CORTISONE INDUCED IMPAIRMENT OF GLUCOSE TOLERANCE IN THE DETECTION OF THE DIABETIC DIATHESIS

¹ The Department of Therapeutics, University of Edinburgh

1. The effect of cortisone on glucose tolerance was investigated by the administration of 200 mg. of cortisone 120 minutes before an intravenous glucose tolerance test. The resultant increment index (I.I.) has been compared with the control I.I.

2. In 20 normal persons no change was observed following cortisone. In 16 patients with mild diabetes, the I.I. after cortisone was lower than the control I.I. by an average of 33 per cent. In 10 persons with latent diabetes, the I.I. after cortisone was lower than the control I.I. by an average of 38·5 per cent. Nineteen persons suspected of being in a prediabetic state were tested, and in 9, cortisone induced a lowering of the I.I. by at least 30 per cent of the control I.I. value. Of these patients, two have subsequently become clinically diabetic. In no other persons tested was this cortisone-induced impairment of glucose tolerance observed.

3. It is suggested that the use of an intravenous technique for the determination of glucose tolerance is the most precise measure of that function, and that the impairment of glucose tolerance induced by preliminary administration of cortisone makes it possible to diagnose the diabetic diathesis before any defect in carbohydrate tolerance is demonstrable by other laboratory tests.

Note:

My thanks are due to Professor D. M. Dunlop for his constant encouragement, and to Dr. A. G. Macgregor for his help in the preparation of this paper.