Journal Article10.1001/JAMA.1936.02770030010003
Clinical experience with protamine insulinate
62
TL;DR: Wide fluctuations in the level of blood sugar, with marked hyperglycemia on the one hand and hypoglycemia ("insulin reactions") on the other, represent one of the chief difficulties in the treatment of severe diabetes with insulin.
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Abstract: Wide fluctuations in the level of blood sugar, with marked hyperglycemia on the one hand and hypoglycemia ("insulin reactions") on the other, represent one of the chief difficulties in the treatment of severe diabetes with insulin. One thinks of the pancreas of the normal individual as adjusting its secretion of insulin according to the need of the body at any given time. The subcutaneous injection of relatively large amounts of insulin two, three or four times daily thus differs considerably from the physiologic process. Consequently there may occur large and sudden fluctuations in glycemia, particularly in those insulin-sensitive patients in whom the blood sugar is unusually labile. Insulin reactions, or the possibility of such, particularly during the night, are often a source of much worry both to the patient and to his family. Accordingly, it was with much interest that we learned a few months ago that Dr. H. C.
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