The glucose mobilization rate in hyperthyroidism

Abstract

The work presented here is a preliminary report of some special investigations we have undertaken during the past twelve months at the Presbyterian Hospital in order to shed more light on the complex problem of hyperthyroidism. The decreased sugar tolerance, so frequently found in this condition, was taken as our point of departure. It occurred to us that the study of the respiratory quotient and the blood sugar at frequent intervals after glucose ingestion might give us a good deal of information as to how cases of Grave's disease utilize carbohydrate.

In brief, our procedure was as follows: the metabolism determinations were made with a 90-liter Tissot apparatus, using a Siebe-Gorman mask and Douglas valves. Samples of gas were taken over mercury in the usual way and were analyzed in duplicate in a Haldane gas analysis apparatus and in triplicate if the two analyses did not check satisfactorily. Previous to the use of the Haldane apparatus each day an analysis of outside air was made as a control. The usual technique was observed as to the preparation of the patient—14 to 16 hours fast and absolute rest for thirty to sixty minutes before the start of the determination.

After obtaining two basal periods each of ten minutes, blood was taken for a fasting blood sugar. The patient was then given a dose of glucose made as palatable as possible with a small amount of fruit juice. For the most part, a standard dose of 1.75 grams per kilo bodyweight was used. Twenty minutes after the glucose ingestion, the metabolic rate was determined, for a period of ten minutes if possible, and for the next two and a half hours, a determination was made each half hour.