Detection of Diabetes Mellitus In Situ (Occult Diabetes)

In recent years, further development and refinement of technique has permitted reproducible serum insulin determinations to become available for correlation, with plasma glucose levels during tolerance testing. In earlier presentations, 1,2 five basic insulin patterns were identified indicating the absence or presence of diabetes through a wide range of insulin response (diabetic state). In a number of cases, normal glucose tolerances were associated with abnormal insulin patterns. Such situations, in which the glucose tolerance curve was normal and correlated insulin pattern was abnormal, were considered indicative of pre-diabetes or occult diabetes. In order to focus greater attention upon this, the earliest detectable phase of diabetes mellitus, the term diabetes mellitus in situ has been proposed and used interchangeably with occult diabetes throughout this report.It is the primary purpose of this paper to review basic insulin patterns which develop in the course of standard glucose tolerance testing and indicate the significance of each.