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INTERPRETATION OF ABNORMAL DEXTROSE TOLERANCE CURVES OCCURRING IN TOXEMIA IN TERMS OF LIVER FUNCTION

INTERPRETATION OF ABNORMAL DEXTROSE TOLERANCE CURVES OCCURRING IN TOXEMIA IN TERMS OF LIVER FUNCTION Abstract The decreased tolerance for carbohydrate which occurs in patients with acute infectious diseases has been confirmed recently by Williams and Dick,1 whose paper contains an excellent review of the previous literature. A similar disturbance in carbohydrate metabolism has been demonstrated in experimentally induced toxemias in animals.2 The "diabetic" type of dextrose tolerance curve obtained in the conditions mentioned has been interpreted by some as being due to a lack of endogenous insulin, consequent to the functional impairment of the islands of Langerhans.3 Others have ascribed the phenomenon to an interference with the action of the available insulin, whether of endogenous or of exogenous origin.4 The former interpretation is based on the belief that the normal dextrose tolerance curve is dependent on an increase in the circulating insulin consequent to pancreatic stimulation by the administered dextrose. We have shown recently, however, that a normal dextrose tolerance curve References 1. Williams, J. L., and Dick, G. F.: Decreased Dextrose Tolerance in Acute Infectious Diseases , Arch. Int. Med. 50:801 ( (Dec.) ) 1932.Crossref 2. Tisdall, F. F.; Drake, T. G. H., and Brown, A.: The Production of a Lowered Carbohydrate Tolerance in Dogs , Am. J. Dis. Child. 32:854 ( (Dec.) ) 1926. 3. Sweeney, J. S., and Lackey, R. W.: The Effect of Toxemia on Tolerance for Dextrose , Arch. Int. Med. 41:257 ( (Feb.) ) 1928.Crossref 4. Sweeney, J. S.: Effect of Toxemia on the Tolerance for Dextrose and on the Action of Insulin , Arch. Int. Med. 41: 420 ( (March) ) 1928.Crossref 5. Schwentker, F. F., and Noel, W. W.: The Circulatory Failure of Diphtheria: The Carbohydrate Metabolism in Diphtheria Intoxication , Bull. Johns Hopkins Hosp. 46:259, 1930. 6. Lawrence, R. D., and Buckley, M. B.: The Inhibition of Insulin Action by Toxaemias and Its Explanation: I. The Effect of Diphtheria Toxin on Blood Sugar and Insulin Action in Rabbits , Brit. J. Exper. Path. 8:58, 1927. 7. Sweeney, J. S.; Barshop, N., and LoBello, L. C.: Effect of Toxemia on the Tolerance for Dextrose and on the Action of Insulin , Arch. Int. Med. 53:689 ( (May) ) 1934.Crossref 8. Sweeney, J. S.: Barshop. N.; LoBello, L. C, and Rosenthal, R. S.: Effect of Toxemia on the Tolerance for Dextrose and on the Action of Insulin: II. Arch. Int. Med. 54:381 ( (Sept.) ) 1934.Crossref 9. Williams and Dick.1 Sweeney and Lackey.2b Sweeney.2c 10. Lawrence and Buckley.2e Sweeney, Barshop and LoBello.2f Sweeney, Barshop, LoBello and Rosenthal.2s 11. Soskin, S.; Allweiss, M. D., and Cohen, D. J.: Influence of the Pancreas and the Liver upon the Dextrose Tolerance Curve , Am. J. Physiol. 109:155, 1934. 12. Soskin, S., and Allweiss, M. D.: The Hypoglycemic Phase of the Dextrose Tolerance Curve , Am. J. Physiol. 110:4, 1934. 13. Tsai, C, and Yi, C. L.: Carbohydrate Metabolism of the Liver: III. The Sugar Intake During Glucose Absorption , Chinese J. Physiol. 8:273, 1934. 14. Eli Lilly & Co. supplied the standardized potent diphtheria toxin. 15. Soskin, Allweiss and Cohen." Soskin and Allweiss." 16. Yannet, H., and Darrow, D. C.: Physiological Disturbances During Experimental Diphtheritic Intoxication: II. Hepatic Glycogenesis and Glycogen Concentration of Cardiac and Skeletal Muscle , J. Clin. Investigation 12:779 ( (Sept.) ) 1933.Crossref 17. Yannet, H.: Darrow, D. C, and Goldfarb, W.: Physiological Disturbances During Experimental Diphtheric Intoxication: III. Respiratory Quotients and Metabolic Rate , J. Clin. Investigation 12:787 ( (Sept.) ) 1933.Crossref 18. Althausen, T. L., and Thoenes, E.: Influences on Carbohydrate Metabolism of Experimentally Induced Hepatic Changes: II. Phosphorus Poisoning , Arch. Int. Med. 50:58 ( (July) ) 1932.Crossref 19. Whipple, G. H.; Peightal, T. C, and Clark, A. H.: Tests for Hepatic Function and Disease Under Experimental Conditions: Phenoltetrachlorphthalein , Bull. Johns Hopkins Hosp. 24:343, 1913. 20. Soskin, S.: The Utilization of Carbohydrate by Totally Depancreatized Dogs Receiving No Insulin , J. Nutrition 3:99, 1930. 21. Porges, O., and Adlersberg, D.: Die Behandlung der Zuckerkrankheit mit fettarmer Kost , Berlin, Urban and Schwarzenberg, 1929. 22. Sansum, W. D.; Gray, P. A., and Bowden, R.: The Treatment of Diabetes Mellitus with Higher Carbohydrate Diets , New York, Harper & Brothers, 1929. 23. Strouse, S., and Soskin, S.: Unpublished data. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

