We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......


JAMA. 1930;94(22):1739-1742. doi:10.1001/jama.1930.02710480015005.
Text Size: A A A
Published online

In the era of undernutrition in diabetic therapy, low blood sugar was observed in several cases of severe diabetes.1 With the introduction of insulin, "the symptom-complex hypoglycemia" became of more general interest.2 It was appreciated both then and later3 that symptoms were not an invariable accompaniment of low blood sugar; many authors have shown that they appear at varying levels.4

The syndrome of spontaneous hypoglycemia without diabetes was described in 1924 by Harris,5 who thought it due to hyperinsulinism or dysinsulinism. Wilder, Allan, Power and Robertson6 three years later published full clinical, biochemical and pathologic studies of a case of severe hypoglycemia arising from carcinoma of the pancreatic islands with metastases. The liver in this case was loaded with glycogen, but injection of epinephrine as well as of pituitary extract failed to elevate the blood sugar. When these extracts fail to elevate low blood


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.