May 1936


Author Affiliations

Chief of Staff on Diseases of Metabolism, St. Agnes Hospital PHILADELPHIA

Arch Intern Med (Chic). 1936;57(5):949-958. doi:10.1001/archinte.1936.00170090114008

There is a controversy as to the optimum time to administer insulin. Many physicians are of the opinion that it should be given immediately before meals; others, within from fifteen to twenty minutes before meals, and still others, a half-hour before meals. The practice of injecting insulin before meals, irrespective of the type of diet, had been universal since the discovery of the hormone.

When the use of insulin in the treatment of diabetes had its inception physicians prescribed diets high in fat and low in carbohydrate, but recently most doctors have adopted diets high in carbohydrate and low in fat. With this change in the proportions of carbohydrate and fat, there comes about a change in the rapidity and amount of absorption of carbohydrate, a change which should influence the time interval for the injection of insulin. I have seen patients with diabetes acquire symptoms of hypoglycemia within five

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