The case is reported of a patient who survived the preinsulin era and lived a total of forty-eight years after the diagnosis of diabetes mellitus had been made. Although he was never strictly controlled, from a purely chemical point of view, his diet and insulin requirement remained fairly constant.

He suffered only slightly from diabetic glomerulosclerosis and less from diabetic retinopathy. In the later years of his life, paralysis agitans became an outstanding feature of his case. Occlusive vascular disease of the extremities also presented problems in management. He suffered two episodes of coronary occlusion without chest pain. Death was finally attributed to coronary artery disease, which was, in turn, part of the generalized arteriosclerotic problem. At autopsy no beta cells could be identified in the islets of Langerhans.

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