D. ROBERT AXELROD, M.D.
To the editor: On the problem of excessive insulin administration examined in the review article by Wilson (1), I write to add some clinical observations.
The most frequent reason that patients are admitted to my care for better control of their diabetes is overuse of insulin. This problem applies not only to type 1 diabetic patients but to any diabetic patient taking insulin regularly. Unsuspected hypoglycemia can frequently be detected by finding ketonuria without, or with a little, glycosuria. This finding results from a shift of energy metabolism to fat, producing ketones because glucose is unavailable, not because of an
D. ROBERT AXELROD. Excessive Doses of Insulin. Ann Intern Med. 1983;98:678. doi: 10.7326/0003-4819-98-5-678_1
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Published: Ann Intern Med. 1983;98(5_Part_1):678.
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