INTERPRETATION OF ABNORMAL DEXTROSE TOLERANCE CURVES OCCURRING IN TOXEMIA IN TERMS OF LIVER FUNCTION

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Publisher
American Medical Association
Copyright
Copyright © 1935 American Medical Association. All Rights Reserved.
ISSN
0730-188X
DOI
10.1001/archinte.1935.00170030095010
Publisher site
See Article on Publisher Site

Abstract

Abstract The decreased tolerance for carbohydrate which occurs in patients with acute infectious diseases has been confirmed recently by Williams and Dick,1 whose paper contains an excellent review of the previous literature. A similar disturbance in carbohydrate metabolism has been demonstrated in experimentally induced toxemias in animals.2 The "diabetic" type of dextrose tolerance curve obtained in the conditions mentioned has been interpreted by some as being due to a lack of endogenous insulin, consequent to the functional impairment of the islands of Langerhans.3 Others have ascribed the phenomenon to an interference with the action of the available insulin, whether of endogenous or of exogenous origin.4 The former interpretation is based on the belief that the normal dextrose tolerance curve is dependent on an increase in the circulating insulin consequent to pancreatic stimulation by the administered dextrose. We have shown recently, however, that a normal dextrose tolerance curve References 1. Williams, J. L., and Dick, G. F.: Decreased Dextrose Tolerance in Acute Infectious Diseases , Arch. Int. Med. 50:801 ( (Dec.) ) 1932.Crossref 2. Tisdall, F. F.; Drake, T. G. H., and Brown, A.: The Production of a Lowered Carbohydrate Tolerance in Dogs , Am. J. Dis. Child. 32:854 ( (Dec.) ) 1926. 3. Sweeney, J. S., and Lackey, R. W.: The Effect of Toxemia on Tolerance for Dextrose , Arch. Int. Med. 41:257 ( (Feb.) ) 1928.Crossref 4. Sweeney, J. S.: Effect of Toxemia on the Tolerance for Dextrose and on the Action of Insulin , Arch. Int. Med. 41: 420 ( (March) ) 1928.Crossref 5. Schwentker, F. F., and Noel, W. W.: The Circulatory Failure of Diphtheria: The Carbohydrate Metabolism in Diphtheria Intoxication , Bull. Johns Hopkins Hosp. 46:259, 1930. 6. Lawrence, R. D., and Buckley, M. B.: The Inhibition of Insulin Action by Toxaemias and Its Explanation: I. The Effect of Diphtheria Toxin on Blood Sugar and Insulin Action in Rabbits , Brit. J. Exper. Path. 8:58, 1927. 7. Sweeney, J. S.; Barshop, N., and LoBello, L. C.: Effect of Toxemia on the Tolerance for Dextrose and on the Action of Insulin , Arch. Int. Med. 53:689 ( (May) ) 1934.Crossref 8. Sweeney, J. S.: Barshop. N.; LoBello, L. C, and Rosenthal, R. S.: Effect of Toxemia on the Tolerance for Dextrose and on the Action of Insulin: II. Arch. Int. Med. 54:381 ( (Sept.) ) 1934.Crossref 9. Williams and Dick.1 Sweeney and Lackey.2b Sweeney.2c 10. Lawrence and Buckley.2e Sweeney, Barshop and LoBello.2f Sweeney, Barshop, LoBello and Rosenthal.2s 11. Soskin, S.; Allweiss, M. D., and Cohen, D. J.: Influence of the Pancreas and the Liver upon the Dextrose Tolerance Curve , Am. J. Physiol. 109:155, 1934. 12. Soskin, S., and Allweiss, M. D.: The Hypoglycemic Phase of the Dextrose Tolerance Curve , Am. J. Physiol. 110:4, 1934. 13. Tsai, C, and Yi, C. L.: Carbohydrate Metabolism of the Liver: III. The Sugar Intake During Glucose Absorption , Chinese J. Physiol. 8:273, 1934. 14. Eli Lilly & Co. supplied the standardized potent diphtheria toxin. 15. Soskin, Allweiss and Cohen." Soskin and Allweiss." 16. Yannet, H., and Darrow, D. C.: Physiological Disturbances During Experimental Diphtheritic Intoxication: II. Hepatic Glycogenesis and Glycogen Concentration of Cardiac and Skeletal Muscle , J. Clin. Investigation 12:779 ( (Sept.) ) 1933.Crossref 17. Yannet, H.: Darrow, D. C, and Goldfarb, W.: Physiological Disturbances During Experimental Diphtheric Intoxication: III. Respiratory Quotients and Metabolic Rate , J. Clin. Investigation 12:787 ( (Sept.) ) 1933.Crossref 18. Althausen, T. L., and Thoenes, E.: Influences on Carbohydrate Metabolism of Experimentally Induced Hepatic Changes: II. Phosphorus Poisoning , Arch. Int. Med. 50:58 ( (July) ) 1932.Crossref 19. Whipple, G. H.; Peightal, T. C, and Clark, A. H.: Tests for Hepatic Function and Disease Under Experimental Conditions: Phenoltetrachlorphthalein , Bull. Johns Hopkins Hosp. 24:343, 1913. 20. Soskin, S.: The Utilization of Carbohydrate by Totally Depancreatized Dogs Receiving No Insulin , J. Nutrition 3:99, 1930. 21. Porges, O., and Adlersberg, D.: Die Behandlung der Zuckerkrankheit mit fettarmer Kost , Berlin, Urban and Schwarzenberg, 1929. 22. Sansum, W. D.; Gray, P. A., and Bowden, R.: The Treatment of Diabetes Mellitus with Higher Carbohydrate Diets , New York, Harper & Brothers, 1929. 23. Strouse, S., and Soskin, S.: Unpublished data.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1935

References

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