Patients suffering from diabetes mellitus are known to have periods during which they do not respond properly to insulin. It is likewise well established that diabetes becomes worse during infection, injury or operation. These observations have aroused much interest and investigation in the past few years. It is interesting that seventy-five years ago Claude Bernard1 was well aware of the danger of infection to diabetic patients.
Patients who temporarily or permanently resist insulin action are called insulin resistant or insulin refractory. The periods of resistance to insulin may be recurrent, ending in spontaneous recovery, or may be lasting, terminating in coma and death.
In July, 1925, E. K., a girl, aged 6 years, with severe diabetes, began to have peculiar reactions to insulin. On a constant diet and without any evident complication, she seemed to resist insulin action at one time and at another to have hypoglycemia on the same
KARELITZ S, COHEN P, LEADER SD. INSULIN INACTIVATION BY HUMAN BLOOD CELLS AND PLASMA IN VITRO: EFFECT OF NORMAL AND OF DIABETIC BLOOD ON INSULIN ACTION. Arch Intern Med (Chic). 1930;45(4):546–558. doi:10.1001/archinte.1930.00140100068007
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