Experimental diabète gras

Abstract

French authors, especially Lancereaux, 1 have described two types of diabetes mellitus: diabète maigre and diabète gras. Lancereaux believed that the former was due to pancreatic disease; diabetes with obesity, according to him, was not of pancreatic origin. Although most clinicians maintain that it is impossible to recognize the sharp distinction between diabète maigre and diabète gras, yet the fact remains that the physician in the majority of cases sees either lean or stout diabetics.

Diabetic children and young adults are usually lean, from the beginning of the disease until exitus. According to Joslin, 2 obesity is a marked feature of diabètes in the fifth and sixth decade of life. One must admit that while diabète gras may ultimately turn into diabète maigre, the latter condition rarely is transformed to the former.

Clinically three varieties of diabete gras may be distinguished:

1. Obesity associated with excretion of sugar in the urine.

2. Obesity with hyperglycemia in the absence of glycosuria.

3. Obesity with lowered glucose tolerance in the absence of hyperglycemia or glycosuria.

The recognition of the first variety is simple. Diabetics belonging to the first variety may remain obese until coma sets in. In order to diagnose the second variety, one must be sure that the renal filter is intact. Under anti-diabetic treatment patients belonging to the second variety may temporarily lose in weight, the glycemia may become normal, but glucose tolerance is usually lowered.

It is our object to show that obesity and hyperglycemia can be produced in dogs in two ways:

1. By almost complete thyroidectomy in partially depancreatized dogs.

2. By ligation of one pancreatic duct.

It was previously shown that in persistently glycosuric dogs, after pancreatectomy, the glycosuria and hyperglycemia ceased after removal of the thyroid in toto, although the animals were on a liberal diet.