Drug compliance in diabetics.
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The patient described developed 2 separate episodes of insulin resistance and on each occassion daily administration of soluble insulin in a daily dose of 980 units failed to achieve satisfactory control. Both episodes responded to steroid therapy. The maximum binding capacity of the serum for insulin was measured on each occasion; in the first episode it was grossly elevated whereas the second time the level was unremarkable. She is currently free of diabetic complications and satisfactorily controlled on a sulphonylurea and diet.
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An extensive hemorrhage in the pharynx appeared in association with dipyridamole administration to a diabetic patient. The hemorrhage caused dysphagia and subsided when the drug was discontinued. Coagulation tests were normal except for a decreased platelet aggregation. Platelet factor 3 and the aggregation tests with adenosine diphosphate and epinephrine were abnormal during the hemorrhagic event and returned to normal after discontinuation of the drug.
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