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Achlorhydria and its clinical significance in diabetes mellitus

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The American Journal of Digestive Diseases

Summary

A study was made of the occurrence of anaemia, neuritis and digestive disturbances in diabetes mellitus and their association with achlorhydria.

The association of each of these conditions with achlorhydria was more than would be expected if chance or random association were the only influencing factors which had brought them together.

On the assumption that the anaemia in many cases of diabetes with achlorhydria is due to a high pH of the duodenal secretions which interferes with liberation of iron from the food materials; with its conversion to the ferrous form and also with its absorption, an attempt was made to treat the anaemia with hydrochloric acid only. Satistically, this resulted in an increase of the red blood cell count. That the difference — average increase of red blood cell count — noted was significant was found by the ratio of the difference to its probable error.

On the assumption that typical diabetic neuritis is due to a combination of destruction and defective absorption of Vitamine B1 due to a high pH of the gastric and duodenal secretions, an attempt was made to treat such cases of neuritis with hydrochloric acid only. The results in the three cases of severe neuritis cited suggest that this is probably the correct explanation.

A study was made of the occurrence of excess excretions of indican in the urine in diabetes mellitus and, compared with that noted in non-diabetics, the incidence was high and definitely higher amongst a group with achlorhydria than amongst the control group. The association of the excess excretions with achlorhydria was more than would be expected if random or chance association were the only influencing factors which had brought them together.

The probable relationships between achlorhydria and other disturbance met with in diabetes mellitus are briefly discussed.

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  1. Montreal

    I. M. Rabinowitch

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  1. I. M. Rabinowitch
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This work was done with the aid of a grant from the Sugar Research Foundation, Inc., New York.

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Rabinowitch, I.M. Achlorhydria and its clinical significance in diabetes mellitus. A. J. D. D. 16, 322–332 (1949). https://doi.org/10.1007/BF03002734

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