Evening star. [volume] (Washington, D.C.) 1854-1972, 1895-08-06
DIET AND DIABETES.
Suggestions as to the Regime That
Should BE Followed.


From the New York Herald.
The diabetic patient must be made to I'M
derstand thoroughly that improvement and
recovery depend on the amount of perse-
verance shown and on The care taken in
self-observation by having careful and me-
thodical analyses made at regular inter-
walls of the quantity of sugar in the urine
The patients weight should also be fol-
lowed exactly and at stated intervals and
the physician should be informed if the
weight of the body appetite diminish
roticeably. Finally. the physician should
rot advise any medicinal remedy until he
has tested the effect of a purely hygienic
and alimentary course of treatment.
If the sugar disappears entirely after
such test, which should be instituted for
a period of two weeks at least, the case is
one that 1t is possible to cure, or at any
rate to improve very notceably. and the
patient can count on living many year,
on condition that rigorous course of
supervision never be departed from.
But even in cases where the sugar disap-
pears after q few days of regime it is i'm
portant never to interrupt the treatment
suddenly, nor can such a patient be cor
sidered cured. 1t is necessary that the use
of starchy foodstuffs. and then of fruit
and sugar. should only be resumed with
the greatest caution atd aXtrema delibera-
ton. These forms of food should only be
resumed when they no longer have any
bad effect, and this can only be ascertain
ed by testing for sugar after each alimen-
tsry experiment.
The patient can then take a little bread
at meals; if then the sugar does not re-
appear in the urine coming from that di-
geston, this can be continued for a week
and the amount of bread can be Somewh hat
increased If the sugar is still absent, a
little milk can be tried. and later on po-
tatoes. other starcny foods or fruit. the
test for sugar being carefully made after
each new departure in eating and no new
substance being taken unless the test is
negative. If the sugar reappears after
some change in the regime. not only must
the new article be dropped, but the strict
est regime must be recommended at once
and the series of experiments in changing
food must be resumed once more.
As general thing, even in the simplest
cases, this gradual return to a normal diet
requires several moaths, and 1t is at this
price only that lasting recovery can be OBJ
tanned.
But after two weeks of the test regime it
can also happen that the sugar has not
disappeared, but has gone down to fixed
point. below which nothing will induce 1t
to descend.
If the case Is comparatively recent one
1t will still be possible to reduce the
amount of sugar by combining a strict diet
with an appropriate course of medca ton;
nevertheless, as this severe diet cannot be
continued for too great a length of time
to handle it skillfully and to alternate it
with the pharmaceutical remedies, the rig
orousness of the regime being somewhat
lessened while the latter are being used
In forms that are more serious still neither
the regime nor medicine can make the
sugar disappear, but they can keep it down
to 4 minimum provided they stick to it for
an indefinite length of time.
1t is, of course, evident in such cases that
a regime that has 70 be scrupulously fol-
lowed for an indefinite length of time must
not be too absolute in Its severity, in the
first place because the patient would final
ly turn against it, and in the second place
because the total absence of starchy food
would finally create dyspeptic disorders
and stimulate the heterogeneous denutrition
that is already so intense in the diabetic
patient.
Under these conditions, and while still
excluding sweets and pure starchy foods
it is possible to put together regime that
will be practically sufficient, to which the
patient will grow accustomed little by lit
tle and that he will follow for long time
Even then, If the glycosuria were TO sud
denly show an increase that could not be
reduced by medicine, the absolute regime
should be taken up again and continued
until the sugar had gone down to its usual
minimum