Anti-diabetic Substance 



419 



204 (2164) 



Clinical observations on the use of the anti-diabetic substance. 

 By C. B. F. GIBBS and C. C. SUTTER. 



[From the Physiological Laboratory of the University of 

 Rochester, Rochester, N. Y.] 



Following the attempts to improve the condition of diabetic 

 patients by administering pancreatic extracts by mouth and by 

 duodenal tube, purified preparations have been given hypoder- 

 matically and intravenously. Most of these preparations were 

 made by acid aqueous extraction; the fresh pancreas of ox or 

 pig being ground in a mill with acid media and the resultant 

 nitrate concentrated and purified. Other material was obtained 

 by perfusing the pancreas with acid aqueous media and then 

 concentrating and purifying the perfused fluid. 



The patients on whom the preparations were used were mostly 

 of severe type not being previously controlled by dietetic regula- 

 tion. All of these cases were hospitalized in order that rigid 

 control of diet, urinary excretion and blood sugar levels could 

 be obtained. The cases in this series were 12 adults ranging from 

 26 to 55 years of age. 



Charts of the clinical data on these cases and graphs showing 

 the changes in blood sugar levels and urinary sugar excretion 

 were demonstrated. 



CONCLUSIONS 



1. Potent preparations of the internal secretion of the pan- 

 creas can be made by aqueous acid extraction and perfusion. 



2. These preparations were made non-toxic and non-irri- 

 tant for hypodermatic and intravenous administration. 



3. The hyperglycemia can be markedly reduced and the gly- 

 cosuria and acetonuria can be made to disappear by means of 

 these preparations. 



4. The clinical condition of patients can be markedly im- 

 proved, e. g., the thirst and polyuria diminished, edema removed, 

 weight gained and mental sluggishness caused to disappear. 



5. The carbohydrate tolerance is increased commensurate 

 with the amounts of extracts employed. 



6. Dessicated pancreatic extracts taken in capsule form by 

 stomach have thus far not proved to be effective in reducing 

 blood or urinary sugar. 



7. Patients in complete coma can be brought back to a ra- 

 tional condition, their acidosis controlled and the non-protein 

 nitrogen and creatinine lowered to a normal level. 



