INSULIN RESISTANCE (WITH OBSERVATIONS IN AN UNUSUAL CASE)

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Abstract
The expression "insulin resistance" should be reserved for cases which require adm. of at least several hundred u. of insulin while on a diabetic diet and in which the carbohydrate equivalent is less than 0.5 g. Reports in the literature and Schloss'' observations support the assumption that absolute insulin resistance does not occur. Even in cases which seem absolutely insulin resistant, some insulin action can be demonstrated. Therefore, insulin resistance is not an indication to discontinue the adm. of insulin. The case discussed progressed under observation from a mild diabetic responding normally to insulin into a severe state of insulin resistance. In the stage of insulin resistance 124,915 u. of insulin were given in 3,037 injs. during 280 days. In the same period 42,330 gs. of sugar were excreted. The largest amt. of insulin injected intramusc. within 24 hrs. was 1,630 u. The highest fasting blood sugar was 892 mg./100 ml. In addition to certain disorders which are known occasionally to precipitate insulin resistance, there are cases in which it arises from unrecognized causes. The mechanisms underlying insulin resistance are still unknown.

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