The Glucose Metabolism of Patients with Malignant Disease and of Normal Subjects as Studied by Means of an Intravenous Glucose Tolerance Test12

Abstract

Since the observations of Freund (2) in 1885 of spontaneous hyperglycemia in patients with malignant disease, there has been speculation that an alteration in glucose metabolism is associated with neoplasia in man (3-18). There have been, however, relatively few studies designed specifically to test this possibility. Rohdenburg, Bernhard, and Krehbiel (5) and Edwards (6), with the advent of the oral glucose tolerance test, reported that a decrease in carbohydrate tolerance was a uniform finding in patients with cancer. Subsequent studies (7-18) did not confirm these reports, though several workers have found a high incidence of an abnormal glucose tolerance test in subjects with various types of neoplasms. These observations have been inconclusive with regard to establishing a relationship between the presence of uncomplicated neoplastic disease and an altered carbohydrate metabolism. A primary reason for the inconclusive nature of these studies is their lack of control of various factors known to decrease glucose tolerance. Certain of these factors, e.g., inadequate dietary intake, fever, infection, hepatic dysfunction and prolonged bed rest, are frequently present in patients with malignant disease. This study was undertaken in a group of care