Disappearance of I131-Labeled Insulin from Plasma as a Guide to Management of Diabetes

THE extremely labile diabetic patient presents a problem in management that can often be only partially solved by manipulation of the diet and insulin. A high proportion of such patients are found among the adults who have received insulin for a number of years for a growth-onset type of diabetes. The factors contributing to this "brittle" state are poorly understood. Somogyi1 has emphasized the role of excessive insulin dosage although simple reduction in dosage too often results in an increasing frequency of periods of ketoacidosis.The capricious response of such patients to insulin therapy suggests among other things an altered . . .