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July 7, 1956


JAMA. 1956;161(10):1002. doi:10.1001/jama.1956.02970100068021

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To the Editor:—  Recently a patient was admitted to this hospital presenting a new cause for diabetic acidosis that is worth bringing to the attention of the medical profession. The patient was an elderly, fairly stable diabetic, whose condition was quite well controlled with 40 units of protamine zinc insulin daily. He had routinely used the Ames Clinitest tablets to determine the urinary excretion of glucose. In this test a negative reaction is indicated when the urine in which the tablet is dissolved becomes blue. About one month before admission the patient was sold, without a physician's prescription, recommendation, or directions, a new unit to use in testing urine ( Lilly Tes-Tape ). In this test, in contrast to the Clinitest, a blue color indicates a 4+ reaction. Despite the printed directions, the patient interpreted the blue color change as indicating a negative reaction in accordance with his previous experience with the

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