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June 14, 1958


Author Affiliations

St. Louis

From the Metabolism Division, Department of Medicine, Washington University School of Medicine and Barnes Hospital.

JAMA. 1958;167(7):859-862. doi:10.1001/jama.1958.72990240021010

Although dietary measures for the treatment of diabetes mellitus have been used for over a century and a half, uncertainty exists in the minds of many physicians today concerning the therapeutic role of diet in diabetes. Professional uncertainty is often combined with an inability to initiate and to supervise properly a suitable diet. Experience and judgment are needed to promote the dietary habits conducive to control of diabetes within the framework of the patient's everyday life.

Prior to the availability of insulin, diabetic diets were generally high in fat and protein but restricted in carbohydrate and total calories. In more severe cases, periods of complete fasting were used to prolong a precarious existence. The early insulin era was characterized by a gradual liberalization of diet restrictions, with increasing carbohydrate intakes. Normal caloric allowances replaced the semistarvation diet of former times. At present, many physicians employ diets for diabetics that differ