Amelioration of Diabetes and Striking Rarity of Acidosis in Patients with Kimmelstiel-Wilson Lesions

Abstract

A REMARKABLE reduction in insulin requirement in a patient (Case 1 — H. R.) with diabetes, who died in uremia, focused attention on the general subject of occasional spontaneous amelioration in diabetes mellitus. Improvement in diabetes has been described as coincident with the following: limitation of diet and consequent loss of weight,¹ cirrhosis,² myxedema,³ extirpation of pheochromocytoma,⁴ radiation of the pituitary gland in acromegaly,⁵ onset of Addison's disease,⁵ relief of Cushing's syndrome,⁶ senescence,⁷ and also, most dramatically, in anterior-pituitary-artery thrombosis. None of these mechanisms seemed to be operative in Patient H. R., in whom the dominant feature of her later . . .