In recent years, since blood sugar determinations have become almost routine, hypoglycemia has become of increasing clinical importance. However, a review of the literature reveals that although much has been written concerning the subject there are marked variations in the blood sugar norms, the symptomatology and the etiology that are reported as characterizing hypoglycemia. It is my purpose to consider these observations, and to add to them a report of my own case, which clinically appeared to be uremia with low blood sugar estimations and at autopsy proved to be subacute glomerular nephritis and hypertrophy of the islands of Langerhans.
The divergence of opinion concerning the blood sugar normal is apparent to any one who seeks to establish a norm. Sendrail and Planques1 cite eight authorities who agree that any reading below 90 mg. is to be considered a hypoglycemia. Joslin2 states that the average fasting normal is