0
April 1960, Vol 99, No. 4 >
Article | April 1960

Studies in the Relationship of Amino Acids to Infantile Hypoglycemia FREE

W. A. COCHRANE, M.D., F.R.C.P.(C)
[+] Author Affiliations

Submitted for publication June 4, 1959.

Children's Hospital.

Aided by a grant from the Banting Research Foundation.


AMA Am J Dis Child. 1960;99(4):476-488. doi:10.1001/archpedi.1960.02070030478010.
Text Size: A A A
Published online
Article
References
Comments

Spontaneous hypoglycemia is not a disease but an indication of a defect in the metabolism of glucose in the organism. Excellent reviews by Skillern,1 Conn,2 and McQuarrie3,4 have indicated the large number of possible etiologic factors. Several authors have emphasized that hypoglycemia occurring in infants and children is not an uncommon condition. In McQuarrie's3 report, 26 of 43 cases of hypoglycemia of infancy were classified as idiopathic and the author referred to these as "idiopathic infantile hypoglycemosis."

In 1956, Cochrane et al.5 observed that certain hypoglycemic infants treated with a high-protein diet had an increased frequency of hypoglycemic attacks. This clinical observation that protein aggravates some cases of infantile hypoglycemia was supported by the finding of a marked fall in blood sugar in three cases after the administration of the amino acid L-leucine.5 The selection of this particular amino acid was partly fortuitous circumstance

