Metabolism of Fructose by the Liver of Diabetic and Non-Diabetic Subjects. ∗

Abstract

Summary and Conclusions

The metabolism of fructose in the liver was investigated by hepatic vein catheterization studies in 3 diabetic patients deprived of insulin and in 3 non-diabetic subjects. (1) There was a large hepatic uptake of fructose during the period of intravenous administration in both diabetic and non-diabetic subjects. (2) In all but one case there was a large hepatic output of pyruvic and lactic acid during the fructose infusion. The liver of one diabetic patient in ketosis continued to remove pyruvic and lactic acid from the blood; hepatic glycogen depletion may have accounted for this divergent result. (3) In half the cases (2 diabetic patients and 1 non-diabetic subject) the output of glucose by the liver was increased during fructose administration. (4) In the absence of ketosis, the liver of the diabetic subject without insulin, therefore, metabolized fructose in a manner similar to that of the liver of the non-diabetic individual. The presence of ketosis, however, was accompanied by a decreased output of pyruvic and lactic acid, despite a normal uptake of fructose.