Gabriel Spergel

Carbohydrate and Fat Metabolism in Patients with Pheochromocytoma

Abstract Abnormal carbohydrate metabolism in pheochromocytoma has been ascribed to glycogenolysis provoked by catecholamines. Studies in two patients with this tumor revealed two additional factors...

The effect of potassium on the imparired glucose tolerance in chronic uremia

Abstract The glucose intolerance of 4 patients with chronic uremia was studied. All patients were shown to have low values for total exchangeable body potassium (K E ), and abnormal oral glucose tolerance tests. Although plasma urea nitrogen values fell during the period of potassium replacement there was no apparent improvement in renal function as plasma creatinine concentrations did not significantly change. When K E was raised by oral potassium supplementation, the glucose tolerance tests returned toward normal. Following potassium the response of endogenous insulin was more prompt and reached higher values than during the control period. Delayed insulin release apparently contributes to the abnormal oral glucose tolerance found in the uremic state.

Studies of Hypertension and Carbohydrate Intolerance Associated with Wilms Tumor

Abstract An infant with a Wilms tumor and severe hypertension was studied to evaluate the concept that a humoral substance secreted by the tumor caused the hypertension. Abnormal glucose tolerance,...

Effects of Diazoxide Administration on Plasma Glucose, Insulin, and Lipids in Von Gierke's Disease

A twelve-year old boy with proven type 1 glycogen storage disease and accompanying hypoglycemia and hyperlipemia was treated with diazoxide. Increase of 30 to 70 mg. per 100 ml. in postprandial plasma glucose levels and decrease in oral glucose tolerance occurred. Skin xanthomata disappeared during diazoxide treatment despite an increase of over 1,700 mg. per 100 ml. in plasma triglycerides. Treatment of the patient had to be discontinued after seventeen days because of a diffuse petechial eruption, presumably due to drug sensitivity. The mechanism(s) by which hyperglycemia is induced with diazoxide are not yet established. Glycogenolysis would appear to be excluded in this patient by virtue of the enzymatic deficiency present. Inhibition of plasma insulin response to glucose was demonstrated. Support for a third mechanism is presented, based on analysis of serial oral glucose tolerance tests. It is suggested that diazoxide, directly or indirectly, inhibits hepatic glucose uptake.

Hypomagnesemia in Neonatal Tetany Associated with Maternal Hyperparathyroidism

HYPOCALCEMIC tetany has been noted in the offspring of 13 mothers with primary hyperparathyroidism since the initial description by Friderichsen in 1938.1 Transplacental passage of the maternal ele...

Effects of Hypokalemia on Carbohydrate and Lipid Metabolism in the Rat

A study has been made of the effect of hypokalemia on carbohydrate and lipidmetabolism. Forty-two male Wistar rats, divided into three groups, were fed a low-potassium diet for two weeks. One group was injected with saline and fed a diet and drinking water supplemented with potassium, a second group was injected with desoxycorticosterone acetate (DOCA), while the third group was DOCA-treated and given potassium supplement. One week after the last injection, intracardiac glucose tolerance tests were performed, and blood and tissue specimens obtained for potassium, insulin, glucose, free fatty acids (FFA), and glycogen. Hypokalemia, successfully induced by this regimen, was associated with: (1) retardation of growth; (2) increased liver and muscle glycogen; (3) no change in liver potassium; (4) increased fat potassium; (5) decreased muscle potassium; (6) elevation of fasting, and one- and two-hour post-glucose blood sugar concentrations; (7) no change in rate of early rapid disappearance of injected glucose; (8) no effect on fasting or post-glucose plasma FFA levels; and (9) no effect on mean fasting or post-glucose insulin levels, but a reduction in differential insulin response after glucose.