The Syndrome of Narcolepsy and Diabetogenic Hyper‐insulinism in the American Negro: Important Clinical, Social and Public Health Aspects

Glucose tolerance in patients with narcolepsy

“…During the 1960s, Roberts conducted a large case series, published in several separate reports, where he found a high rate of impaired glucose tolerance and diabetes due to diabetogenic ("functional") hyperinsulinism in 200 narcoleptic patients. 10,11 Again, diagnosis of narcolepsy may have been questionable due to a lack of operationalized criteria. The first systematic approach was undertaken by Honda and coworkers in 1986.…”

“…8 Moreover, three studies suggest impaired glucose metabolism in narcolepsy: One Japanese study suggests that narcolepsy is associated with an increased incidence of type 2 diabetes mellitus 9 ; and during the 1960s, Roberts conducted a large case series, published in two separate reports, where he found a high rate of impaired glucose tolerance and diabetes due to diabetogenic ("functional") hyperinsulinism in 200 narcoleptic patients. 10,11 To study differences in glucose metabolism and endocrine parameters, the measurements between patients and healthy controls matched on a group level for age, sex, and BMI were statistically compared using univariate analyses of variance. For descriptive purposes only, effect sizes were calculated from t-statistics as Hedges d as described by Morris and DeShon.…”

Delayed Thrombophlebitis and Systemic Complications After Vasectomy: Possible Role of Diabetogenic Hyperevsulinism*

“…Prominent among the metabolic and immunologic factors which could contribute to diminished sexual function and altered nervous‐system behavior in such men are the ravages of diabetogenic hyperinsulinism on the central, peripheral and autonomic nervous system. In fact, most of the patients in our series complained of narcolepsy, migraine and spontaneous leg cramps—symptoms commonly due to severe reactive hypoglycemia (3–5, 39–41). The development of multiple sclerosis shortly after vasectomy in Case 6 assumes increased significance in view of the following considerations: (a) diabetogenic hyperinsulinism may be a major factor in the pathogenesis of multiple sclerosis (39); and (b) the hyperinsulinized state can be potentiated by testosterone (42), which undoubtedly is released into the testicular tissues—and from there into the systemic circulation—in abnormal amounts following vasectomy.…”

“…As a medical consultant without previous professional or other bias against vasectomy, I have become increasingly concerned relative to several possible serious systemic complications of the procedure, especially when performed on well‐nourished young men who are subject to the chronic hyperinsulinized state (diabetogenic hyperinsulinism). This state is tending to become a hallmark of our culture, largely owing to nutritional developments since the turn of the century (3–5). These misgivings are further heightened by the immunologic consequences of experimental vasectomy and related procedures.…”

The Role of Diabetogenic Hyperinsulinism in Nocturnal Angina Pectoris, With Special Reference to the Etiology of Ischemic Heart Disease*

“…It should also incorporate the principle of “scientific nibbling,” i.e., 7 or more feedings a day. Most patients with D.H. require food at progressively shorter intervals as the day advances because of their cyclic acceleration of insulinogenesis (6, 7). Particular pains must be taken to protect those patients who fail to recognize the hunger and the autonomic evidences of reactive hypoglycemia sufficiently early (9).…”