Although it is generally accepted that insulin accelerates the removal of glucose from the blood (1, 2), there has been disagreement regarding the effect of epinephrine on glucose utilization in normal individuals (2-5). The effect of hyperthyroidism on glucose tolerance tests has been found to be variable. The present study was undertaken to clarify the effects of epinephrine, insulin, and hyperthyroidism on the rate of removal of glucose from the blood of adult subjects by means of the rapid intravenous glucose tolerance test (6). MATERIAL AND METHODSAll subjects had been on a diet containing at least 150 grams of carbohydrate daily for at least one week. The rapid intravenous glucose tolerance test was carried out after a 14 hour fast, and the rate of glucose disappearance from the blood was determined as described in a previous publication (6). By this method the range of blood glucose disappearance rates in normal individuals is from 3.00 to 4.84 per cent per minute.A group of 21 normal males was employed in studying the effect of insulin and of epinephrine. A control test was performed on each subject. The test was performed in 17 of the group, 30 minutes following the subcutaneous administration of 0.5 mg. epinephrine. In a normal individual epinephrine produces a rise in the blood sugar which reaches a maximum within 25 minutes, following which there is a relative plateau for approximately 90 minutes corroborating previous work. In 18 of the group the test was performed immediately after the intravenous administration of 4 units of crystalline insulin. A time interval of approximately one month was allowed to elapse between tests in each subject.Seventeen patients with uncomplicated hyperthyroidism were studied before treatment with radioactive iodine, and the studies were repeated when a remission of the hyper-
A number of reports have appeared in the literature describing abnormal glucose tolerance in various mental disorders as measured by reduction in tolerance for ingested sugar. Carbohydrate metabolism is extremely complex and is interrelated with the fat and protein metabolism as well as with mineral metabolism. The measurement of one particular phase of carbohydrate metabolism by observation of the manner in which the organism utilizes a given amount of sugar gives rise to speculation that changes are occurring throughout the body, both within the cells and in the extracellular fluids, influencing all the metabolic processes in a chain reaction type of circuits and cycles. To date, no means of measuring total metabolism has been devised, and we must content ourselves with the piecemeal type of approach, subject to our limited techniques, and attempt to draw workable conclusions.The relationship between carbohydrate metabolism and mental illness became apparent first in 1928, when Manfred Sakel observed that long periods of insulin-induced hypoglycemia influenced mental symptoms. The exact nature of these changes is not known, but it is established that glucose is the only source of metabolic fuel utilized by the cells of the central nervous system, and alterations in its availability may act as a
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