INSULIN INHIBITION BY SERUM OF INSULIN RESISTANT PATIENT

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Abstract
INSULIN resistance is, fortunately, a rarity among diabetics. However, in diabetic coma it may be quite common depending on one's definition. In the literature fewer than 50 cases of true insulin resistance are recorded (2, 3, 9–12, 14, 16–18). We have one more case to add to this small but significant group, and this case was distinguished from many others (2, 11, 12, 17) because an insulin inhibiting factor was detected in the serum of the patient at the height of insulin resistance. CASE HISTORY The patient was a 79 year old female, who for six years had mild diabetes and hypertension. Glycosuria was controlled by diet alone, until she developed gangrene of the right foot incident to an infected laceration. Polyuria and polydipsia developed, and she excreted as much as from six to seven per cent glucose. At the time of admission to the Montefiore Hospital, October 20, 1944, she had a four plus acetonuria; the blood sugar was over 400 mg. per cent; the CO2 content of the serum was 54 volumes per cent; and serum chlorides were 343 mg. per cent.

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