LIVER DYSFUNCTION HYPERGLYCEMIA: ITS ETIOLOGY AND RELATION TO DIABETES MELLITUS

Abstract

Numerous conditions other than diabetes mellitus are accompanied by hyperglycemia; the more significant of these conditions include obesity, liver damage, and hyperpituitarism. This finding of hyperglycemia appearing in such diverse diseases, can be explained by the fact that control of the blood sugar is determined not only by the level of insulin in the blood but by the state of the liver, kidneys and gastrointestinal tract as well as by the level of the pituitary-adrenal hormones. In testing a new modified insulin prepn. in a series of diabetic patients, the authors found considerable differences between the 2 major classes of diabetes mellitus patients; the adult and juvenile diabetics. The large majority of adult diabetics, developing after the 3d decade, were found to be suffering from low grade liver damage rather than insulin deficiency or diabetes mellitus. Blood chemistry studies revealed a sub-clinical or low grade liver disease, the outstanding finding being, a vacillating blood sugar level, generally higher than normal; running on the avg. about 200-250 mg.%. A diabetic or semi-diabetic glucose tolerance curve. A normal blood level of acetone bodies in well nourished patients. Alterations in the blood values of uric acid, NPN, total proteins, A/G ratio, cholesterol and cholesterol esters and bilirubin. In liver damage, a dysfunction of the enzyme systems regulating the blood sugar is probably the main etiologic factor. A diabetic regime and insulin adm. are contraindicated in these patients. They improve on a high carbohydrate high protein and low fat diet plus vit. B complex and choline chloride.