Insulin-Resistant Diabetes after Total Pancreatectomy

Abstract

CONTRARY to speculation diabetes mellitus that follows total pancreatectomy in man is relatively mild. In the absence of infection or other complications the requirement for insulin is usually stable and ranges from 20 to 40 units daily. There is relatively little tendency to spontaneous ketosis and coma, but insulin sensitivity has been a frequent problem in management. The marked contrast of these findings with those in many cases of naturally occurring diabetes mellitus has stimulated consideration of factors besides lack of insulin that produce hyperglycemia and ketosis and require large doses of insulin for correction.In the following case, which . . .