Observations on the Insulin Tolerance Test with Special Reference to Psychoneurotic Cases

The discovery of insulin in 1922 brought hope to the thousands of diabetics throughout the world. Characteristically, it also brought new avenues of scientific research, and within less than a year, papers were being published in regard to the actions, uses and results of the injection of insulin into human beings. From then until the present, work of this nature has gone on and will continue until all of the potentialities of this endocrine factor have been completely exhausted. The most dramatic effect of insulin in the human being is the resultant lowering of the blood sugar which follows its injection, subcutaneously, intramuscularly, or intravenously; the latter route, of course, produces the most rapid response. An attempt to evaluate the response of the blood-sugar level to the intravenous injection of insulin has been made since shortly after its discovery. Gradually a method of study has evolved which follows the curve formed by depicting the graph of blood-sugar levels at short intervals over a fairly long period of time. Refinements and alterations have been made during the course of time. It is the intent in this thesis, after a preliminary brief discussion of carbohydrate metabolism., to present the results obtained by this type of testing in a diverse group of disease states, with emphasis on the psychoneurotic type. The discussion of some of the current concepts of carbohydrate metabolism may furnish a background to understanding of the action of insulin. Following this, the technique of the insulin-tolerance test will be detailed; ensuing pages thereafter will be concerned with the results of testing, their interpretation, and finally a discussion of the implications of the results. Possible future pathways of investigation will be indicated