UNUSUALLY HIGH INSULIN REQUIREMENTS IN DIABETES MELLITUS

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Abstract
There is no definite dextrose-insulin ratio applicable to all persons with diabetes. The amount of insulin needed to control the defective carbohydrate metabolism of any one patient must be determined empirically and may vary from time to time. Although diabetic persons with large insulin requirements are encountered infrequently, a number of cases of such requirement have been reported since the introduction of the hormone in 1922. These cases may be divided into two groups. In one the large insulin requirement is associated with some recognizable complication, such as diabetic ketosis, an infection, an endocrine disorder, hepatic disease or some other intercurrent illness. In the second there is no definite cause to account for the large amount of insulin that must be administered. This group, though small, includes some of the most extreme examples of huge insulin need.1 Clinical and postmortem studies in such cases have revealed little to explain

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