In the late nineteenth century, publications on ocular complications of diabetes mellitus frequently mentioned primary optic atrophy. Clifford Allbutt in 1871 stated “atrophy of the optic discs … does undoubtedly occur in a sufficient number of cases of glycosuria to make the coexistence seem more than accidental.” In 1875 Leber quoted a number of cases recorded by other observers, but stated that he had not seen such a patient himself. In the 1927 edition of von Noorden's book on diabetes, 4 per cent of 477 diabetic patients are recorded as suffering from simple optic atrophy. More recently, Waite and Beetham (1935) found optic atrophy in 0.6 per cent of 2,002 diabetics and in 0.4 per cent of 457 nondiabetics. The only other reference in recent literature is that of Wolfram (1938) who reported from the Mayo Clinic four cases of diabetes mellitus and simple optic atrophy among siblings. This communication is concerned with two further cases.

One of the earliest papers on insulin therapy by Banting and his colleagues described a slight induration of the subcutaneous tissue and reddening of the skin immediately surrounding the point of injection. At this time Joslin and his co-workers stated that induration had been seen frequently at the site of insulin injections and described four cases of urticaria developing among the first 83 diabetic patients treated. Later, redness and swelling were observed to follow the injection of protamine insulin, and similar reactions have been described following the use of globin insulin.

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