REFERENCES

1 +
Skillern, P. G., and Rynearson, E. H.:  Medical Aspects of Hypoglycemia , J. Clin. Endocrinol. 13: 587, 1953;.
2 +
Conn, J. W., and Seltzer, H. S.:  Spontaneous Hypoglycemia , Am. J. Med. 19:460, 1955;.
3 +
McQuarrie, I.; Ulstrom, R. A., and Ziegler, M. R.:  Random Notes Concerning the Etiological Mechanisms and Treatment of Spontaneous Hypoglycemia , Acta paediat. 43:481 ( (Supp. 100) ) 1954;.
4 +
McQuarrie, I.:  Idiopathic Spontaneously Occurring Hypoglycemia in Infants , A.M.A. Am. J. Dis. Child. 87:399, 1954;.
5 +
Cochrane, W. A.; Payne, W. W.; Simpkiss, M. J., and Woolf, L. I.:  Familial Hypoglycemia Precipitated by Amino Acids , J. Clin. Invest. 35: 411, 1956;.
6 +
Harris, M. M., and Harris, R. S.:  Effect of Insulin Hypoglycemia and Glucose on Various Amino Acids in Blood of Mental Patients , Proc. Soc. Exper. Biol. & Med. 64:471, 1947;.
7 +
Munro, H. N., and Thomson, W. S. T.:  Influence of Glucose on Amino Acid Metabolism , Metabolism 2:354, 1953;.
8 +
Nelson N.:  A Photometric Adaptation of the Somogyi Method for Determination of Glucose , J. Biol. Chem. 153:375, 1944;.
9 +
Meister, A.: Biochemistry of the Amino Acids , New York, Academic Press Inc., 1957;, p. 116, 118.
10 +
Ashmore, J.; Cahill, G. F., Jr.; Earle, A. S., and Zottu, S.:  Studies on the Disposition of Blood Glucose: A Comparison of Insulin and Orinase , Diabetes 7:1, 1958;.
11 +
Hökfelt, B.:  Discussion of Hypoglycemia and Its Causes, in Proceedings of the Section of Pediatrics and School Hygiene of the Swedish Medical Society, Oct. 12, 1956  abstracted, Acta paediat . 46:396, 1957;.
12 +
Korp, W., and LeCompte, P. M.:  The Nature and Function of the Alpha Cells of the Pancreas: Their Possible Role in the Production of Glucagon , Diabetes 4:347, 1955;.
13 +
Greenberg, R. E., and Gardner, L. I.:  Studies of Free Norepinephrine and Epinephrine Excretion in the Newborn , A.M.A.J. Dis. Child. 98:671, 1959;.
14 +
Conn, J. W.:  The Advantage of a High Protein Diet in the Treatment of Spontaneous Hypoglycemia: Preliminary Report , J. Clin. Invest. 15:673, 1936;.
15 +
Talbot, N. B.; Crawford, J. D., and Bailey, C. C.:  Use of Mesoxalyl Urea (Alloxan) in Treatment of an Infant with Convulsions Due to Idiopathic Hypoglycemia , Pediatrics 1:337, 1948;.
16 +
Gall, J. C., and Burke, E. C.:  Idiopathic Hypoglycemosis: Report of Two Cases , Proc. Staff Meet. Mayo Clin. 30:477, 1955;.
17 +
Meister,9 p. 146.
18 +
Wright, E. M.; Lyson, M. J., and Mortimer, E. A.: Varicella and Severe Hypoglycemia: A Previously Undescribed Syndrome, read by title, at the 66th Annual Meeting of the American Pediatric Society, May 9-11, 1956, Buck Hill Falls, Pa.
19 +
Manzini, C., and Arullani, C.:  Azioni degli aminoacidi sui leucociti e sulla curva glicemica nell 'uomo sano , Fisiol. e med. 5:500, 1934;.
20 +
Manzini, C., and Arullani, C.:  Action des acides aminés sur les leucocytes et sur le combe glycémique , Arch. ital. biol. 89:201, 1933;.
21 +
Schenck, E. G.:  Über die Beeinflussbarkeil der Blutzuckerregulation durch Eiweisstoffe, Aminosäuren und deren Derivate II , Arch. exper. Path. u. Pharmakol. 170:546, 1933;.
22 +
Lockhart, C. E., and Elman, R.:  The Effect of Intravenous Glucose and Amino Acids on Glycosuria and Urinary Output in Humans , Surg. Gynec. & Obst. 88:97, 1949;.
23 +
Grühn, F.:  Über Beeinflussung des Kohlehydralstoffwechsels durch Aminosäuren , Ärtzl. wchnschr. 5:827, 1950;.
24 +
Mellinkoff, S. M.; Boyle, D.; Frankland, M., and Greipel, M.:  The Effect of Amino Acid Administration upon the Blood Sugar Concentration , Stanford M. Bull. 13:117, 1955;.
25 +
Mirsky, I. A.; Perisutti, G., and Diengott, D.:  The Hypoglycemic and Insulinase Inhibitory Action of L-Tryptophane , Endocrinology 59:369, 1956;.
26 +
Gullino, P.; Winitz, M.; Birnbaum, S. M.; Cornfield, J.; O'Key, M. C., and Greenstein, J. P.:  The Toxicity of Individual Essential Amino Acids and Their Diastereomers in Rats and the Effect on Blood Sugar Levels , Arch. Biochem. & Biophys. 58:253, 1955;.
27 +
Maske, H.:  Interaction Between Insulin and Zinc in the Islets of Langerhans , Diabetes 6:335, 1957;.
28 +
Renold, A. E.; Winegrod, A. I.; Froesch, E. R., and Thorn, G. W.:  Studies of the Site of Action of the Arylsulfonylureas in Man , Metabolism 5:757, 1956;.
29 +
Fruton, J. S., and Simmonds, S.: General Biochemistry , New York, John Wiley & Sons, Inc., 1954;, p. 126.
30 +
Harris, J. I., and Li, C. H.:  The Biologic Activity of Enzymatic Digests of Insulin , J. Am. Chem. Soc. 74:2945, 1952;.
31 +
Greenlee, R. G.; White, R. R., and Phillips, C.:  Chronic Hypoglycemia in an Infant Treated by Subtotal Pancreatectomy , J.A.M.A. 149:272, 1952;.
32 +
Gross, R. E.: The Surgery of Infancy and Childhood: Hypoglycemia , Philadelphia, W. B. Saunders Company, 1953;, p. 574-587.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Skillern, P. G., and Rynearson, E. H.:  Medical Aspects of Hypoglycemia , J. Clin. Endocrinol. 13: 587, 1953;.
