The risk of hypothalamic or pituitary imaging abnormalities is low among men evaluated for erectile dysfunction and secondary hypogonadism. However, this risk increases markedly when the serum testosterone level is markedly decreased.

Oscillations in the concentration of plasma glucose were found to reflect large fluctuations in hepatic glucose production. The fluctuations in glucose production were synchronous with fluctuations in the concentration of plasma insulin and glucagon. This synchrony suggests that hepatic pathways are entrained to the islet cycle with a minimal time delay.

In 1980 we described an in vivo method for estimating the rate of glucose uptake among selected tissues during an acute insulin response. The method was based upon the same principles as Sokoloff's 2-deoxyglucose (2DG) method. We now report further examination of the basic assumptions of the model and validation of its general applicability by comparing the response of brain and other tissues to prolonged insulin infusion (while glucose is held constant) with their response to a single injection of insulin. The method provides a reproducible estimate of relative insulin response in any tissue that can be anatomically separated at death. Tissues that are minimally sensitive to insulin such as spleen, lung, skin, and gut do not display increments in the calculated value for net rate of tissue uptake of 2DG. Insulin-sensitive tissues display increased rates of uptake that are characteristic for each specific tissue, ranging in magnitude from 1.7- to 17.9-fold over basal among an array of insulin-sensitive tissues. The duration of a unit response to a sub-maximal dose of insulin also varied among the tissues, persisting for 20-30 min after plasma insulin had returned to basal in heart and for 10-20 min in the other insulin-sensitive tissues. The method provides a reproducible measure of glucose metabolism in vivo and has been validated as a means of quantifying relative insulin sensitivity among the peripheral tissues. During steady-state conditions with plasma glucose held constant, brain glucose metabolism was unaffected by a 60-min infusion of insulin.