Abstract

The treatment of diabetes mellitus has been very greatly improved in the recent past, owing to the work of Allen1 and his colleagues. It has been shown by him that the urine of the severest diabetics can be made sugar free by sufficiently prolonged starvation and will remain sugar free if the total energy intake is kept sufficiently small.

It has been the general custom to make up the diet largely of protein, because of the undoubted desirability of omitting carbohydrates, and because of the almost universal fear of precipitating a dangerous acidosis by allowing more than a minimum of fat. This high protein, low fat, low carbohydrate diet, given in quantities sufficient to maintain metabolic needs, is accompanied by a glycosuria in the severe diabetics. In order to prevent glycosuria, it is necessary to restrict the total energy intake so much that inanition results. In other words, this leaves