Glucagon, Pancreatectomy and Ketoacidosis

To the Editor: The paper of Barnes et al.¹ provides important new evidence in support of the key role of glucagon in the metabolic derangements of acute insulin deficiency. Their findings clearly show that acute insulin deprivation by itself does not generate the same syndrome of severe and rapidly developing hyperglycemia and hyperketonemia that occurs when hyperglucagonemia coexists.^{2 3 4} The difference is all the more important when one considers that, although the plasma glucagon levels of these pancreatectomized subjects were said to be “zero,” in the radioimmunoassay employed “glucagon-stripped” plasma was added to the glucagon standards,⁵ thus preventing measurement of certain.