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