The use of extreme states of insulin shock in the treatment of psychiatric patients, particularly of those with schizophrenia, has in the last few years afforded an opportunity to study electrocardiographic changes in presumably normal hearts under the influence of large doses of insulin. Insulin shock therapy was introduced by Sake1 in 1933 for patients with hitherto relatively hopeless schizophrenia. After a preliminary period of suspicious aloofness, psychiatrists and physicians interested in mental disease have adopted the method on a large scale because of the brilliant results at times achieved.
The method and technic are given in detail in Sakel's monograph and elsewhere. The usual technic requires patients to be in coma from hypoglycemia for an hour or more. This means that from the time the insulin is injected to the termination of the coma three to five hours elapses, during which severe hypoglycemia is present, with minimum blood sugar
GOLDMAN D. THE ELECTROCARDIOGRAM IN INSULIN SHOCK. Arch Intern Med (Chic). 1940;66(1):93–108. doi:10.1001/archinte.1940.00190130103007
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