The Effect of Ventriculin on the Blood Sugar Level in Patients with Pernicious Anemia.

A reduction of the blood sugar content, analogous to that produced by insulin, was noted by Blotner and Murphy (1) after administration of whole liver and certain of the liver fractions ineffective in the treatment of pernicious anemia. Fractions G, an effective liver extract prepared by Cohn and his collaborators (2), appeared to contain little if any blood sugar reducing substances. An observation repeated by Riddle (3) substantiated the evidence that this liver extract contained no specific blood sugar reducing properties. After the introduction by Sturgis and Isaacs of ventriculin as a specific treatment in pernicious anemia (4), it was decided to determine whether or not this preparation possessed blood sugar reducing properties similar to those of whole liver. The blood sugar level was determined on eleven patients with pernicious anemia at frequent intervals during treatment with ventriculin, liver extract, and on one patient in spontaneous remission. The samples of blood were obtained under fasting conditions at 8 A.M., and the blood sugar values were estimated according to the micro method of Folin and Wu (5). Each patient was given 40 grams of ventriculin daily, and observations were made during the interim of the rise of the reticulated red blood cell count, at intervals of one to two days. Data on the red blood cell counts, hemoglobin and reticulocyte percentage were also recorded. The fasting blood sugar values obtained during the treatment with ventriculin are listed in Table I. The results for each patient are recorded separately, showing daily variations as well as the general trend. With two exceptions, the initial values were within the range of 84-135 mgm. of sugar per 100 cc. of blood-the majority of the results bordering on the upper limits of normal. Six to ten days after the onset of treatment, the blood sugar values in each case reached their lowest levels, the decrease being gradual. These minimal readings were within the range of 61-97 mgm. The average decline of the blood sugar level was about 45 mgm. per cent, the upper and lower extremes being 30 and 60 mgm. In the series of cases which were studied during the entire period of the rise and fall of the reticulated cell count, the blood sugar levels