Anhydremia with insulin and water intake.

Abstract

Pronounced hypoglycemia due to the injection of large amounts of insulin has been shown by Drabkin and Edwards 1 to be associated with a concentration of the blood. Although this symptom was invariably found, the animals studied fell into two groups: some developed anhydremia rapidly with an acute fall in blood pressure; a larger group exhibited a gradual rise in blood concentration with a well-maintained blood pressure. The clinical observations of Joslin, Gray and Root 2 indicate that desiccation through diarrhea renders patients prone to dangerous insulin hypoglycemia.

The natural outgrowth of the problem was to study the influence of the water intake upon the type of reaction with insulin, especially with reference to the severity of the resulting anhydremia. A more exact statement of the problem was framed in the question: “Will an animal which has been desiccated through water starvation react differently to a large amount of insulin than one which has had plenty of water?”

The procedure was as follows: Unanesthetized dogs (5 to 10 kilograms in weight) were used. The first “control” blood samples were drawn, and the dogs were either thirsted (water starved) or given by stomach-tube an average of 800 cc. of water daily for periods of 3 to 7 days. As an added check upon the results, some of the dogs previously thirsted were also studied under a forced water régime, and vice versa. Just before the administration subcutaneously or intravenously of a large dose of insulin (20 units per kilogram body weight), the second “control” samples were drawn. Blood samples were then taken at suitable intervals following the insulin administration. Each blood sample was analyzed for hemoglobin and dry solids, as indices of the amount of blood dehydration, and for sugar.