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overcome. The energy with which selected manufacturing chemists
have tackled its production on a commercial scale from the pancreas of
different animals has been most commendable, and Insulin is the name
that has been given to this product. In this Country the manufacture
and distribution of Insulin are undertaken by several firms under licence
from the Medical Research Council, who holds the patent rights, and it
is retailed at a uniform price of 25s. per 100 units.
It is unfortunate that the press has exaggerated the claims of this
discovery, and has proclaimed to the public " a cure for diabetes" and
has thus raised unjustifiable hopes in the minds of the sufferers from
diabetes, when it is more correctly an adjunct to dietetic treatment.
Sugar is normally present in the blood, and the amount varies in
health with the amount of carbohydrate in the diet, but it never rises
above a definite level. In diabetes the patient cannot dispose of carbohydrate
in the same way as in health: sugar accumulates in the blood
above the normal level and as a result sugar passes in to the urine.
Insulin has the power of dealing with carbohydrate, thus removing the
excess from the blood, while allowing the patient to take a sufficient
diet. The most serious complication of diabetes, namely, coma, is due
to the presence of acid bodies in the blood due to defective combustion
of carbohydrate. Insulin, in dealing with the carbohydrate, causes a
disappearance of these acid bodies and so wards off this complication.
If Insulin is given in doses too large in proportion to the diet taken,
the blood sugar is reduced to a dangerous level, and certain nervous
symptoms, coma and death might follow. It will thus be seen
that Insulin should be given in dosage sufficient to keep the blood
sugar within no rnal limits, and yet not so low as to produce Insulin
symptoms. To do this efficiently blood-sugar estimations are necessary
when dealing with true diabetes, keeping a trace of sugar in the urine
will ensure that the dosage is not excessive.
Certain persons, with normal blood sugar, pass sugar in the urine.
As a rule there are no symptoms, and sugar is found on routine
examination. To give Insulin to the case of Renal or Innocent Glycosuria
would be dangerous. To diagnose this class with certainty,
blood sugar estimation is necessary.
Insulin is administered by hypodermic injection and 10 units
(0.5 cc.) is considered as one dose. The exact dosage is determined
by the severity of the case, the blood sugar, and must be regulated