Protamine insulin in the treatment of diabetes

Summary

1. Diabetes showing marked fluctuations in the blood sugar, or those cases associated with certain complicating factors, as hyperthyroidism, hepatic enlargement, etc., can be controlled better by protamine insulin than by regular insulin.

2. Cases of diabetes showing a persistent hyperglycemia or where it is desired to diminish the frequency of insulin administration should receive protamine insulin.

3. Protamine insulin should not be used in cases of acidosis or impending coma or those complicated by surgical conditions.

4. Untreated cases of diabetes should not receive protamine insulin as an initial form of treatment.

5. When changing from regular to protamine insulin we have obtained good results by giving 70% of this amount as protamine insulin and the balance as regular insulin, both administered about one hour before breakfast as separate injections.

6. After a period of 4 to 7 days if the morning urine is sugar free, discontinue the dose of regular insulin. If the morning glycosuria persists, increase the protamine insulin.

7. Increases or decreases in protamine insulin should consist of only five units at a time.

8. Too many factors should not be changed at one time, nor should the effected changes be made at too frequent intervals, when using protamine insulin.