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October 1964

Alcohol Hypoglycemia: Effects of Ethanol on Plasma; III. Glucose, Ketones, and Free Fatty Acids in "Juvenile" Diabetics: A Model for "NonKetotic Diabetic Acidosis"?

Author Affiliations


From the Thorndike Memorial Laboratory and Second and Fourth (Harvard) Medical Services, Boston City Hospital, and the Department of Medicine, Harvard Medical School.

Arch Intern Med. 1964;114(4):501-507. doi:10.1001/archinte.1964.03860100083009

Within the last two years, it has been shown that pure ethanol * can elicit hypoglycemia when administered after appropriate periods of fasting.1-4 In normal subjects, a minimum of two to three days of starvation is necessary.1,3,4 On the other hand, in subjects with marginal gluconeogenic reserve, only overnight fast may be required.1,2 In both situations, the hypoglycemia is not responsive to glucagon2-4 and it is not attended by elevations of plasma insulin.1,2,5 Direct in vitro studies have indicated that lowering of blood sugar may be ascribed, at least in part, to an interference with intrahepatic mechanisms for gluconeogenesis from smaller carbon fragments.1,6

Since ketogenesis and gluconeogenesis usually increase in concert during starvation, we have attempted to assess whether the ethanol-induced hypoglycemia is accompanied by alterations in plasma ketones. For our studies, we have employed "juvenile" diabetics from whom short-acting (ie, "regular") insulin was withheld

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