Abstract
The object of this study was to determine the action of insulin upon the production and excretion of ketone bodies and upon the acid-base equilibrium of the blood of human cases of diabetes mellitus. This report presents the results of seventeen observations upon fourteen patients. The only therapeutic agent employed was insulin.
To avoid the necessity of utilizing other agents such as alkalies or glucose, it was essential to grade the dose of the insulin so as to secure the maximum beneficial effect without producing untoward results. In a series of preliminary experiments it was demonstrated that for individuals weighing from 50 to 70 kg. one unit of insulin decreased the blood sugar about 0.008 per cent in from 4 to 6 hours. The doses of insulin employed in the present studies were calculated as the quantity required to decrease the initial blood sugar to 0.130 per cent.
Previous to the administration of the insulin the patients had been starved overnight for 12-14 hours, and during the period of observation lasting from 8 to 10 hours, no food was taken. However, water by mouth was permitted ad libidum. As a control on the factor of starvation in 5 cases, two series of curves were obtained representing changes in the blood sugar and carbon dioxide combining power of the plasma with and without insulin. It was noted that the starvation alone continuously decreased the blood sugar about 0.04 per cent, but this drop is insignificant in comparison with the fall after insulin. In three instances the carbon dioxide combining power rose steadily during starvation, but in the 2 remaining cases a fall of 5 vol. per cent was noted.
The insulin used in these experiments was the product of the Eli Lilily Co. The subjects were all patients of Dr. H. O. Mosenthal of the Department of Medicine.
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