DIFFICULTIES IN EVALUATING AN INSULIN PREPARATION

To the Editor:—  The efficiency of a new insulin preparation is determined by its effect on the sugar metabolism of a diabetic patient who is receiving suitable quantities of food. Judgment is rendered difficult by unexplained variations in sugar excretion, though every effort has been made to control insulin dosage, diet, physical and mental activities and the like. It is probable that this annoying irregularity is occasioned by unknown limiting factors that are necessary for insulin activity. The profession is distressingly ignorant of this phase of carbohydrate metabolism, and it is to be hoped that further work by biochemists and physiologists will elucidate this question.Another disturbing factor, more amenable to correction, is the lack of agreement among writers as to what constitutes acceptable regulation of the diabetic patient. A committee of men especially interested in diabetes might undertake to dispose of this problem.