Laboratory Diagnosis of Diabetes: A Reappraisal

IT IS QUITE possible that means will soon be developed for identifying a specific defect in persons with genetically determined diabetes. But for the present the diagnosis still requires evidence of disturbed glucose tolerance. It has now been more than half a century since Jacobsen 1 (1913) reported on the use of a glucose-loading test as a means of measuring carbohydrate tolerance. Other pioneers in this field included Hopkins, 2 and Hamman and Hirschman. 3 These early workers observed that in contrast to normal persons those with diabetes exhibited blood sugar levels, after an oral glucose load, which were usually over 200 mg/100 ml at some time during the first hour and which failed to return to fasting levels by the third hour. Hamman and Hirschman 3 concluded in 1917 that: "In normal persons after ingestion of 100 gm of glucose, the blood sugar rises promptly to a level not