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7 III Kongress der International Diabetes Federation, this- seldorf, 625, George Thieme Verlag, 12) Ruedi, B. Felber, J. P., Eisold, A. & Vannotti, de Medicine 93: 1004, ) Samols, E. & Marks, V. : Interpretation of the intravenous glucose test, Lancet i: 462, ) Buchanan, K. D. & Mckiddie, M. T.: The normal insulin response to. glucose. The relationship between blood sugar and plasma insulin, Diabetologia 3: 460, R.: Study of the relationship between glucose and in- responses to an oral glucose load in man. Diabetes sulin Conn, J. W. & Fajans, S. S. : The Prediabetic state: A concept of dynamic resistance to a Prolonged fasting on Insulin secretion, Diabetes 15: 17: 560, ) Genuth, S. M.: Effects of genetic diabetogenic influence, Diabetes 11: 335, , ) Sussman, K. E.: Effect of Prolonged fasting, glucose and insulin metabolism in exogenous obesity, Arch. Int. Med. 117: 343, ) Perley, M. & Kipnis, D. M.: Plasma insulin responses to glu- and tolbutamide of normal weight and obese diabe cose 4) Buchanan, K. D. & Mckiddie, M. T.: Factors tic and nondiabetic subjects, Diabetes 15: 867, determining the plasma insulin response to oral glucose in diabetes mellitus, Diabetes 16: 466, ) Yalow, R. S. & Berson, S. A.: Immunoassay of endogenous plasma insulin in man, J. Clin. Invest. 39: 1157, ) Hales, C. N. & Randle, P. J.: Effects of low carbohydrate diet and diabetes mellitus on plasma concentrations of glucose, nonesterified fatty acid, and insulin during oral glucose-tolerance tests, Lancet P. H. Forsham: Serum insulin response to glucose in Herron, A. L. & Brennan, M. T.: Insulin secretion in Prediabetic Subjects, Lancet i : 290, response to glycemic stimulus: Relation of delayed initial release to carbohydrate intolerance in mild diabetes response to hyperghycemia in prediabetes and 24) Colwell, J. A. & A. Lein: Diminished insulin diabetes mellitus, J. Clin. Invest. 46: 323, ) Novak, M.: Colorimetric ultramicro method for the determination of free fatty acids, J. Lipid Res. 6: 431, ) Oberdisse, K. & Jahnke: Diabetes, A. : Insulin et activite insulinosemblade, Journal Suisse. 20) Kreisberg, R. A., Boshell, B. R., Diplacido, J. & Roddam, R. F.: Insulin secretion in obesity, New Engl. J. Med. 276: 314, ) Luft, R. & Cerasi, E.: Effect of human growth hormone on insulin Production in panhypopituitarism. Lancet ii: 124, ) Ricketts, H. T., R. A. Cherry & L. Kirsteins: Biochemical studies of "Prediabetes", Diabetes 15; 880, ) Grodsky, G., J. Karan, F. C. Pavlatos & mellitus, Diabetes 16: 560, ) Tayler, K. W., J. Sheldon, D. A. Pyke & W. G. Oakley: glucose tolerance and serum insulin in the unaffected first-degree relatives of diabetes, Brit. Med. J. 4: 22, 1967.

8 26) Pyke, D. A. & K. W. Tayler: glucose tolerance and serum insulin in unaffected identical twins of diabetes, Brit. Med. J. 4: 21, ) Luft, R.: Some considerations on the pathogenesis of diabetes mellitus, New Engl. J. Med. 279: 1086, ) Soeldner, J. S., R. E. Gleason, R. F. Williams, M. J. Garcia, D. M. Beardwood & A. Marble: Diminished serum insulin response to glucose in genetic prediabetic males with normal glucose tolerance, Diabetes 17: 17, ) Boden, G., J. S. Soeldner, R. E. Gleason & A. Marble: Elevated serum human growth hormone and decreased serum insulin in prediabetic males after intravenous tolbutamide and glucose, J. Clin. Invest. 47: 729, ) Chiumello, G., Del Guercio, M. J., Carnelutti, M. & Bidone, G.: Relationship between Obesity, chemical diabetes and beta pancreatic function in children, Diabetes 18: 238, ) Bagdate, J. D., Bierman, E. L. & Porte D.: The significance of basal insulin levels in the evaluation of the insulin response to glucose in diabetic and nondiabetic subjects, J. Clin. Invest. 46: 1549, ) Randle, P. J., Garland, P. B., Newsholme, E. A. & Hales, C. N. : The glucose fatty acid cycle in obesity and maturity onset diabetes mellitus, Ann. N. Y. Acad. Sci. 131: 324, ) Reitsma, W. D.: The relationship between serum free fatty acid and blood sugar in non-obese and obese diabetics, Acta. Med. Scand. 182: 353, ) Bierman, E. L., Schwartz, I. L. & Dole, V. P. : Action of insulin on release of fatty acid from tissue stores, Amer. J. Physiol. 191: 359, Abstract Relationship between Glucose Tolerance Curve and Serum Insulin Response after Glucose Loading Reiko Saito, M. D. Department of Internal Medicine (Director: Tokyo Women's Medical College, Tokyo Prof. Kinori Kosaka, M. D.), The serum insulin response of diabetic subjects is reported to be higher than that of nondiabetic ones, and there are also studies which reported lower insulin response in diabetics. In order to clarify this discrepancy or changes from high insulin response to low one, the relationship between glucose tolerance curve and serum insulin response was investigated. Two hundred and fourteen males and one hundred and thirty-two females, untreated diabetic or obese, were studied. As controls eleven males and fourteen females, healthy and non obese, were used. One hundred glucose was administered orally, and serum sample were obtained at fasting, half, one, one and half, two and three hours after administrati on. Serum blood sugar, FFA and IRI were determined. The results are as follows: 1) The IRI response of borderline hyperglycemic subjects was higher and more delayed than that of normal ones. The patterns of responses of blood sugar and IRI are quite similiar each other. 2) The IRI response of diabetic subjects with fasting blood sugar level of less than 119 mg/dl was highest among tested, and the peak rise of insulin was retarded till two hours after glucose loading. 3) The IRI response became lower little by little, coincidently with the progress of decrease of glucose tolerance. Especially, diabetics with fasting blood sugar level of more than 160 mg/dl showed very low insulin response in comparison with those of less blood sugar value. 4) In subjects with same glucose tolerance, obese

9 group showed higher insulin response than non obese one. Both had lower insulin response with the progress of decrease of glucose tolerance. 5) The ratio ƒ IRI/ƒ Blood Sugar during initial thirty minutes after glucose loading decreased with the lowering of glucose tolerance. 6) Fasting levels of FFA in serums of diabetic, borderline and normal subjects were high in this order, but there was no significant difference in their falling rate after glucose loading.

1) Roth, J., Glick, S. M., Yalow, R. S. and Berson, S. A.: Hypoglycemia: A potent stimulus to secretion of growth hormone. Science, 140, 987-988, 1963. 2) Ogawa, N.: Routine Ultramicro-Measurement of Human

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