Experimental Diabete Gras 



211 



ease; diabetes with obesity, according to him, was not of pan- 

 creatic origin. Although most clinicians maintain that it is im- 

 possible to recognize the sharp distinction between diabete maigre 

 and diabete gras, yet the fact remains that the physician in the 

 majority of cases sees either lean or stout diabetics. 



Diabetic children and young adults are usually lean, from the 

 beginning of the disease until exitus. According to Joslin, 2 obesity 

 is a marked feature of diabetes in the fifth and sixth decade of 

 life. One must admit that while diabete gras may ultimately 

 turn into diabete maigre, the latter condition rarely is trans- 

 formed to the former. 



Clinically three varieties of diabete gras may be distinguished : 



1. Obesity associated with excretion of sugar in the urine. 



2. Obesity with hyperglycemia in the absence of glycosuria. 



3. Obesity with lowered glucose tolerance in the absence of 

 hyperglycemia or glycosuria. 



The recognition of the first variety is simple. Diabetics belong- 

 ing to the first variety may remain obese until coma sets in. In 

 order to diagnose the second variety, one must be sure that the 

 renal filter is intact. Under anti-diabetic treatment patients be- 

 longing to the second variety may temporarily lose in weight, the 

 glycemia may become normal, but glucose tolerance is usually 

 lowered. 



It is our object to show that obesity and hyperglycemia can 

 be produced in dogs in two ways : 



1. By almost complete thyroidectomy in partially depan- 

 creatized dogs. 



2. By ligation of one pancreatic duct. 



It was previously shown that in persistently glycosuric dogs, 

 after pancreatectomy, the glycosuria and hyperglycemia ceased 

 after removal of the thyroid in toto, although the animals were 

 on a liberal diet. The hyperglycemia, however, cannot be checked 

 by slight suppression of thyroid function, as by partial ligation 

 of the thyroid arteries, or by one-sided lobectomy. After these 

 operations depancreatized dogs usually continue to lose weight 

 as without these procedures. But if after removal of one lobe 

 the second lobe of the thyroid is at a later date removed and a 



2 Joslin, E. P., Jour. Am. Med. Assn., 1921, lxxvi, 2, p. 79. 



