An Inquiry Into the Pathogenesis, Rational Treatment and Prevention of Multiple Sclerosis, With Emphasis Upon the Combined Role of Diabetogenic Hyper‐insulinism and Recurrent Edema*

Intravenous Glucose Tolerance and Pancreatic Islet β-Cell Function in Patients With Multiple Sclerosis During 2-yr Treatment With Cyclosporin

“…Previously, several authors have asserted that multiple sclerosis patients are at increased risk for diabetes and that there is an increased association between the two diagnoses in patients and family members (19)(20)(21)(22)(23)(24)(25)(26). Our data from a group of 22 multiple sclerosis patients do not suggest a tendency toward diabetes.…”

“…Three blood samples were drawn at -1 0 , -5 , and 0 min before intravenous pulses of glucose (20 g) and arginine (2 g) were given. Additional samples were drawn 3,4,5,7,10,15,20,25,30,45,60,90, and 120 min after injection of the intravenous glucose pulse and 2, 3, 4, 5, 7, 10, 15, and 30 min after a subsequent intravenous arginine pulse. Basal glucose, insulin, and C-peptide values were calculated as the mean of the three preinjection values.…”

“…Basal glucose, insulin, and C-peptide values were calculated as the mean of the three preinjection values. Glucose disappearance rates were calculated as the slope of the line representing the negative correlation of the natural log of the glucose concentration in plasma as a function of time (10,15,20,25, and 30 min after the glucose pulse). First-phase insulin responses to glucose were calculated as the mean of the values at 3, 4, and 5 min after the glucose pulse minus the basal insulin value.…”

Obesity Due to the Syndrome of Narcolepsy and Diabetogenic Hyperinsulinism: Clinical and Therapeutic Observations on 252 Patients*

“…2), this reversed pattern appeared to be permanent, i.e., it was not affected by daytime recumbency, diuretic therapy, cessation of smoking, surgical castration, dietary modification, season of the year, or dexamethasone therapy. During treatment with synthetic oxytocin (Syntocinon ) , either by injection (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) or nasal spray, the diurnal volume pattern became normal or nearly normal (reproducibly) in all but 2 patients, generally with symptomatic improvement (8).…”

“…Recurrent ("idiopathic") edema was a prominent feature in 126 patients (50 per cent), including 11 males. Such edema is significantly related to the following factors: (a) the inhibition of sodium excretion (7) and ensuing retention of water after glucose ingestion; (b) impaired water metabolism, as manifested by a reversed diurnal volume of urine (8), chiefly reflecting an acquired disturbance involving the kidneys, hypothalamus and pituitary (anterior, posterior); (c) excessive water intake; and (d) enhanced intracellular ingress of water caused by the hyperinsulinized state.…”