Carbohydrate Intolerance In Gastrectomy Patients

Samuel Alpert, MD
JAMA. 1966;198(11):1224. doi:10.1001/jama.1966.03110240132054.
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To the Editor:—  I would like to comment on a recent editorial, "Carbohydrate Intolerance in Post-gastrectomy Patients" (197:918, 1966). We have observed results of oral glucose tolerance tests done on 34 gastrectomized patients.1 Twenty-one of these exhibited the characteristic pattern of initial hyperglycemia followed by sharp descent to hypoglycemic levels. Six of these subjects underwent an intravenous glucose tolerance test. The subsequent one-, two-, and three-hour levels were within normal limits. No hypoglycemia was noted in reaction to the sharp rise in the systemic level of blood sugar, produced by the administration of glucose intravenously. None of these patients to date (and some have been observed for as long as 20 years), has exhibited clinical evidence of diabetes mellitus. To consider these patients as potential diabetics is, in my opinion, erroneous. Diabetes mellitus is a genetic disorder, exhibiting, in addition to the carbohydrate disturbance, accelerated atherosclerosis, microangiopathy (involving


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