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 ......
Article |

Diphenylhydantoin and Insulin-Secreting Tumors

JAMA. 1973;223(5):553-554. doi:10.1001/jama.1973.03220050053016.
Text Size: A A A
Published online


Originally intended and still used mainly for prevention of epileptic seizures, diphenylhydantoin has been shown to have multiple effects. One of these is hyperglycemia. After Belton and associates1 had induced hyperglycemia by diphenylhydantoin in rabbits (1965), there soon followed several reports of hyperglycemic hyperosmolar coma associated with diphenylhydantoin intoxication in man, and a report of glucose intolerance induced by conventional therapeutic doses of the drug.2 A number of in vitro studies on isolated rat pancreas are now providing insights into the mechanism of this hyperglycemic effect.

The immediate action of diphenylhydantoin was postulated by Millichap3 to be the stimulation of the hypothalamus with consequent hyperactivity of the sympathoadrenal system and its effects on the beta cell. Kizer et al4 suggested that diphenylhydantoin depresses the excitability of the beta cell and hence secretion of insulin by stimulating the Na-K-ATPase ("sodium pump") system with resulting reduction of intracellular


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




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.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

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