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October 27, 1917


JAMA. 1917;LXIX(17):1431. doi:10.1001/jama.1917.02590440041013

Although a person in the diabetic condition may be excreting valuable sources of energy, in the form of sugar and ketone substances derived from incompletely burned nutrients, there is no decrease in the quantities of energy transformed in contrast with a comparably healthy individual. There is merely an alteration in the source of the energy; for when carbohydrates can no longer be satisfactorily metabolized, other foodstuffs must be drawn on to supply the body's inevitable needs. Few diabetics can tolerate as much food as their former needs indicate to be essential. The modern starvation treatment of diabetes in the form advised by Allen, which introduces a rigorous regimen of fasting until the diabetic patient becomes free from urinary glucose and from acidosis, meets the energy problem in a direct way. The resulting emaciation apparently decreases the amount of active tissue substance. Calorimetric observations have shown that if a person whose