UNDERNUTRITION AND CARBOHYDRATE METABOLISM

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Abstract
"The maximum utilization of administered glucose is found in the normal individual when carbohydrate has been abundantly supplied in the diet. The minimum effect is obtained in the completely depancreatized animal which excretes all of the ingested sugar in the urine. Between these extremes is a series of less sharply defined intermediate stages. As the amt. of carbohydrate in the diet is diminished the glucose tolerance test indicates a decreased utilization. During complete inanition there is a progressive deprivation of the carbohydrate stores in the body and an increasingly larger fraction of the test meal is lost by excretion as the fast continues. A more drastic and exaggerated condition is seen in the animal depleted by phlorhizin glycosuria. Approaching pancreatic diabetes at the lower end of the scale are the various stages of diabetes mellitus and the endocrine disturbances involving the pituitary and the adrenal. Of the many factors exerting a controlling influence on the different degrees of carbohydrate utilization as outlined, the importance of two is apparent[long dash]the amt. of carbohydrate available to the cells and the endocrine control. The former seems to predominate at the beginning of the series but is superseded by the latter toward the minimum end." The literature presented in this review gives the evidence supporting these generalizations, with special emphasis on the nutritional condition with respect to carbohydrate.