2 +
Conn, J. W., and Seltzer, H. S.:  Spontaneous Hypoglycemia , Am. J. Med. 19:460, 1955;.
3 +
McQuarrie, I.; Ulstrom, R. A., and Ziegler, M. R.:  Random Notes Concerning the Etiological Mechanisms and Treatment of Spontaneous Hypoglycemia , Acta paediat. 43:481 ( (Supp. 100) ) 1954;.
4 +
McQuarrie, I.:  Idiopathic Spontaneously Occurring Hypoglycemia in Infants , A.M.A. Am. J. Dis. Child. 87:399, 1954;.
5 +
Cochrane, W. A.; Payne, W. W.; Simpkiss, M. J., and Woolf, L. I.:  Familial Hypoglycemia Precipitated by Amino Acids , J. Clin. Invest. 35: 411, 1956;.
6 +
Harris, M. M., and Harris, R. S.:  Effect of Insulin Hypoglycemia and Glucose on Various Amino Acids in Blood of Mental Patients , Proc. Soc. Exper. Biol. & Med. 64:471, 1947;.
7 +
Munro, H. N., and Thomson, W. S. T.:  Influence of Glucose on Amino Acid Metabolism , Metabolism 2:354, 1953;.
8 +
Nelson N.:  A Photometric Adaptation of the Somogyi Method for Determination of Glucose , J. Biol. Chem. 153:375, 1944;.
9 +
Meister, A.: Biochemistry of the Amino Acids , New York, Academic Press Inc., 1957;, p. 116, 118.
10 +
Ashmore, J.; Cahill, G. F., Jr.; Earle, A. S., and Zottu, S.:  Studies on the Disposition of Blood Glucose: A Comparison of Insulin and Orinase , Diabetes 7:1, 1958;.
11 +
Hökfelt, B.:  Discussion of Hypoglycemia and Its Causes, in Proceedings of the Section of Pediatrics and School Hygiene of the Swedish Medical Society, Oct. 12, 1956  abstracted, Acta paediat . 46:396, 1957;.
12 +
Korp, W., and LeCompte, P. M.:  The Nature and Function of the Alpha Cells of the Pancreas: Their Possible Role in the Production of Glucagon , Diabetes 4:347, 1955;.
13 +
Greenberg, R. E., and Gardner, L. I.:  Studies of Free Norepinephrine and Epinephrine Excretion in the Newborn , A.M.A.J. Dis. Child. 98:671, 1959;.
14 +
Conn, J. W.:  The Advantage of a High Protein Diet in the Treatment of Spontaneous Hypoglycemia: Preliminary Report , J. Clin. Invest. 15:673, 1936;.
15 +
Talbot, N. B.; Crawford, J. D., and Bailey, C. C.:  Use of Mesoxalyl Urea (Alloxan) in Treatment of an Infant with Convulsions Due to Idiopathic Hypoglycemia , Pediatrics 1:337, 1948;.
16 +
Gall, J. C., and Burke, E. C.:  Idiopathic Hypoglycemosis: Report of Two Cases , Proc. Staff Meet. Mayo Clin. 30:477, 1955;.
17 +
Meister,9 p. 146.
18 +
Wright, E. M.; Lyson, M. J., and Mortimer, E. A.: Varicella and Severe Hypoglycemia: A Previously Undescribed Syndrome, read by title, at the 66th Annual Meeting of the American Pediatric Society, May 9-11, 1956, Buck Hill Falls, Pa.
19 +
Manzini, C., and Arullani, C.:  Azioni degli aminoacidi sui leucociti e sulla curva glicemica nell 'uomo sano , Fisiol. e med. 5:500, 1934;.
20 +
Manzini, C., and Arullani, C.:  Action des acides aminés sur les leucocytes et sur le combe glycémique , Arch. ital. biol. 89:201, 1933;.
21 +
Schenck, E. G.:  Über die Beeinflussbarkeil der Blutzuckerregulation durch Eiweisstoffe, Aminosäuren und deren Derivate II , Arch. exper. Path. u. Pharmakol. 170:546, 1933;.
22 +
Lockhart, C. E., and Elman, R.:  The Effect of Intravenous Glucose and Amino Acids on Glycosuria and Urinary Output in Humans , Surg. Gynec. & Obst. 88:97, 1949;.
23 +
Grühn, F.:  Über Beeinflussung des Kohlehydralstoffwechsels durch Aminosäuren , Ärtzl. wchnschr. 5:827, 1950;.
24 +
Mellinkoff, S. M.; Boyle, D.; Frankland, M., and Greipel, M.:  The Effect of Amino Acid Administration upon the Blood Sugar Concentration , Stanford M. Bull. 13:117, 1955;.
25 +
Mirsky, I. A.; Perisutti, G., and Diengott, D.:  The Hypoglycemic and Insulinase Inhibitory Action of L-Tryptophane , Endocrinology 59:369, 1956;.
26 +
Gullino, P.; Winitz, M.; Birnbaum, S. M.; Cornfield, J.; O'Key, M. C., and Greenstein, J. P.:  The Toxicity of Individual Essential Amino Acids and Their Diastereomers in Rats and the Effect on Blood Sugar Levels , Arch. Biochem. & Biophys. 58:253, 1955;.
27 +
Maske, H.:  Interaction Between Insulin and Zinc in the Islets of Langerhans , Diabetes 6:335, 1957;.
28 +
Renold, A. E.; Winegrod, A. I.; Froesch, E. R., and Thorn, G. W.:  Studies of the Site of Action of the Arylsulfonylureas in Man , Metabolism 5:757, 1956;.
29 +
Fruton, J. S., and Simmonds, S.: General Biochemistry , New York, John Wiley & Sons, Inc., 1954;, p. 126.
30 +
Harris, J. I., and Li, C. H.:  The Biologic Activity of Enzymatic Digests of Insulin , J. Am. Chem. Soc. 74:2945, 1952;.
31 +
Greenlee, R. G.; White, R. R., and Phillips, C.:  Chronic Hypoglycemia in an Infant Treated by Subtotal Pancreatectomy , J.A.M.A. 149:272, 1952;.
32 +
Gross, R. E.: The Surgery of Infancy and Childhood: Hypoglycemia , Philadelphia, W. B. Saunders Company, 1953;, p. 574-587.

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems