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The glucose tolerance, the insulin concentration in serum, and concentrations of free fatty acids (FFA), triglyceride and cholesterol in plasma or serum were examined in 25 patients of normal weight and below the age of 62 years; they were all suffering from ischaemic heart diseases (angina pectoris and/or earlier episodes of coronary occlusion). A clinical diagnosis of diabetes mellitus was not established in any of these cases; the patients were not predisposed to diabetes, and neither hypertension nor reduced renal function was observed in any of the patients. Patients who on an earlier occasion had experienced episodes of coronary occlusion were seen at least three years after such occurrence. Among the 25 patients the glucose tolerance was reduced in 12 (k <1.10), determinations being made by glucose elimination after intravenous application of glucose. In patients in whom the glucose tolerance was found to be reduced, concentrations of insulin were reduced and FFA elevated, suggesting latent diabetes mellitus. In patients in whom the glucose tolerance remained normal, the insulin concentration in serum was found to be abnormally high. Whether the demonstrated abnormal metabolism may be of significance for the pathogenesis of ischaemic cardiovascular lesions remains to be defined.

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