Irvine McQuarrie 



419 



given, administration of 2 gm. of NaCl per kilogram of body weight per day not 

 infrequently resulted in the patient's having typical hypoglycemic reactions. 

 The level of serum K tended to fall and the vninary excretion of K was in- 

 creased slightly by excessive ingestion of NaCl. Both the systolic and the dias- 

 tolic blood-pressure readings were gradually elevated to levels between 30 

 and 50 per cent above their base lines, as a result of the increased NaCl intake. 

 In the case of one patient, showing the hypercorticoadrenal syndrome with 

 an atypical form of diabetes mellitus, arterial hypertension, and a disturbance 



Fig. 1. Effects of fiigh-Na, low-K regimen on glycosuria, fasting blood sugar (Bl. Gl.) and 

 respiratory quotient (R.Q.) in severe diabetics. L.R., age 15 years, a salt craver, was more re- 

 sponsive to Na than other diabetics tested. 



in electrolyte metabolism (increased Na and reduced K in the serum), inges- 

 tion of extra NaCl appeared from a single short test to have a deleterious rather 

 than a beneficial effect (McQuarrie and co-workers"'). 



In an attempt to learn which, if either, of the two ions, Na or CI, was the 

 more important in producing these changes, KCl was substituted for, or was 

 given in addition to, NaCl in approximately one-third chemically equivalent 

 amounts in a number of separate experiments. As illustrated by the three 

 experiments represented in figure 2, w^hich is largely self-explanatory, the 

 effects of the K salt were found to be diametrically opposite to those produced 

 by Na salts. Glycosuria and fasting blood-sugar levels were gradually increased, 

 while the blood pressure w\is reduced. In a small series of unpublished observa- 

 tions on ordinary juvenile diabetics, Thompson'' subsequently found that 

 the dosage of insulin required for adequate treatment could be reduced signifi- 

 cantly by selecting a diet w^ith a very low K content, other factors remaining 

 unchanged. In an unusually severe case of spontaneous hypoglycemia is an 

 adult patient showing a low concentration of K in the serum, the fasting blood 

 sugar rose from a level around 12 mg. per cent to values varying between 53 



