Some thoughts on the etiology of human diabetes.

A suggested classification of the possible causes of diabetes mellitus is presented, based on the assumption that the disorder is genetically controlled. On the one hand there are factors which produce a failure in the formation, liberation, or action of insulin; on the other hand, there are factors which produce an increased formation, liberation, or action of substances which, in excess, have diabetogenic effects. As well, genetic defects that give rise to diabetes mellitus may involve insulin-dependent reactions or, as a theoretical consideration, be independent of hormonal actions. Final clarification of the physiological mechanisms by which each of the causes produces abnormalities in metabolism offers a challenge for future investigation, as well as elucidation of the primary defect or defects in diabetes mellitus.