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March 10, 1945

THE USE OF INSULIN AND THE ABUSE OF GLUCOSE: IN THE TREATMENT OF DIABETIC COMA

JAMA. 1945;127(10):557-564. doi:10.1001/jama.1945.02860100001001
Abstract

Deficiency of insulin is the cause of diabetic coma. Anew this has been demonstrated by the discovery of experimental alloxan diabetes,1 in which diabetic ketosis and coma result when the islands of Langerhans which secrete insulin are destroyed. Here is a new method for the production of diabetic coma in its pure and uncomplicated form. Insulin cures coma because it enables the body to utilize glucose present in the blood and fluids of the tissues. It restores glycogen depots and provides energy for the body by oxidation of carbohydrate instead of fat and so stops excessive ketone production. If one would only appreciate this action of insulin, the administration of excessive glucose intravenously and by mouth with its lethal effect in patients with severe diabetic coma would be ended and more recoveries reported. My associates and I are so impressed by the reported high mortalities in diabetic coma published

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