1. To test whether impaired carbohydrate tolerance in cirrhosis could be modified by dietary means ten cirrhotic patients, five of them taking insulin, took as breakfast either lentils or whole-meal bread and cottage cheese containing the same amount of carbohydrate and protein. 2. Lentils resulted in significantly diminished blood glucose, insulin (in those not on insulin) and gastric inhibitory peptide responses. 3. Enteroglucagon and neutrotensin levels were high with lentils, suggesting that absorption of lentil carbohydrate continued into the ileum with perhaps some malabsorption, so confuming the results of earlier studies in vitro. 4. However, breath hydrogen studies on a separate group of eight healthy volunteers indicated that the difference in carbohydrate malabsorption between lentil, and wholemeal bread was insignificant. 5. It is suggested that slowly digested carbo-hydrate foods, such as leguminous seeds, may minimize carbohydrate intolerance in patients with cirrhosis.
1. A simple method is described for measuring the hydrogen concentration in alveolar air by end-expiratory sampling, by using a modified Haldane—Priestley tube and gas chromatography. Hydrogen was generated in vivo by ingestion of the non-absorbable sugar lactulose. 2. Alveolar hydrogen concentration showed a highly significant correlation with hydrogen production measured either by a rebreathing technique or by a total collection procedure. 3. The coefficient of variation of the end-expiratory method, assessed by comparing sixty-one paired results, was 11·6%. The coefficient of variation in ten measurements in one subject at 1 min intervals was 17·6%.