Abstract
Ingestion of medium chain triglycerides (MCT) results in a quantitatively reproducible increase of acetone concentrations in end-expiratory air as measured by gas chromatography. Acetone concentrations rise rapidly, reach a maximum several hours after ingestion of MCT and gradually return to base-line values. Under standardized conditions, ingestion of increasing amounts of MCT results in increasing acetone concentrations. Repeated tests in the same subject are reproducible within narrow limits. The acetone response is quantitatively suppressed by the administration of increasing amounts of sucrose. Maximal acetone concentrations increase with prolongation of fasting before ingestion of MCT. Three insulin-dependent diabetics had an acetone response in the MCT test 2 1 2 times greater than the mean response of 4 normal subjects. The acetone response of a thiazide-induced diabetic was normal. Interpretation of the results of MCT tests in normal subjects is that the magnitude of ketosis in man is the result of carbohydrate deficiency relative to the amount of fat entering the liver. The MCT test is a means of measuring the tendency of a subject to develop ketosis in response to a standardized fat load and may be useful for the classification of diabetes mellitus.
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