The inheritance of essential diabetes mellitus from studies of the synalbumin insulin antagonist

Patients with essential diabetes including prediabetes have more synalbumin antagonism to insulin than normal subjects or patients with “pancreatic” diabetes, e.g. after pancreatectomy. Thus excessive synalbumin antagonism (synalbumin positive) can be regarded as a biochemical marker to ascertain whether a given person is constituted as an essential diabetic-without reference to carbohydrate intolerance.-On this premise, the genetic transmission of essential diabetes has been examined by studying the relatives of essential diabetics. The results strongly suggest that excessive synalbumin antagonism is inherited as an autosomal “dominant” character.-Ninety-seven members of nine families were studied, 39 were synalbumin negative whereas 58 were synalbumin positive, but only 16 of these latter have overt carbohydrate intolerance. A further three have spontaneous hypoglycaemia whereas the remainder are quite asymptomatic. These observations suggest that overt carbohydrate intolerance is relatively uncommon or will be a late event in many people constituted as essential diabetics.