The type of treatment and the degree of control of the diabetic state most desirable for optimal management of youthful patients with severe diabetes has long been the subject of much debate. That the duration of diabetes is an important factor in determining the incidence and severity of degenerative vascular lesions among diabetic patients is a well accepted fact. However, our experience has led us to believe that continuous, aggressive treatment directed toward maintaining physiologic conditions, including normal levels of blood sugar, is of the greatest importance in reducing the incidence and severity of degenerative complications.
Several recent articles have advocated a regimen of management which by our standards falls far short of being adequate therapy.1 These plans of treatment, in general, allow a more or less free selection of food and disregard of hyperglycemia and glycosuria as long as frank symptoms and acidosis are absent. Many factors must
James Lee Wilson, Howard F. Root, Alexander Marble. CONTROLLED VERSUS FREE DIET MANAGEMENT OF DIABETES. JAMA. 1951;147(16):1526–1529. doi:10.1001/jama.1951.03670330018006