Abstract
It has been recognized that there is a difference in many respects between the severe type of diabetes mellitus occurring in the child and the mild type of glycosuria found in obese, middle aged people. An explanation defining this difference on a metabolic basis has not been presented. The following experiments indicate that in obese, middle-aged patients with glycosuria there is no deficiency in the oxidation of glucose. There is, however, a disturbance in the mechanism which removes glucose from the blood stream and deposits it as glycogen.
Normal controls were fed a diet containing 200 gm. of carbohydrate, 80 gm. of protein and approximately maintenance calories for 3 days. They then entered the respiration chamber. 1 The next morning they were instructed to arise, void, and imbibe 100 gm. of glucose in solution. Immediately after the glucose had been ingested a continuous 4-hour period of indirect calorimetry by the open circuit method 1 was obtained. The subjects disposed of 40 to 50 gm. of the ingested glucose by oxidation during this 4-hour period. The urine contained no glucose. Since the blood sugar of normal individuals under these circumstances has returned to the fasting level in 3 hours or less, it is evident that 50 to 60 gm. of the ingested glucose was disposed of by the deposition of glycogen in the liver (and possibly to some extent in the muscles).
Using the same technic, 5 obese patients with glycosuria, who came to the clinic to be treated for diabetes mellitus were found to oxidize normal amounts of glucose. The urine contained from 4 to 17.5 gm. of glucose in the 4-hour period. The glucose tolerance curves of these patients performed a few days before the studies in the respiration chamber were definitely diabetic in type.
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