“…Recent investigations suggest that the hyperinsulinemia reflects generalized insulin resistance, and abnormal insulin tolerance test results support this conclusion (3,11). However, other researchers have observed normal insulin tolerance responses (6,9,12,13), and many myotonic dystrophy patients differ distinctly from other diseased patients with hyperinsulinemia, in that their basal insulin levels are normal (4,9,14,15,16). No abnormalities of endogenous insulin (6,8,10,16) or proinsulin (16) have been reported and a preliminary search for anti-insulin receptor antibody in one patient was unsuccessful (17).…”