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SUGAR FORMATION FROM FATS. 413
indicate the same, namely, that in phlorhizin diabetes after the disap-
pearance of the liver-glycogen the fat which migrates to the liver serves
as material for the formation of sugar (Pfluger). These observations
make the formation of sugar from fat highly probable and the same is true
for the observations of Junkersdorf.1
He found that in an animal made
glycogen free, by starvation and with phlorhizin poisoning, that toward
death, the nitrogen as well as the sugar elimination increased but that
the D : N ratio was higher than with the sugar formation from protein
alone. His calculations are not free from exception.
On the other hand there are many observations on animals and
also clinical observations which oppose the theory of the formation
of sugar from fat in diabetes. Lusk found in a dog with phlorhizin
diabetes that the quotient D:N = 3.65:1 was not changed on feeding fat,
and he has published further results of experiments 2
which show that
active muscular work, which strongly increases the fat decomposition,
does not change the quotient in dogs with phlorhizin diabetes. It is
difficult to draw positive conclusions from these experiments, still Lusk
seems to deny the formation of sugar from fat.
Attempts have been made to solve the question as to the material
from which sugar is formed by the determination of the respiratory
quotient and comparing this with the quotient D:N. The calculations
in this direction have not led to positive results.3
As the quotient D : N
is not an accurate measure of the quantity of sugar formed, and as we,
as yet, do not know the quantity of oxygen necessary to form sugar
from protein, Hammarsten believes that it is just as impossible to con-
clude from the respiratory quotient that sugar is formed from the fats
as from the proteins.
We have no complete proofs for the formation of sugar from fat, still
we can indicate the probable proofs therefor. There is really no objec-
tion from a theoretical standpoint to the assumption that the body has
the power of producing sugar from protein as well as from fat, and such
a power does not seem improbable.
As a formation of sugar from protein is now generally considered as
proved, it follows that the protein can yield material for the formation
of glycogen and that it is a true glycogen-former. Pfluger and Junkers-
dorf 4
have given direct proof for this. They fed a dog, which had
previously been made glycogen-free by starvation and phlorhizin injec-
1
Pfliiger’s Arch., 137.
2
Amer. Journ. of Physiol., 22.
3
Magnus-Levy, Zeitschr. f. klin. Med., 56; Pfliiger’s Arch., 108; Mohr, Zeitschr.
I. exp. Path. u. Therap., 4.
* Pfliiger’s Arch., 131.
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