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Mrs. R. K., aged 54, was admitted into the ward service of Dr. Ralph Bettman, Michael Reese Hospital, Chicago, Aug. 10, 1927, with the complaint of gangrene of the first toe of the right foot of six months' duration. She had been treated for diabetes mellitus, and in spite of the fact that the urine was sugar free without the use of insulin, the gangrene had progressed. On admission a mild generalized arteriosclerosis was found. The great toe was in a condition of dry gangrene to the proximal end of the first metatarsai joint. There was no evidence of toxic absorption. On admission the leukocyte count was 12,500; the blood sugar was 220 mg.; the urine was sugar free. The blood pressure was 164 systolic and 70 diastolic.
Amputation of the right toe was done, August 15. Following this the blood sugar was 276 mg. The urine contained acetone,
Imerman SW. INTRACARDIC INJECTION OF DEXTROSE IN A CASE OF INSULIN HYPOGLYCEMIA. JAMA. 1927;89(21):1778. doi:10.1001/jama.1927.92690210001013
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