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March 21, 1959


Author Affiliations

615 Williams Ave. Brooklyn 7, N. Y.

1801 Gerritsen Ave. Brooklyn, N. Y.

JAMA. 1959;169(12):1368. doi:10.1001/jama.1959.03000290094022

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To the Editor:—  An article by Nugent and Millhon, entitled "Clinical Evaluation of the Starch Tolerance Test," which appeared in The Journal (168:2260-2262 [Dec. 27] 1958), deserves comment. This test was proposed by Althausen and Uyeyama (Ann. Int. Med.4:563-575 [Sept.] 1954) for the diagnosis of pancreatic disease. They used soluble starch as prepared by Lintner. Nugent and Millhon used both soluble starch and corn starch. Both are practically raw starch. The mixture is most unpalatable. The maximal rise in blood sugar level after the oral ingestion of 100 Gm. of glucose was compared to the rise after the oral ingestion of 100 Gm. of starch, and conclusions were drawn from the difference. In some cases paradoxical results were obtained. In one patient in whom the pancreatic duct was completely obstructed the test gave negative results. In another patient in whom the proximal two-thirds of the pancreas was

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