CLINICAL OBSERVATIONS WITH INSULIN
1. The Use of Insulin in Diabetic Treatment
FREDERICK M. ALLEN, M. D., AND JAMES W. SHERRILL, M. D.
The Physiatric Institute, Morristown, New Jersey.
Page
INTRODUCTION .............................................. 804
CASE RECORDS ........................................ ...... 805
DISCUSSION .................................................. 934
I. General plan of treatment . ..................................... 934
1. Purpose and standards .................................... 934
2. Institutional and home treatment ................... ....... 935
! l' 3. Dangers of inaccuracy .................... .............. .. 935
4. Character and duration of initial treatment................. 936
5. Incidental difficulties of insulin administration ............. 937
3 6. Hypoglycemia ........................................ ... 939
7. Quantity of daily doses ................... ................ 941
8. Distribution of doses and meals ................... ........ 942
II. General results of insulin treatment . . .......................... 947
1. Statistical summary ...................................... 947
2. Significance for theory of diabetes ......................... 947
3. Immediate effects upon blood and urine sugar .............. 947
4. Results in cases under long observation ................... . 951
5. Results in extremely severe cases.......................... 955
6. Results in moderate or mild cases ................... ...... 956
7. Results in terms of tolerance for different foodstuffs....... 956
8. Results in terms of total diet and body weight............ 957
9. Results in relation to exercise............................. 959
10. Results in relation to other metabolic disorders ............ 960
11. Influence on fidelity....................... ............. 961
12. Abuses of insulin......................................... 962
III. Treatment of diabetic coma .................................. 962
1. Statistical results ............. ................ . 962
2. Auxiliary measures .................... .................. 963
3. Insulin dosage ....................................... .... 964
4. Autopsy findings ...................................... ... 965
5. Causes of death .......................................... 965
IV. Treatment of infectious complications . . ....................... 966
1. Local infections ...................... ................... 966
2. General infections ......................,............... 967
3. Insulin dosage ........................................ 968
4. Incidence of infections ................................... 969
5. Methods of treatment............................... 971
6. General considerations ................................ 972
V. Gain or loss of tolerance under insulin treatment .............. 975
CONCLUSIONS ......................... ............. ... 982
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