INSULIN

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Onset of Insulin Deficiency

Determining the type of untreated Insulin Deficiency
Disease	Type 1 diabetes	Insulin deficiency without diabetes
Mortality	High If left untreated	Normal If no major trauma or disease occurs
Onset	Childhood Adults who became thin at a certain period of life	Babies, children, adults who were thin all their life Elderly men, postmenopausal women who became thinner with age
Blood Levels	High glucose Low insulin High glycosylated hemoglobin	Normal to low glucose Low insulin Low-normal glycosylated hemoglobin
Start	Often acute, developing over several weeks, months	From birth on, or Slow, progressive
Major signs	Major signs: Diabetic signs Dehydration: poly/dipsia/uria Greater fatigue, sleepiness Sugar cravings	Major signs: Thin body, low weight Thin(ning of the) body Weight loss Sweets and sugar are less well tolerated
Syncopal Signs	Syncopal sign caused by Hyperglycemia and cellular Depletion in glucose	Less frequent Syncopal signs caused by hypoglycemia and cellular depletion in glucose
Dehydration	Signs of dehydration: sunken Eyes, prolonged skin fold, etc.	Absent or less frequently found signs of dehydration
Athero-sclerosis	Often present: gangrene and Poor wound healing	Less or no gangrene, but possible poor wound healing
Prognosis	Poor if left untreated	Remains acceptable, if no major trauma or disease occurs
Patient’s age	Children Adults who became thin at a certain period of life	Babies, children, adults who were thin all their life Elderly men, postmenopausal women who became thinner with age

Complaints suggestive of Insulin Deficiency

Complaints suggestive of Insulin Deficiency
PHYSICAL
	Diabetes type 1	No diabetes
Head	Headache	Normal (no or rare headaches)
Face	Hollow, emaciated face	Emaciated face
Body	Thinning Weight loss Premature aging	Major thinness Low body weight Muscle hypotrophy
Muscles	Volume loss, hypotrophy Strength loss Greater weakness	Underdeveloped muscles, hypotrophy Poor strength
Nervous System	Sleepiness Polyneuropathy	Normal (no or low sleepiness; no polyneuropathy)
Appetite	Sugar cravings Feels transiently better with sweets	Sugar cravings Sugar intolerance
Thirst	Excessive thirst Excessive water drinking (polydipsia)	Normal
Urine	Excessive urination (polyuria)	Normal
Skin	Dry skin Episodes of sweating (hyperglycemia episodes + intracellular sugar depletion)	Less dry skin Episodes of sweating (hypoglycaemia)
Sexual	Sexual impotence	Normal or mildly attenuated
PSYCHIC
Energy	Greater fatigue, general weakness Greater lack of endurance	Fatigue, weakness Lack of endurance
Alertness	Moments of low alertness, inattention Coma possible	Normal or mildly attenuated
Behavior	Apathetic	Relatively normal
Character	Difficulties in receiving and giving love	Fragile personality Vulnerable character
Sexual	Low libido Men: low sexual potency	Normal or mildly attenuated

Physical Signs of Insulin Deficiency

Physical signs suggestive of Insulin Deficiency
Type	Insulin deficiency With (type 1) diabetes	Insulin deficiency (without diabetes)
Face	Thin, hollow, emaciated face Loss of facial fat	Emaciated face Lack of facial fat Prominent jugular bones
Body	Thinning Low body weight, weight loss (BMI < 22 kg/m2) Premature aging body	Extreme thinness, ‘skin on bone’ Person (BMI < 18 kg/m2) Low body weight
Muscles	Droopy muscles (with volume loss, Hypotrophy)	Underdeveloped muscles Hypotrophy)
Nervous System	Loss of nervous reflexes Abnormal Babinski reflex (slow Extension of foot when foot sole is Run over with the point of a reflex Hammer)	NORMAL
Fat	Loss of fat: loss of subcutaneous, Facial, breast, subscapular, Abdominal, buttock, hip and thigh Fat Thin feet, lacking fat	Often severe lack of fat mass Loss of fat: loss of subscapular, Abdominal, buttock, hip and thigh fat Thin feet, lacking fat
Thirst	Excessive thirst Excessive water drinking (polydipsia)	NORMAL
Genitals (men)	Peyronie’s disease	NORMAL
Skin	Dry skin	Less dry skin