About 12 years ago the scientific world was startled and rejoiced by the announcement that the substance which had long been looked for in the pancreas, which was the substance lacking in diabetes, had been isolated. It is now named “insulin,” and can be obtained at any drug store. Its manufacture and the prices which are charged for it are controlled, so that the patient receives this at the lowest possible price and with the lowest possible profit to the manufacturer and the retailer.
Insulin exerts its action by helping to burn the glucose in the blood. The actual place where this burning takes place is probably in the muscles. Exactly how insulin acts is not determined. That it increases the oxygenation of glucose has not been proved. Its action is probably in the muscles. Exactly how insulin acts has not been proved. Its action is probally on the liver, having to do with the formation or the release of glycogen.
At any rate, we know that when injected into an animal body it reduces blood sugar in definite proportions, depending upon the number of units given. It does this not only in the normal, but also in the diabetic body.
Insulin is not needed by all diabetics. There are two general classes of diabetics, they may be said to be the young severe diabetics and the old mild diabetics. A middle-aged person who has a moderate amount of diabetes and L200 grams of carbohydrate a day, is not under the necessity of resorting to insulin. With a moderate amount of self-control in his-dl tâiy he can get enough energizing material to keep him going.
This is really a great advantage, because the use of insulin is, at the present time, a dreadful nuisance. It has to be administered hypodermically, because when taken by mouth it is destroyed by the juices of the stomach, and the utmost precautions must be taken to see that the hypodermic is kept sterile. This means when one is taking a trip, that the hypodermic and the insulin and the sterilizer have to go along, and it involves the annoyance of a hypodermic injection and the annoyance of the preparation two or three times a day. This fact that it acts only when given subcutaneouslyis really the only disvantagr insulin has.
For years we have been searching for a substance which, if taken by mouth, will do the same thing, but as yet no certain and reliable one has been discovered. I have heard just recently of a new production which may be an improvement on the ones which we are now using, named “synthalin” and “neo-synthalin.” However, in those severe cases in which it is necessary, or in cases which occasionally’ need to be cleared up when they have not been sufficiently strict about their dieting, insulin is one of the great boons which the medical profession has conferred upon mankind.
By its employment the treatment of the young diabetic has been changed, so that instead of being compelled to lead a life of starvation and self-control which would do credit to much older and more self-willed people, these youngsters are able to lead a comfortable and happy existence. They also learn to administer insulin to themselves with extremely good technic, and in Doctor Joslin’s “Manual of Diabetes” there are several pictures of little children who are administering insulin to themselves hypodermically, taking all the precautions that are necessary to insure sterility.