Diminished Glycolysis in the Blood in Diabetes

Abstract

It is well known that when blood is removed aseptically from the body and kept at body temperature, the blood sugar steadily diminishes and may entirely disappear in twenty-four hours. This process is called glycolysis, and is thought to be caused by a ferment known as the glycolytic ferment. It is important to emphasize that this action occurs in vitro.Very little is known about this ferment, even less than the little we know of the fundamental nature of most of the other ferments. It has been demonstrated 1 that the glycolytic ferment is present only in the cellular elements of the blood, and not in the plasma; also there is evidence that the leukocytes contain considerably more than do the red blood cells.A ferment similar to, and in all probability identical with, the glycolytic ferment of blood is present in other tissues, perhaps in varying amounts in all tissues.Pieces of kidney, obtained aseptically, will cause a marker lowering of the copper-reducing power of a solution of glucose; Levene and Meyer2 have shown that lactic acid is formed.Our interest in this ferment has been stimulated by the remarkable work of Banting, Best, Macleod, and their collaborators on insulin. The clinical work that we have undertaken with insulin 3 has caused us to study a number of phases of carbohydrate metabolism, but in this preliminary report only the studies of blood glycolysis will be presented. Other investigations are in progress and will be reported later. BLOOD GLYCOLYSISWe have been able to find in the literature only two important investigations of blood glycolysis. Lepine 4 states that the glycolytic ferment is markedly dimin¬ ished in diabetic blood. Careful search of his publica¬ tions reveals that all his observations, with the exception of one, were made on the blood of depancreatized dogs with experimental diabetes. The one exception was the blood of a patient with severe diabetes, in which the blood glycolysis was very much diminished. His observations will be of inestimable value when more is known about carbohydrate metab¬ olism and the mechanism of the action of insulin.Macleod,5 as a result of his experiments, states that blood glycolysis is not changed in "diabetes." He places "diabetes" in quotation marks, referring to hyperglycemia produced in dogs and not to true diabetes. This hyperglycemia was caused by stimula¬ tion of the splanchnic nerves, by asphyxia (with curare) or by injections of epinephrin. All of the ani¬ mals were anesthetized with ether. His experiments show that under these conditions there is no change in

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