THE EFFECT OF PROLONGED FASTING ON CARBOHYDRATE METABOLISM: EVIDENCE FOR HETEROGENEITY IN OBESITY

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Abstract
Abnormal glu-cose tolerance is known to occur in the obese. Twelve obese patients were treated by complete starvation for 2-1/2 to 18 weeks. Before fasting an oral glucose tolerance test was performed. According to blood sugar values 120 min. after glucose load, patients were divided into "diabetic" and "nondiabetic" groups. During starvation the "non-diabetic" group showed marked deterioration in glucose tolerance. Mean insulin levels were also altered. The "diabetic" group showed little change on fasting; plasma insulin curves showed reduced, but prolonged insulin response. Results indicate that there may be separate etiological factors in the genesis of obesity in these 2 groups.