INSULIN resistance has been arbitrarily defined as a state which requires 200 or more units per day for longer than 48 hours for regulation in a nonacidotic person with diabetes mellitus.1 Diabetic acidosis and acute infectious processes are well known causes of temporary increase in the daily insulin requirement, but such cases are not classified as true resistance to the hormone. Absolute refractoriness to insulin probably does not exist as an entity, since administration of large quantities of the substance has always resulted in a definite and frequently adequate therapeutic response. Sheppard2 reported on a patient in diabetic coma who was given 56,080 units of insulin over a 26 hour period, with subsequent regulation on 40 units of protamine zinc insulin and 60 units of regular insulin each day. His case, though striking, constituted only a temporary increase in insulin requirement due to diabetic acidosis and was not
DAVIDSON JK, EDDLEMAN EE. INSULIN RESISTANCE: Review of the Literature and Report of a Case Associated with Carcinoma of the Pancreas. AMA Arch Intern Med. 1950;86(5):727–742. doi:10.1001/archinte.1950.00230170080007
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