Influence of Estrogen on Insulin Requirement of the Diabetic

This study consists of a series of 9 diabetic women taken from the Metabolic Service of Sea View Hospital. The patients were chosen without regard for an indication for estrogen therapy. They were followed for a period of one year: 4 months before the beginning of estrogen, 5 months during its administration, and 3 months after it had been discontinued. Estrogen was administered intramuscularly in doses of 10,000 International Units twice a week for a period of 4 months.

During the 4 months before estrogen therapy a definite effort was made to maintain the individual insulin dosage at the lowest level compatible with proper control of the diabetes. A patient was considered well controlled when in the absence of acetonuria there was less than 1 % of sugar in each of the partition specimens of urine and the total amount of sugar spilled in a period of 24 hours was less than 20 g. To meet these requirements it was necessary to increase our daily insulin dose steadily from 63 units at the beginning of this period of observation to 84 units at the end of this 4-month period.

Two weeks after estrogen was instituted the average daily insulin requirement started to show a significant decline so that during the 5 months in which our patients were receiving estrogen there was a drop in the daily average insulin requirement from 84 to 54 units, representing a saving of 35%.

At the end of this 5-month observation period estrogen was discontinued. The patients were then followed 3 months longer. There was a gradual increase from an average daily requirement of 54 units at the beginning of this time to 63 units at the end.