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This work was presented in part at International Symposium on the Occasion of the 50th Anniversary of the Discovery of Insulin, Jerusalem, Israel, 25-27 October 1971. Dr. Arieff is a Clinical Investigator, Veterans Administration (Wadsworth), Los Angeles, Calif. Received for publication 17 January 1972 and in revised form 24 October 1972. primarily by accumulation of idiogenic osmoles rather than loss of water or gain in solute. When plasma glucose is rapidly lowered with insulin, an osmotic gradient develops from brain to plasma. Despite the brain to plasma osmotic gradient, there is no net movement of water into brain until plasma glucose has fallen to at least 14 mM, at which time cerebral edema occurs.

Effects of Hyperglycemia and Rapid Lowering of Plasma Glucose in Normal Rabbits