抄録
In order to investigate the electrocardiographic changes and its causal factors after glucose ingestion, electrocardiograms of the patients with probable diabetes mellitus in whom insulin secretion was supposed to be increased, with diabetes mellitus in whom insulin secretion was decreased, and with history of gastrectomy in whom glucose ingestion was followed with rapid changes of the serum insulin and with ischemic heart disease whose electrocardiograms showed most significant ST and T. changes were studied as well as that of normal which was reported previously. MATERIALS AND METHODS Subjects were consist of 18 diabetics, 7 probable diabetics, 7 gastrectomized and 10 patients with ischemic heart disease. Vectorcardiogram by Frank's lead was taken in 7 patients with ischemic heart disease and in 7 normal subjects. Methods: Patients were prohibited from eating after last supper and in the early morning electrocardiogram and phonocardiogram were recorded and blood was drawn for the measurement of serum glucose, potassium, natrium and calcium level. Then 100 grams of glucose was given orally with 400 to 500 ml of water. Same tests were repeated in 30, 60, 90, 120 and 180 minutes after glucose ingestion. In some cases insulin and NEFA were measured. In some cases insulin and glucose were given intravenously. Ad-ministration of KCl and nitroglycerin sublingua and intravenous injection of ATP were done after oral glucose ingestion. RESULTS Serum potassium: The most remarkable changes were seen in patients with ischemic heart disease in 13.3 per cent in 60 minutes, less remarkable changes in probable diabetics and the slightest changes in diabetics. Serum insulin: The most significant increase was seen in probable diabetics and last long. Rapid increase and rapid return was seen in gastrectomized patients. No significant changes were seen in diabetics. Electrocardiographic changes after glucose ingestion: R-R intervals were shortened in many cases of all groups. T waves became lower after glucose ingestion in all groups. The most significant changes were seen in 30 minutes in patient's with ischemic heart disease: decreased amplitude of the T wave were more than 50 per cent. T wave changes were seen in an early period in gastrectomized patients in whom changes of insulin and potassium were also seen in an early period. T wave changes were not significant in diabetics.
