Before the isolation of insulin in 1923, growth failure and eventual death from starvation
were predictable in children with type 1 diabetes mellitus (T1DM), because nutritional
therapy was inadequate in the absence of insulin therapy. Purified animal-sourced insulin
became a miracle drug that allowed survival; however, metabolic control remained far from
optimal. Poor metabolic control despite insulin therapy led to a relatively common condition,
Mauriac syndrome, in which children with T1DM also had growth failure and hepatomegaly …