Protamine-Zinc-Insulin in Diabetes
Since the appearance of Hagedorn’s paper in January, 1936,1 regarding the use of protamine-insulin, a wide interest in it has developed. The original claims that it had a prolonged action, gave better control in most cases, a tendency to less frequent insulin reactions with a diminishing number of injections and a reduction in actual dosage have largely been corroborated by other investigators.2,3,4,5 More recently, the addition of zinc to protamine-insulin has received considerable attention and it appears likely that a combination of the zinc with protamine will supercede the use of plain protamine-insulin.
The observations reported in this paper were gathered in the management of forty-eight patients, some of whom had been treated with various preparations of protamine-insulin since February, 1936. Since August of 1936, all patients in this group have received protamine-zinc-insulin. Cases of all degrees of severity have been treated and four children are included in the group. The ages of the patients vary from 8 to 76 years.
It has been felt advisable to hospitalize all patients during the first part of their treatment. The hospital stay averaged fourteen days. No patient was confined to bed except for some complication. An attempt was made in each case to maintain physical activity comparable to that of the patient’s average day. During the hospital stay, venous blood was taken routinely for determination of the blood sugar at 8 a. m., 12 noon, 4 p. m., and 10 p. m. daily and in some cases at other hours in addition, . . .