Glucose disappearance rates and serum immunoreactive insulin levels following the infusion of glucose and glucose with glucagon were studied in eleven normal subjects, fortyeight children classified as chemical diabetics, and seventeen children with the recent onset of overt diabetes in the early recovery phase of the disease.

Children with chemical diabetes had significantly lower glucose disappearance rates than the normal controls and significantly higher disappearance rates than the children with overt diabetes. Compared with the normal controls, the change in glucose disappearance rates due to glucagon was significantly reduced in chemical diabetics and absent in overt diabetics.

Normal subjects and chemical diabetics responded to glucose and glucagon infusion by increasing the serum IRI levels. Chemical diabetics formed a heterogeneous group with respect to the serum IRI response to glucagon. Children classified as “late” chemical diabetics, like the overt diabetics, had decreased serum IRI responses to glucagon.

Children with chemical diabetes who have blood sugar values outside the ninety-seventh and third percentiles of the distribution of normal values during an oral glucose tolerance test are already in an advanced (late) stage of chemical diabetes and are likely to have their disease progress rapidly to overt diabetes. Children with “late” chemical diabetes have glucose disappearance rates less than 1.1 per cent per minute, less than +0.3 change in glucose disappearance rates after glucagon stimulation and an impaired serum IRI response to an intravenous infusion of glucose or glucose and glucagon. Identification of children in earlier stages of chemical diabetes is desirable in order to evaluate the feasibility of altering the progressive loss of insulin reserve.

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