Four patients with clinically and histologically diagnosed necrobiosis lipoidica had normal glucose tolerance tests. However, two of the patients had abnormal cortisone glucose tolerance tests, which suggests that necrobiosis lipoidica, even without other evidence of diabetes mellitus, may precede the development of actual clinical diabetes and thus may be analogous to diabetic nephropathy and diabetic neuritis which are both known to precede, at times, the development of actual clinical diabetes. It is thought that any patient with necrobiosis lipoidica with a normal glucose tolerance test should nevertheless be suspected as a potential diabetic and be reexamined periodically for further evidence of clinical diabetes. It is further believed that the cortisone glucose tolerance test should be carried out in all such patients.
KOMISARUK E. Cortisone Glucose Tolerance Test in Necrobiosis Lipoidica. Arch Dermatol. 1964;90(2):208–210. doi:10.1001/archderm.1964.01600020076019
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