Abstract
In studying the carbohydrate tolerance in hyperthyroidism and other conditions, three methods have been employed, the diastatic activity of the blood, the fluctuations in the level of the blood sugar, and the sugar excreted in the urine after the administration of a definite amount of glucose by mouth. The diastatic activity was determined by the technic of Myers and Killian, 1 the blood sugar was estimated by the Lewis-Benedict method as modified by Myers and Bailey; 2 the Benedict-Osterberg 3 technic was utilized in the determination of the urinary sugar. It was early appreciated that fasting for twelve hours increased the tolerance for carbohydrate, so that glucose tolerance curves carried out on a fasting stomach did not truly represent the individual's carbohydrate assimilation limit. In our series the patients received in the morning, a standard meal which consisted of one egg in any form, two slices of bread, a cup of coffee, without sugar or milk, or a glass of water. Two hours later, the patient voluntarily emptied the bladder, and then received about 100 c.c. of water to drink. One hour after this, a specimen of blood and a specimen of urine were obtained. These represent the control specimens. The glucose was then administered by mouth in a 50 per cent. solution, 1.75 gm. per kilogram of body weight. At hourly intervals the specimens of blood and urine were obtained, and in these and in the control the sugar was estimated. The diastatic activity was determined only on the control specimen of blood.
The 23 cases presented are from a series of 275 patients examined, representing normal and various pathological conditions. The control specimen of blood represents the level of blood sugar 3 hours after the standard meal.
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