Sugar in Diabetes Mellitus. 



151 



mental diabetes leads to a diminution or cessation of the glyco- 

 suria with a progressive rise in the sugar content of the blood. 

 The removal of both kidneys in animals, previously made dia- 

 betic by pancreatectomy, causes a progressive increase in the 

 hyperglycemia. 1 



4. Operative procedures in non-diabetic individuals, involving 

 the use of anesthetics (nitrous oxid and ether) lead to the develop- 

 ment of a hyperglycemia, and rarely a glycosuria. 



5. Cases of diabetes are frequently encountered showing no 

 evidence of renal disease, in which the glycosuria disappears 

 spontaneously or as the result of treatment, but in which a hyper- 

 glycemia persists. The hyperglycemia may be of high degree, 

 and show slight or no variation. 



When tests to ascertain the functional activity of the kidneys 

 are instituted on the different types of cases represented above, 

 the following phenomena are observed: 



1. In diabetic individuals in whom the glycosuria is propor- 

 tionate to the hyperglycemia the response of the kidneys to the 

 phenolsulfonephthalein test is normal. 



2. That when the hyperglycemia and the glycosuria in dia- 

 betic individuals do not show any relationship (the hyperglycemia 

 being greater than one would expect to find with a limited gly- 

 cosuria) there is a delayed excretion of phenolsulfonephthalein. 

 This group of cases, as stated above, is usually demonstrably 

 nephritic. 



3. Non-diabetic cases, subjected to surgical procedures (under 

 anesthesia) which develop a hyperglycemia but no glycosuria, 

 show a delayed elimination of phenolsulfonephthalein. 2 



4. Diabetic individuals, who lose their glycosuria spontan- 

 eously or as a result of treatment, but retain a hyperglycemia, 

 show a normal excretion of the dye. 



5. From the observations thus accumulated, the following 

 deductions are made: 



I. When a diabetic process is active (as a result of disease or 

 experimental procedures) actual disease or defective function of 



1 Epstein, Albert A., and Baehr, George, J. Biol. Chem., Vol. XXIV, p. 1, 1916. 

 « Epstein, A. A., Reiss, J., and Branower, J., Soon to be published. Jour. BioL 

 Chem. 



