GT and concomitant FFA decreases have been examined in forty-three patients with myocardial infarction below fifty years of age with no history of diabetes, fasting hyperglycemia or glycosuria. The majority had an impaired GT, which was associated, in two thirds of the cases, with a prompt and long-lasting FFA decrease similar to, or exceeding, that of normal subjects. It is suggested that a state of differential effectiveness of insulin exists in a large proportion of patients with myocardial infarction, whereby normal response of adipose tissue persists while glucose utilization of nonadipose tissues is impaired. The association of selective unavailability of insulin with the development of arteriosclerosis is briefly discussed.

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