Effects of Insulin upon the Production of Ketone Bodies

In 1936 we reported the occurrence of severe ketosis “immediately following hypoglycemic shock in insulin-treated diabetics, who for some time prior to the insulin shock were well under control on diets containing 120 to 250 gm. of carbohydrates with commensurate doses of insulin” (1). Since 1935, when we first observed this causal connection between hypoglycemia and ketosis, appreciation of the phenomenon and its proper application in the treatment of diabetic patients in our institute have consistently produced gratifying clinical results (2). In the light of this experience the subject assumed sufficient significance to deserve further study. With regard to Claude Bernard’s thesis that pathological processes differ only quantitatively from normal physiological processes, our observations were extended beyond diabetic patients to include normal human subjects and laboratory animals. The results of these studies were briefly reported last year in a preliminary note (3).