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June 1966

Carbohydrate Intolerance in Postgastrectomy Patients

Author Affiliations

From the Department of Internal Medicine, University of Iowa, College of Medicine, Iowa City. Dr. Robertson is presently at Edinburgh University, Scotland.

Arch Intern Med. 1966;117(6):764-768. doi:10.1001/archinte.1966.03870120028006

AFTER a gastric operation for peptic ulcer many patients show an abnormal response to an oral glucose tolerance test.1 The blood sugar curve obtained during a test is characterized by a rapid rise to an abnormally high level and then a fall to normal, or to hypoglycemic levels, at two hours. The fall in blood sugar levels may be accompanied by hypoglycemic symptoms.2 This type of blood sugar curve has been called the lag curve,3 or the curve of alimentary hyperglycemia. It is usually attributed to the rapid absorption of glucose in the jejunum, secondary to rapid transit from the stomach. This curve is not confined to those who have had a gastric operation, however, for it may be found in otherwise healthy people, or in thyrotoxic patients.

LeQuesne and co-workers 4 studied carbohydrate metabolism and plasma volume changes in patients who developed the dumping syndrome after

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