Metabolism of carbohydrate and insulin was evaluated in 24 patients with Parkinson's disease before and during L‐dihydroxyphenylalanine (levodopa) therapy. In the untreated state these patients had low rates of glucose utilization (k) and impaired release of insulin during an intravenous glucose tolerance test (GTT). These abnormalities could not be related to age, diet, or degree of neurological disability. In addition these untreated patients had high fasting serum glucose and free fatty acid (FFA), normal human growth hormone (HGH), and low fasting serum insulin levels. It is proposed that the primary abnormality in carbohydrate‐insulin metabolism observed in these parkinsonian patients is a deficit in pancreatic insulin release. Levodopa treatment did not alter the low k and impaired insulin release. A trend toward more normal fasting serum levels of glucose, insulin, and FFA during levodopa therapy was suggested.