October 1936


Author Affiliations


From the George F. Baker Clinic, Elliott P. Joslin, M.D., Medical Director, the New England Deaconess Hospital.

Arch Intern Med (Chic). 1936;58(4):577-588. doi:10.1001/archinte.1936.00170140002001

Exercise along with diet and insulin is an accepted part of the present day treatment of diabetes.1 Its ability to increase the blood sugar-lowering effect of insulin is well recognized.2 Under certain conditions, however, exercise may cause a marked increase in the sugar content of the blood of a diabetic subject. This occurs particularly if the diabetic condition is severe and if several hours have elapsed since insulin and food were given. Such a finding is in keeping with the clinical observation of the preinsulin days that, whereas patients with mild diabetes profited by exercise, those with severe diabetes were often unable to tolerate it.3

In this connection the studies of Grote,4 Bürger and Kramer5 and Richardson6 are of especial interest. Richardson found that the effect of exercise on the diabetic patient depended on the initial level of the

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