Islet-Cell Surface Antibodies in a Patient with Diabetes Mellitus after Rodenticide Ingestion

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Abstract
To the Editor: An insulin-deficient, ketoacidosis-prone form of diabetes mellitus associated with severe toxic neuropathy has developed in as many as 20 survivors of ingestion of a rodenticide, N-3-pyridylmethyl N′-p-nitrophenyl urea ([PNU] Vacor, Rohm and Haas, Philadelphia), recently introduced into the United States.1 2 3 4 Two patients with this syndrome were recently treated at the University of California Hospitals. The first, a 27-year-old man, was initially ketoacidotic after ingesting the rodenticide in 1976, but continued to require insulin for only 10 months.1 His neuropathy persists, and he now requires sulfonylureas to avoid sustained glucosuria. Fasting plasma glucose values are 120 to 130 . . .

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