ASTHMA, DIABETES MELLITUS AND HYPERINSULINISM

Abstract

THE LITERATURE of the past decade is replete with reports that asthmatics have a tendency to hypoglycemia. Black (1) found more than half of a large series of asthmatic patients to have low fasting blood sugar levels and increased glucose toler’ ance (low glucose tolerance curves). Ohler, in a personal communication to Joslin (2), said that he found low glucose tolerance curves in 14 asthmatics. Wil-mer, Miller and Beardwood (3), Malone (4) and Waldbott and his collaborators (5) made similar ob’ servations. If hypoglycemia is an essential factor conditioning the appearance of asthmatic seizures in sensitive individuals, we should expect such attacks to be absent, or, at most; very rare in diabetics. Kern (6) has shown that although diabetes mellitus and bronchial asthma often share a common heredity they are to some extent mutually exclusive, both diseases occurring very frequently in members of the same family but only extremely rarely in the same person. He postulated a genetic relationship between the two conditions and assumed that they were due to a defect in the same gene that can take one of two directions. According to him, diabetes is the recessive and allergy the dominant variation. Joslin was formerly impressed with the rarity of asthma in diabetics and had but 6 cases among the 7,000 or so reported (2). Later, he stated (7) that he had seen 12 additional cases among a large number (not given) of diabetics. More recently, he states (8) that “the usual belief that diabetes and allergy seldom occur in the same patient [is true] only if the phrase ‘at the same time’ was added.” Apparently, he still feels that the concomitant occurrence of the two diseases is rare.