AN INVESTIGATION OF PROLONGED INSULIN RESISTANCE IN A CASE OF DIABETES MELLITUS1

IN cases of diabetes mellitus that have become resistant to insulin the pheno-menon has been attributed to causes such as the production of excessive quan-tities of insulm-antagonizing hormones, an abnormally fast rate of insulin destruction, or the formation of antibodies neutralizing insulin. These matters have been discussed at considerable length by Smelo (1948) and Davidson and Eddleman (1950). The subject of the present investigation received about 260,000 unite of insulin during a period of 18 weeks in hospital, and required 600 units daily from the date of discharge until her death nine months later. The patient was a middle-aged diabetic, whose disease had followed an un-eventful course for many years. An apparently trivial episode, a skin infection, led to the development of profound insulin resistance. Beginning this investiga-tion with the assumption that the patient's blood might contain some insulin-neutralizing factor, we were surprised to discover instead that the blood-serum lowered the blood-sugar concentration in rats.- So far as we are aware, the only published report indicative of such an abnormally high concentration o