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Summary  Serum insulin responses to 100 g oral glucose, intravenous tolbutamide, and oral glucose plus intravenous glucagon and tolbutamide, were studied in patients who were definitely diabetic but subsequently improved to have normal glucose tolerance following treatment. Definite diabetes was diagnosed when the patient had had fasting blood sugar higher than 150 mg/ 100 ml or had clear diabetic retinopathy plus glucose intolerance. This improved group, whether nonobese or obese, had significantly decreased insulin responses during glucose tolerance test and glucose-glucagon-tolbutamide test, but the insulin response to intravenous tolbutamide was not significantly different from the control. In contrast, in the secondary diabetes group, whose glucose intolerance might be attributable to other diseases than diabetes, insulin response to glucose was enhanced, and was normalized when glucose tolerance became normal. The insulin response to glucose of the prediabetes group (i.e. with both parents diabetic) with normal glucose tolerance was intermediate between those of the healthy and diabetes groups. It seems that the low insulin response to glucose is a less easily corrigible feature than glucose intolerance and probably constitutes one of the most fundamental abnormalities in primary diabetes.

Insulin secretory response of diabetics during the period of improvement of glucose tolerance to normal range