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Article
November 1962

Serum Osmolality and Glucose in Maturity Onset Diabetes Mellitus

Author Affiliations

BOSTON

Formerly Research Fellow in Medicine, Harvard Medical School, and Thorndike Memorial Laboratory (Dr. Singer); Associate in Bio-Statistics, Harvard School of Public Health (Margaret Drolette); Assistant Clinical Professor of Medicine, Harvard Medical School; Chief, Diabetes Clinic, and Visiting Physician, Second and Fourth (Harvard) Medical Services, Boston City Hospital; Chief, Medical Service, Mount Auburn Hospital, Cambridge, Mass. (Dr. Hurwitz); Assistant Professor of Medicine, Harvard Medical School; Assistant Physician, Thorndike Memorial Laboratory, Boston City Hospital; Assisting Physician, Boston City Hospital; Investigator, Howard Hughes Medical Institute (Dr. Freinkel).; Thorndike Memorial Laboratory and Second and Fourth (Harvard) Medical Services, Boston City Hospital, and the Department of Medicine, Harvard Medical School, and the Harvard School of Public Health.

Arch Intern Med. 1962;110(5):758-762. doi:10.1001/archinte.1962.03620230204028
Abstract

Although extensive investigation has been focused upon the derangements of intermediary metabolism which result from impaired utilization of glucose, relatively little attention has been paid to the physiological consequences of hyperglycemia per se. In this regard, it should be recalled that glucose, as a solute, adds to total osmolality of body water and that it is principally confined to the extracellular fluids. Thus, excessive elevations of plasma glucose should elicit a shift of water from intracellular to extracellular compartments and result in cellular dehydration1-3 unless repair is effected by the stimulation of thirst and the renal conservation of water.

These interrelationships are uniquely challenged in diabetes mellitus. The stresses are mediated not only by the sustained hyperglycemia that characterizes poor regulation, but also by the almost invariable, excessive hyperglycemia that occurs in the immediate postprandial period. Since each change of blood sugar of 18 mg. % also represents a change

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