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January 2, 1943


JAMA. 1943;121(1):52-53. doi:10.1001/jama.1943.02840010054013

Many cases in which insulin has failed to lower the blood sugar in the normal manner have been recorded since insulin first came into use in 1922. Glassberg, Somogyi and Taussig1 observed a diabetic patient who was relatively refractive to insulin for some months and who responded only to enormous doses, as much as 1,100 units in twenty-four hours. The diabetes in this case was due, the authors suggest, not only to a lack of pancreative secretion but also to a lack of some substance which activates insulin, probably a muscle enzyme (phosphatese, insulin complement, glycomutin). Apparently there may exist two types of diabetes: one due to pancreatic disease, which responds to insulin, the other due to a deficiency in the production of a substance which activates insulin. Marble2 reported observations on a woman with chronic rheumatoid arthritis and diabetes whose insulin requirement varied from 240 to 675