemia. This can be a permanent problem due to islet alpha-cell destruction or other, less well understood processes (eg, autonomous neuropathy). It can also be functional, most often due to over-tight blood glucose control and may be reversible after decreasing insulin doses.