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March 10, 1923


JAMA. 1923;80(10):697-698. doi:10.1001/jama.1923.02640370033013

It is an established fact that many diabetic patients exhibit not only a hyperglycemia but also an undue content of fat in the circulating blood—a lipemia. The latter has not received the amount of attention that has been given the abnormal level of the blood sugar, presumably because the latter usually discloses itself by a coincident glycosuria, and the fat estimations require a well trained analyst. If diabetes is to be interpreted as a derangement not only of the carbohydrate metabolism but also, in the severer cases, of the behavior of fat and protein in the chemical transformations of the organism, treatment may become a problem of adjusting the diet to the tolerance of the organism for each of the great classes of foodstuffs. For this reason the advocacy of a low protein, low carbohydrate, high fat diet by Newburgh and Marsh1 has provoked considerable debate.

Ketosis is commonly