DIABETES TREATMENT.

New Zealand Herald, Volume LX, Issue 18346, 12 March 1923, Page 12

DIABETES TREATMENT.

THE SUCCESS OF INSULIN.

REPORT BY SPECIALISTS.

MIRACULOUS RESULTS.

[FROM OUR OWN CORRESruJNUj!.«A. j TORONTO, Jan. 27. An important announcement concerning results from the new insulin treatment of diabetes lias been published by the discoverer of the treatment, Dr. F. G. Banting, associated with two prominent Toronto diabetes specialists,' Dr. W. R. Campbell and Dr. A. A. Fletcher. Treatment of a few cases by insulin has been proceeding at a number of hospitals throughout Canada and the United States ever since early last year, when processes of manufacture were invented. As the whole process is still in a somewhat experimental stage, manufacture and the administration of the treatment were Tn each case authorised by the University of Toronto, which required that reports should be made to it as holder of the patents. This course was adopted for the protection of the. public and the advancement of the investigation. The most striking passage in the report is that which deals with the treatment of diabetic coma. In diabetes, coma has been regarded from time immemorial as the last stage before dissolution. In recent years science, refusing to concede victory to any adversary, lias been attacking diabetic coma with every resource at its command. But, observe the Toronto doctors, "the fact remains that in the past four years no case entering our wards in advanced diabetic coma, has recovered by any of these methods. Though we are aware of a few isolated instances of such having taken "place in other hospitals, we believe the opinion is commonly held that such cases are practically hopeless " Ten "Hopeless" Oases. Now what, has insulin accomplished in cases of coma ? The Toronto doctors report "We have had an opportunity of treating 10 cases of complete coma (stage )f complete anaesthesia) as well as other :ases of coma imminens (first stages of unconsciousness). "Of the 10 cases of complete coma reated, four died. Owing to the difficulty in the production of insulin at that ime, many of the preparations lacked potency, and satisfactory treatment was mpossible. Six Cases all Living. " The remaining six cases of coma reated are all living. One has recovered ind is now ag!yeosuiic (without sugar in he urine), without insulin on a diet about louble the basal requirement. The other ive patients have remained free of sympoms and the urine free from sugar and cetones under a dietic treatment and a laiiy administration of insulin." Stripped of its scientific setting this is he narrative of events which the lavnan might, describe as miracles. It is Imost as if 'he dead were brought to ife, and as far as observation goes, to lealth. The results of these coma, cases, having >een communicated to the conservative British Medical Journal, that authority emarks :— Statements of this kind are laturally received with caution and even vith some misgiving. The reader is •ound to ask whether the authors have xissibly been misled by their own enhusiasm. But the fact remains that these ii patients are alive." Applications for insulin treatment have >o'ir(d in since a preliminary public anlouncement was made in March, 1922. Jut in view of the limited quantities f insulin available only the most severe ases, who had been under observation or long periods on well-controlled diets, nd in spite of that were gradually failng, have bee.i treated by the Toronto loctors. Consequently, they say, they re not yet in a position to make any re>ort on what insulin will do to diabetics vhen applied in the early stage. That nteresting problem remains. Beneficial Results. Meanwhile, what has been accomplished rith the serious advanced cases (apart roni the ten coma cafes)? The report., ;hich is fascinating for lavmen and docors alike in that it tells in detail what ctualiy happened to patients says "Up a the present tinw over fifty cases of iabetes mcllitus (the virulent progressive ype of the disease) have been treated -ith insulin and . some have been under reatment continuously for several months, although the most striking results have een seen in children and young adu'ts, 11 patients have been benefited by the •eatment. "Many of the patients have come to *16 hospital in a state of extreme underutrition, suffering from great weaknesses long with an indisposition to any physiil activity. On the first or second day f treatment, if sufficient insulin is given, he urine becomes sugar free, and on the -cond or third day ketone (a poisonous y-product) free. These patients become >nscious of increasing strength before the id of the first week. From a state which lav be one of discouragement or of pronind mental depression they become leerful and interested.

Recovery of Weight. "Some patients have been able to return to work after a month of treatment. The patient's weight frequently increases, and this can readily be brought about by supplying food in excess of the caloric requirement and increased amount of nutriment. One patient, aged 16, who had lost forty pounds during her three years of diabetes, gained 351b. in less than four months." Here the Toronto doctors are probably referring to the case of Miss Elizabeth Hughes, daughter of Mr. Charles E. Hughes, Secretary of State for the United States, who was under personal treatment by Dr. Banting in Toronto. Some curious indirect benefits from insulin injections are noted. Mild infections are favourably influenced; for example, the pain of chronic pyorrhoea (an inflammatory disease of the gums) was relieved by treatment; it recurred when the injections were stopped and was relieved again when they were continued. Simple catarrhal infections are no longer of serious import. Quickness of Action. The quickness with which insulin works is one of the most phenomenal things about it. Of all the medical antidotes for a serious disease discovered in modern times, insulin is perhaps the quickest in giving resuit*. In five weeks after a bank clerk was admitted to the hospital in a condition of helpless weakness and somnolence he was discharged from the hospital and, although required to take daily injections of insulin, he was able to go back to his work. Dr. Banting and his associates still make no claim that insulin is a permanent cure for diabetes. But after less than one year's observation they do go this far:— " Certain cases may, after a period of insulin treatment, recover such a degree of tolerance as no longer to require extract to maintain them on a basal diet." Summarised, the results of insulin as observed are:— 1. It has saved the lives of patients in hitherto fatal emergencies. It has brought them back to a state approaching normal from the hitherto fatal state of unconsciousness preceding death. It has built them up so they can be successfully operated on for gangrene and other serious infections common to the diabetic state. 2. Repeated injections of insulin are keeping all patients in a state nearly normal. 3. Insulin seems to have practically cured some patients, one of whom was suffering from the severest type of the disease and was at the point of death. It has seemed in some cases to give the pancreas a rest so that the patient can continue in a state approaching normal simply on a diet without further administration of insulin.