During the past two years we have treated some of our diabetic patients, both in the outpatient department and in the hospital wards, with protamine zinc insulin. Like others,1 we hoped that by virtue of its slow activity a single daily dose of this new preparation could be substituted for three or even four doses of regular insulin. However, when we put this thought into practice we experienced considerable difficulty in maintaining the urine free from sugar. We appreciated the facts that we employed the higher carbohydrate diet—200 to 250 Gm.—and that we had not worked out a technic for the use of protamine insulin. As a matter of fact, there is no definitely established technic for the administration of this preparation. All sorts of combinations2 are recommended, with or without the addition of regular insulin—that is, two or more hypodermic injections daily. It was, and still is our
TOLSTOI E, WEBER FC. PROTAMINE ZINC INSULIN: A METABOLIC STUDYTREATMENT IN TWO CASES OF SEVERE DIABETES BY EQUALLY AND UNEQUALLY DIVIDED DIETS, WITH COMMENTS ON CRITERIA FOR TREATMENT. Arch Intern Med (Chic). 1939;64(1):91–104. doi:10.1001/archinte.1939.00190010101009
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