DIABETES AND THE INSULIN-ADMINISTRATION PROBLEM

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Abstract
Author''s summary, abridged: "So far, there has been found no substitute for insulin. Dosage with oral prepns. in place of insulin therapy and/or diet has, in some instances, allowed the disease to progress to a more severe form and has even resulted in the onset of coma. There does, however, appear to be no doubt that certain oral prepns. have properties which alleviate some of the symptoms characteristic of diabetes mel-litus. Extracts which contain tannins appear to decrease the distressing diabetic thirst; others which, due to their nauseating or narcotic properties, depress the appetite, decrease blood and urine sugar levels and reduce acidosis, but this effect is produced by the reduced intake of food. The guanidine derivatives are the most important group of synthetic antidiabetics; among these decamethylene diguanidine ("Synthalin"), synthesized by Heyn, has had many claims made for its efficacy. Synthalin has a definite hypoglycemic action and, in addition, reduces the concn. of urinary ketone bodies. Its action is, however, much less powerful and is slower than that of insulin. It is potentially toxic, causing damage to the liver which may lead to serious complications such as jaundice or hepatitis. The lowering of the blood sugar level is not due to a specific hormonal effect, but to a toxic action upon hepatic tissues which deranges glycogen synthesis and breakdown." Extracts of many naturally occurring substances have also been tried and found antidiabetic but unsatisfactory substitutes for insulin.