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January 14, 1939

SURGICAL ASPECTS OF HYPOGLYCEMIA ASSOCIATED WITH DAMAGE TO THE LIVER

Author Affiliations

ANN ARBOR, MICH.

From the Department of Surgery, University of Michigan Medical School.

JAMA. 1939;112(2):128-134. doi:10.1001/jama.1939.02800020034007
Abstract

One of the many important functions of the liver is concerned with carbohydrate metabolism. It is fairly well established that the liver makes and stores glycogen and liberates it to the blood stream as dextrose, through which mechanism the normal glycemic level is maintained. It has been shown that gross interference with the liver, such as surgical extirpation, massive destruction by poisoning or replacement of large amounts of liver tissue by tumor, greatly disturbs this function.

The experiments of Mann1 on extirpation of the liver established the fact that this organ is absolutely essential to the maintenance of a normal blood sugar level. Several hours after total hepatectomy his animals had a definite train of symptoms on the basis of demonstrated hypoglycemia. Invariably the animals were temporarily restored to normal by intravenous injection of dextrose.

Recognition of the clinical state of hypoglycemia followed the introduction of insulin into diabetic

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