The control of acidosis and its relation to impaired sugar metabolism in human diabetes

Abstract

Acidosis exerts a distinct influence upon carbohydrate metabolism. This assertion is supported by the observation of Elias, 1 who demonstrated that the introduction of acid into dogs and rabbits leads to hyperglycemia and glycosuria. Moreover, the same author 2 has concluded that the so-called “hunger diabetes” of young dogs 3 is in part, at least, a condition due to acidosis, as determined by the carbon dioxide content of the blood and analysis of the alveolar air. Observations upon human diabetes teach that acidosis obtains in this condition also.

A state of alkalosis is likewise potent in exerting an action upon carbohydrate metabolism but this influence is contrary to that of acidosis. Pavy and Godden 4 showed that the glycosuria provoked by ether and chloroform disappears after the intravenous injection of sodium carbonate. Given by mouth or intravenously sodium carbonate will abolish the hyperglycemia of “hunger diabetes” and glycosuria will either entirely disappear or be greatly diminished, according to Elias. 5 After removal of the pancreas sodium carbonate introduced into the blood stream causes diminution in the excretion of sugar. 6 Later work by Murlin (reported at the December meeting of the Society for Biological Chemists) has shown that under the influence of sodium carbonate the respiratory quotient is increased in depancreatized dogs. At the December meeting of the Society of Biological Chemists Underhill reported that in the hyperglycemia produced by epinephrine the intravenous administration of sodium carbonate will significantly lower the excretion of sugar in the urine, the hyperglycemia being correspondingly decreased in height and duration. It was also stated that the intravenous injection of sodium carbonate into normal animals will sometimes although not invariably cause a distinct fall in the blood sugar content.

From these illustrative observations it may be concluded that a condition of acidosis tends toward the elimination of carbohydrate from the body whereas alltalosis shows a tendency to conserve the carbohydrate.