Necrobiosis Lipoidica Diabeticorum

Abstract

To determine the effect of cortisone acetate on the standard glucose-tolerance test as a means of appraising insulinogenic reserve and to evaluate more completely the relationship of necrobiosis lipoidica diabeticorum (NLD) to diabetes mellitus, the authors reexamined 19 patients who had NLD but who had not been found to have diabetes mellitus during previous examinations at the Mayo Clinic. Standard glucose-tolerance tests gave abnormal results in three cases, including that of one patient who was taking hydrochlorothiazide. Cortisone glucose-tolerance tests gave abnormal results in five of the remaining 16 cases. Six of the 11 patients without evidence of carbohydrate intolerance gave family histories of diabetes. These findings confirm the close relationship between NLD and diabetes mellitus and suggest a relation to the prediabetic state, perhaps independent of carbohydrate metabolism.