Intensive Carbohydrate Therapy in Diabetic Patients with Manifest or Suspected Liver Disease

Abstract

Two diabetic patients who developed cholecystitis with liver damage were observed before and after surgical treatment combined with high carbohydrate therapy aimed at treatment of the liver damage. A dramatic improvement in carbohydrate tolerance occurred. Of 6 diabetic patients with no overt clinical signs or symptoms of liver disease but with unexplained losses in carbohydrate tolerance, 4 yielded some laboratory evidence of liver dysfunction while 2 did not. All were treated as liver disease, the treatment consisting essentially of the daily intraven. or oral adm. of 300 to 350 g. of glucose in addition to the regular diet, together with sufficient extra insulin to keep the blood sugar level approx. that of the renal threshold at about 200 mg. %. The aim was to maintain a high blood sugar level in the presence of adequate insulin for 12 hrs. daily over a period of a wk. With 1 exception, the patients showed a significant improvement in carbohydrate tolerance.