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April 3, 1954


JAMA. 1954;154(14):1182. doi:10.1001/jama.1954.02940480034013

The thesis that sudden trauma can cause diabetes has steadily lost support with the expanding knowledge of the nature of diabetes; however, evidence has accumulated to show that trauma indirectly can activate, or accelerate, the appearance of latent diabetes in the hereditarily predisposed, particularly if accompanied by infection, reduced muscular exercise, overweight, overeating, disease of the pituitary, thyroid, adrenal, or liver, and pregnancy.

To prove that trauma is the cause of diabetes in any individual case the evidence must show that: (a) the disease did not exist before the trauma; (b) the trauma was severe, injuring the pancreas; (c) the symptoms and signs of the disease developed within a reasonable period after the trauma, the etiological importance of the trauma waning with the prolongation of the interval; and (d) the symptoms and signs of diabetes were not transitory but permanent and if permanent that the evidence was such that as

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