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To the Editor:—
In the article in The Journal (176:854 [June 10] 1961), entitled, "The Child with Diabetes Mellitus," Dr. R. L. Jackson thoroughly discusses diabetic acidosis in children. However, he fails to discuss protein metabolism in this condition.The genesis of diabetic acidosis results in the rapid depletion of the glycogen stores of the liver and muscle. As a consequence, tissue protein is rapidly broken down in an apparently hopeless attempt to furnish antiketogenic fuel, and urinary nitrogen reaches enormous figures.Protein cannot be stored dry, for it retains with it 3 or more parts of water. Thus, the loss of 1 lb. of body protein will result in a concomitant loss of 3 lb. of water and a weight loss of 4 lb. The loss of this water in no way affects the water balance of the body.The author states, "Inasmuch as the patient has a
Wishnofsky M. The Child with Diabetes Mellitus. JAMA. 1962;179(5):386. doi:10.1001/jama.1962.03050050076019
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