Hyperinsulinism as an Etiologic Factor in Acute Rheumatic Fever

Abstract

INTRODUCTION THAT DIABETICS are largely free of allergic diseases is well known (1) whereas allergic individuals are prone to hyperinsulinism (2, 3). Diabetics have far less than their expected quota of peptic ulcers (4) and experimental evidence supports the view that these lesions, too, are accompanied by hypoglycemia that suggests hyperinsulinism. Another disorder seldom seen in diabetics is rheumatic fever (Joslin, 5). This disorder, according to Levine (6), represents an allergic reaction to the products of the causative organisms. Levine's conclusion is supported by the fact that bacteria have not been isolated from accessible rheumatic lesions. The appearance of allergic symptoms requires, in addition to contact with the specific allergen—in the case of rheumatic fever, bacteria or their toxins—the presence of a non-specific constitutional factor. In other types of allergy, it has been shown that this constitutional factor is, in some way, connected with hyperinsulinism since that metabolic abnorma...