Abstract
A report was given on two cases of diabetes mellitus—in a man and a woman—who both developed their illness under the strain of an emotional conflict of striking similarity. Both subjects showed unusually strong tendencies to receive and to be taken care of. The first patient's essential demands were stimulated by a physical trauma at the end of his weaning period; the second patient's by a traumatic weaning process. Both patients retained an infantile dependent and demanding attitude, and felt frustrated because their demands for attention and love were out of proportion to the reality situation of an adult and consequently were never adequately satisfied. To this frustration both patients reacted with hostility. Diabetes developed in, both cases when these infantile wishes conflicted with the demands that were frustrated, and the sugar output decreased when they temporarily renounced their demanding attitudes. In the diagram we see very clearly that sugar output is increased under the strain of the above conflict, and decreased when the patients indulged in self-pity and passivity. It seems probable to us that these food-demanding drives, under the condition that nobody is there to satisfy them externally, may turn to an autoplastic satisfaction in a metabolic process which mobilizes glucose out of the glycogen stores of the body. The observation of the increased sugar output during the night, i. e., independent of the carbohydrate intake, under certain emotional conditions described above, is consistent with these assumptions. This interpretation is in conformity with recent experimental findings, namely, that in certain cases of diabetes mellitus the rise of the sugar level is dependent not on failure of sugar utilization but on sugar mobilization.
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