I. THE BLOOD SUGAR IN THYROID AND OTHER ENDOCRINE DISEASES

Abstract

It is generally recognized that the thyroid and other endocrine glands exert an influence on carbohydrate metabolism, but a clear understanding of this function has not as yet been reached.Experi¬ mental studies of this subject were accordingly undertaken and are reported in this article.They demonstrate that following the abolition of thyroid function there ensues (1) hypoglycemia and (2) a ten¬ dency to delayed removal of glucose from the blood ; that is, a delayed blood sugar tolerance curve.Clinical studies on hypoglycemia and the blood sugar tolerance were also made in a series of thyroid and other cases.This paper presents a detailed account of these observa¬ tions which emphasize the value of blood sugar estimations in the study and diagnosis of endocrine diseases./. Experimental Hypoglycemia and the Delayed Blood Sugar Curve.-Previousstudies on the effect of thyroidectomy on carbo¬ hydrate metabolism have led to contradictory results.Falkenberg,1 Rahel Hirsch,2 also Underhill and Saiki3 have reported diminished tolerance to carbohydrates after thyroidectomy.Eppinger, Falta and Rudinger failed to obtain similar results.Subsequently these authors,4 and also McCurdy5 reported an increased tolerance for sugar after thyroidectomy, with preservation of the parathyroids, in all or in part.Hunter6 observed increased sugar tolerance after thyroidectomy in sheep.The chief cause of these discrepancies is the extreme difficulty of performing thyroidectomy in dogs without injury to the para¬ thyroids, which minute organs very probably influence carbohydrate metabolism differently from the thyroid glands.In the work of all of these authors, the tolerance studies have been confined to an exam- *