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January 27, 1923


JAMA. 1923;80(4):256-257. doi:10.1001/jama.1923.02640310036017

The considerations of both the theory and the therapy of diabetes no longer deal solely or even preeminently with the fate of ingested carbohydrate so far as it is expressed by glycosuria. Something more than the metabolism of sugars is involved in the pathology of this disease. Second only to the occurrence of sugar in the urine or an abnormally high sugar content in the blood are the evidences of disturbance in the chemical transformation of other fragments of the foodstuffs, expressed in so-called ketosis. The elimination of acetone, acetoacetic acid or betahydroxybutyric acid is always indicative of a metabolic abnormality that of late has usually been associated with disturbances in the breakdown of fatty acids and their physiologic derivatives. It has long been known that ketosis, as expressed by ketonuria, tends to occur when sugar is not burned suitably or sufficiently in the organism. To combat ketosis, it has