February 21, 1966

Glucose Tolerance and "Dumping" Syndrome

JAMA. 1966;195(8):700-701. doi:10.1001/jama.1966.03100080140053

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To the Editor:—  On occasion of the recent "Diabetes Week" (JAMA194:664, 1965) with emphasis on laboratory diagnosis, it may be timely to caution that the traditional glucose tolerance test routinely performed in doubtful cases of diabetes may not always be an entirely harmless procedure. With greater numbers of gastrectomized individuals at large, there are increasing chances of precipitating "dumping" syndromes after the drinking of highly concentrated glucose solutions which may pass rapidly through potential gastric stumps and stomata into the small intestines. Since 5% solution of glucose is isotonic (more precisely, 5.43% of —0.56 C freezing point identical with that of serum and yielding 302 mOsm/liter [JAMA192:1112; 194:471,1965] ), it follows that the conventional 100-gm dose dissolved in about 200 ml must be diluted with nearly 2 liters of water in order to lower the osmolarity to isotonic level. Thus, grossly hypertonic glucose within the intestinal

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