With the important advances that have been made in recent years in the management of diabetes, during a period that has included the advent of insulin therapy, a growing uncertainty has developed regarding the real nature of the metabolic defects involved. The fundamental observations include the hypoglycemia and loss of sugar through the kidneys. The involvement of the pancreas in the pathogenesis of diabetes is also generally conceded. Beyond that, however, opinions differ-greatly.
The majority of those who discuss the perversion of metabolism have concluded that the organism has lost its capacity to oxidize carbohydrates. A recent writer 4 has summarized the current belief by the statement that the loss of sugar is not in itself such a serious matter: it means that so much of the food is wasted, but the body can use other materials besides sugar as fuel in the tissues—fats can be so used, and so
THE THEORY OF DIABETES. JAMA. 1930;95(20):1508-1509. doi:10.1001/jama.1930.02720200044015