THE EFFECT OF FRACTURES ON BLOOD SUGAR

The author’s attention was first called to the imifluence of fm-actum-es omi sugar metabolismu by the followimig case: A young lads’, twenty-two years of age, adulitte(l to the Utliversity Hospital on July 21, 1933, with a comminuted fracture of the left tii)ia. The fracture was reduced and a cast applied. This patient gave a history of ilaving been a (liabetic for eleven years, but for the past eight yeais she had been sugar-free. She laid taken insulin from time to tune and had watched liei- diet to a certain extent. Illlnlediatelv following the iijuny, a sufficient alnOunt. of sugar was excreted in tile umine so pmonlptly that reduction took place with one drop of urine. Four days after admission, the patient became comatose and tile blood sugar was found to he 400 milli-glaills per 100 cui)ic centimeters of blood, the acet.omle 3 plus and diacet.ic acid 2 plus. She was given orange juice alld treated with imisulinl-twenty-five units every two ilOurs. \\itliill twenty-four hours tile blood sugar had dropped to 100 milligrams per 100 cubic centimeters, but there was still present acetone 3 plus and diacetic acid 3 plus. Th