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June 1953

INSULIN REACTIONSManifestations and Need for Recognition of Long-Acting Insulin Reactions

AMA Arch Intern Med. 1953;91(6):695-703. doi:10.1001/archinte.1953.00240180004001

MANY DIABETIC patients have insulin reactions that are undetected even by trained medical personnel. Why such a situation should exist after more than 25 years of intensive experience with insulin poses several questions. Is it because there is less awareness of insulin reactions; have the symptoms changed, or are the symptoms so mild that they are hard to recognize and thus of little or no importance? Perhaps all of these questions may be answered "yes," except that all insulin reactions must be considered to be important. As a result of long experience with regular insulin, sweating, hunger, tremor, and palpitation have become accepted as the principal symptoms of the hypoglycemic state. It has also been long recognized that abnormal behavior, double vision, unconsciousness, and other serious central nervous system symptoms frequently occur if the hypoglycemic state is prolonged or becomes more marked. In fact, judgment of the degree of severity

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