CLINICAL PHARMACOLOGY 2003 (PART 36)

Diabetes mellitus affects 1-2% of many national populations. Its successful management requires close collaboration between the patient and the doctor. • Diabetes mellitus and insulin • Insulins in current use (including choice, formulations, adverse effects, hypoglycaemia, insulin resistance) Oral antidiabetes drugs Treatment of diabetes mellitus Diabetic ketoacidosis Surgery in diabetic patients Obesity and overweight Diabetes mellitus and insulin HISTORY Insulin (as pancreatic islet cell extract) was first administered to a 14-year-old insulin-deficient patient on 11 January 1922 in Toronto, Canada. . | SECTION 8 Diabetes mellitus insulin oral antidiabetes agents obesity SYNOPSIS Diabetes mellitus affects 1-2 of many national populations. Its successful management requires close collaboration between the patient and the doctor. Diabetes mellitus and insulin Insulins in current use including choice formulations adverse effects hypoglycaemia insulin resistance Oral antidiabetes drugs Treatment of diabetes mellitus Diabetic ketoacidosis Surgery in diabetic patients Obesity and overweight HISTORY Insulin as pancreatic islet cell extract was first administered to a 14-year-old insulin-deficient patient on 11 January 1922 in Toronto Canada. An adult sufferer from diabetes who developed the disease in 1920 and who because of insulin lived until 1968 has told how Many doctors after they have developed a disease take up the speciality in it. But that was not so with me. I was studying for surgery when diabetes took me up. The great book of Joslin said that by starving you might live four years with luck. He went to Italy and whilst his health was declining there he received a letter from a biochemist friend which said there was something called insulin appearing with a good name in Canada what about going there and getting it. I said No thank you I ve tried too many quackeries for diabetes I ll wait and see . Then I got peripheral neuritis . So when the friend cabled me and said I ve got insulin it works come back quick I responded arrived at King s College Hospital London and went to the laboratory as soon as it opened . It was all experimental for neither of us knew a thing about it. So we decided to have 20 units a nice round figure. I had a nice breakfast. I had bacon and eggs and toast made on the Bunsen. I hadn t eaten bread for months and months . by 3 o clock in the afternoon my urine was quite sugar free. That hadn t happened for many months. So we gave a cheer for Banting and But at 4 pm I had a terrible shaky feeling and a terrible sweat and hunger pain.

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