[Insulin secretion in maturity-onset- diabetes--indications for etiopathogenesis and therapy]

Primary diabetes mellitus is usually subdivided into the types JOD and MOD. In MOD different insulin secretion patterns may be found. The authors have checked the frequency of the different patterns of disturbed insulin secretion in a number of 130 indiscriminate MOD-patients. It was investigated to what extent the insulin values correlated with the fasting blood glucose level. The results show that in fasting blood sugar values up to 140 mg/dl a highly different behaviour of the insulin secretion is present. In this range different etiopathogenetic clinical pictures certainly exist. With increasing blood sugar values a reduction of the insulin secretion is to be expected with increasing probability. In 24% of the patients an increase of the insulin levels in the blood after administration of glucose was missing altogether. In 96% of the patients with MOD additional stimulation by glucagon led to a significant increase of the insulin levels in the blood. As concerns treatment a still existing own insulin secretion of the patients should be assumed in those cases where the blood sugar values are only slightly elevated. It is not possible to derive the necessity of an additional treatment with sulfonylureas from the fasting blood sugar level or from the insulin values alone.