To the Editor.—
In a recent EDITORIAL, "Function of the Alpha Cell in Diabetic Ketoacidosis" (224:1643, 1973), you mentioned the work of Unger et al1 and Müller et al2 that demonstrated the hyperglucagonemia of ketoacidosis. It would be interesting to see what effect a hypoglycemic sulphonylurea had on these elevated levels of glucagon, since Samols and coworkers3,4 have shown that these agents directly suppress plasma glucagon values, although this has been disputed. Tolbutamide, or similar agents, if effective, could reduce the requirement of large doses of insulin.
Bartle B. The Alpha Cell in Diabetic Ketoacidosis. JAMA. 1973;225(12):1533. doi:10.1001/jama.1973.03220400059023