Spontaneous Hypoglycemia in "Smoke" Drinkers

Brown, Thomas McP.

doi:10.1001/jama.1941.02820270012005

Cited by 66 publications

(8 citation statements)

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“…Hypoglycemia after ingestion of ethanolic beverages has been reported (1)(2)(3)(4). In some cases (1,2), hypoglycemia was attributed to the nonethanol ingredients in such mixtures as "smoke" and "solox" (methyl alcohol, and gasoline and ethyl acetate).…”

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confidence: 99%

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Studies on the Mechanism of Ethanol-Induced Hypoglycemia*

Field¹,

Williams²,

Mortimore³

1963

J. Clin. Invest.

188

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Hypoglycemia after ingestion of ethanolic beverages has been reported (1-4). In some cases (1, 2), hypoglycemia was attributed to the nonethanol ingredients in such mixtures as "smoke" and "solox" (methyl alcohol, and gasoline and ethyl acetate). Cummins, however, suggested that hypoglycemia might be caused by ethanol itself (3). He described a 6-year-old boy who had convulsions and hypoglycemia after ingestion of gin. Neame and Joubert also ascribed hypoglycemia observed in their patients to ethanol rather than other ingredients (4). They also emphasized the inadequate dietary intake before the ethanolic ingestion and the development of hypoglycemia.Recently, we studied a chronic alcoholic patient who had several documented episodes of hypoglycemia and minimal evidence of abnormal liver function. Our findings indicated that his hypoglycemia was probably induced by ethanol consumption in combination with a poor dietary intake. Studies were also performed with normal control subjects which indicated that ethanol ingestion after a 2-day fast caused hypoglycemia. During ethanol-induced hypoglycemia, conversion of fructose to glucose was normal, but glycogen synthesis appeared to be inhibited, from the failure of an adequate hyperglycemic response to glucagon. Animal studies suggested that ethanol caused hypoglycemia by interfering with gluconeogenesis as well as glycogen synthesis. Recent studies reported in abstract form have also proposed that the mechanism of ethanol-induced hypoglycemia might be an interference in gluconeogenesis (5). MATERIALS AND METHODSThe patient C.P. was a white, 52-year-old, male plumber. He had a long history of ethanol ingestion averaging approximately one pint of whiskey daily. His dietary habits were variable and he would frequently miss one or two meals a day. His first episode of hypoglycemia came 10 years ago when he suddenly felt dizzy and collapsed after a 24-hour fast. He denied any ethanolic intake just before this episode. He was treated with iv glucose and made a prompt recovery. His next attack came 6 years later under similar circumstances; blood sugar was 28 mg per 100 ml, and he responded rapidly to 25 g iv glucose. One year later, another episode of hypoglycemia with a blood glucose of 28 mg per 100 ml was documented; a 6-hour glucose tolerance test was normal, and a 3-day fast did not cause hypoglycemia. Two years before admission, he was seen at home by his physician for another, similar, but somewhat milder, attack. He gave a history then of heavy alcoholic consumption for the 2 preceding days and no food intake for the 24 hours just before the attack. He was treated with glucose and responded promptly. The recurrence of a similar episode with a blood glucose of 25 mg per 100 ml led to the patient's hospitalization at the Clinical Center of the National Institutes of Health. Physical examination was unremarkable, except for severe, symmetrical, subcutaneous lipomatosis limited to the upper half of the body and bilateral, sensory, peripheral neuropathy of the legs. He...

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confidence: 99%

“…In some cases (1,2), hypoglycemia was attributed to the nonethanol ingredients in such mixtures as "smoke" and "solox" (methyl alcohol, and gasoline and ethyl acetate). Cummins, however, suggested that hypoglycemia might be caused by ethanol itself (3).…”

mentioning

confidence: 99%

Studies on the Mechanism of Ethanol-Induced Hypoglycemia*

Field¹,

Williams²,

Mortimore³

1963

J. Clin. Invest.

188

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“…Conceming alcoholic hypoglycemia, more than one hundred reports (Heggarty 1970, Ohlzra et al 1973, Deodhlzr, Desai, Haii, Pimparkar and Mehta 1974 have been presented since Brown and Harvey (1941) reported their studies. Only a few have dealt with changes in endocrine function.…”

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confidence: 99%

Isolated Corticotrophin-deficiency Found through Alcohol-induced Hypoglycemic Coma

Baba¹,

Takase²,

Uenoyama³

et al. 1976

Horm Metab Res

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“…The investigations have also inspired a new test, employing alcohol, which may have usefulness in the metabolic characterization of clinical disorders. 12 During the subsequent 20 years, this syndrome of "alcohol hypoglycemia" had been reported in less than 100 other patients, as reviewed by Freinkel et al 7 Thus, as of 1962, the hypoglycemia had been ascribed to denaturants or congeners in the alcoholic beverages or to a "toxic" hepatitis induced by the ethanol. 8 They are summarized in the present communication together with further extensions based on ongoing work.…”

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Effects of Alcohol on Carbohydrate Metabolism in Man

Freinkel

Arky²

1966

Psychosomatic Medicine

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Since 1960, studies in this laboratory have focused on the interactions between ethanol and carbohydrate metabolism. It has been demonstrated that alcohol has hypoglycemic properties when administered after appropriate periods of dietary deprivation. The blood-sugar-lowering action is independent of changes in insulin secretion or alterations in the peripheral utilization of glucose. It results from direct inhibition of gluconeogenesis. Ketogenesis may be interrupted at the same time coincident with hepatic "over-production" of lactic acid. Mediation has been ascribed to the "extra-reducing equivalents" which are generated in the liver during alcohol oxidation. The diverse potentialities in vivo depend upon the metabolic mixture which is being utilized at the time of exposure to alcohol and upon the ongoing turnover of pyruvate and glycogen within the liver. These considerations have prompted efforts to employ the blood sugar response to standard infusion of alcohol as a new clinical tool for characterizing metabolic disorders.1 N THE fasting state, normal blood sugar is maintained via a delicate equilibrium between the endogenous production and the utilization of glucose. Within the last few years, it has been demonstrated that alcoholf can disrupt this balance.

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Spontaneous Hypoglycemia in "Smoke" Drinkers

Cited by 66 publications

References 0 publications

Studies on the Mechanism of Ethanol-Induced Hypoglycemia*

Studies on the Mechanism of Ethanol-Induced Hypoglycemia*

Isolated Corticotrophin-deficiency Found through Alcohol-induced Hypoglycemic Coma

Effects of Alcohol on Carbohydrate Metabolism in Man

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