TY - JOUR
T1 - Alimentary Hypoglycemia in the Absence of Gastrointestinal Surgery
AU - Permutt, M. Alan
AU - Kelly, John
AU - Bernstein, Robert
AU - Alpers, David H.
AU - Siegel, Barry A.
AU - Kipnis, David M.
PY - 1973/6/7
Y1 - 1973/6/7
N2 - In three patients who had repeated episodes of symptomatic postprandial hypoglycemia, oral glucose tolerance testing demonstrated normal initial insulin response but subsequent hyperinsulinemia and hypoglycemia. Intravenous glucose and tolbutamide provoked normal glucose and insulin responses, suggesting normal beta-cell function. Evidence that the hyperinsulinism and hypoglycemia provoked by oral glucose was due to alimentary factors included hyperglycemia, hyperinsulinism, and subsequent hypoglycemia after duodenal glucose infusions, normal gastric emptying as measured by a radioisotopic method, and control of the hyperglycemic, hyperinsulinemic responses and of hypoglycemic symptoms in these patients by phenformin, a drug reported to impede glucose absorption from the gut. We conclude that alimentary hypoglycemia may occur in the absence of gastrointestinal surgery, and can be distinguished from the hypoglycemia of early diabetes by normal to increased initial insulin secretion after the ingestion of glucose. (N Engl J Med 288:1206–1210, 1973).
AB - In three patients who had repeated episodes of symptomatic postprandial hypoglycemia, oral glucose tolerance testing demonstrated normal initial insulin response but subsequent hyperinsulinemia and hypoglycemia. Intravenous glucose and tolbutamide provoked normal glucose and insulin responses, suggesting normal beta-cell function. Evidence that the hyperinsulinism and hypoglycemia provoked by oral glucose was due to alimentary factors included hyperglycemia, hyperinsulinism, and subsequent hypoglycemia after duodenal glucose infusions, normal gastric emptying as measured by a radioisotopic method, and control of the hyperglycemic, hyperinsulinemic responses and of hypoglycemic symptoms in these patients by phenformin, a drug reported to impede glucose absorption from the gut. We conclude that alimentary hypoglycemia may occur in the absence of gastrointestinal surgery, and can be distinguished from the hypoglycemia of early diabetes by normal to increased initial insulin secretion after the ingestion of glucose. (N Engl J Med 288:1206–1210, 1973).
UR - http://www.scopus.com/inward/record.url?scp=0015916848&partnerID=8YFLogxK
U2 - 10.1056/NEJM197306072882304
DO - 10.1056/NEJM197306072882304
M3 - Article
C2 - 4700554
AN - SCOPUS:0015916848
SN - 0028-4793
VL - 288
SP - 1206
EP - 1210
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 23
ER -