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June 30, 1956


Author Affiliations


From the Joslin Clinic, New England Deaconess Hospital (Drs. Root and Barclay) and Harvard Medical School (Dr. Root).

JAMA. 1956;161(9):801-806. doi:10.1001/jama.1956.02970090027006

• The course of diabetes was studied in the records of 96 patients whose histories indicated an onset of the disease 35 to 46 years ago, before the discovery of insulin. Some had had it since childhood. All were selected from a series of 34,000 patients who satisfied rigid criteria for the diagnosis of diabetes mellitus.

Of the 96, 45 were dead, and death was ascribed to coronary arteriosclerosis. Hypertension was about twice as frequent among the female as the male diabetics. Complications included retinitis proliferans in 26 cases, and peripheral circulatory impairment necessitated amputation in 9 cases.

Data from the 51 surviving patients revealed varying degrees of dependence on insulin. Three patients used from 80 to 90 units per day. One patient whose usual requirement was 70 units per day required 250 units per day for some months during a period of insulin resistance.

The general tendency for the disease was to progress. Nevertheless, the remarkable prolongation of life seen in the statistics shows that early diagnosis and intelligent cooperation between physician and patient have been well rewarded.