The general acceptance of the principle of restriction of the total caloric intake in the dietetic management of diabetes mellitus in contrast to the older principle of overfeeding has increased the importance of an accurate knowledge of the minimum amount of protein that will maintain nitrogenous equilibrium in the diabetic patient. The ultimate effect of long continued gradual loss of body nitrogen is not known, but it seems probable that such a condition is very undesirable. The subject whose nitrogen excretion is constantly higher than his nitrogen ingestion is certainly suffering for want of one of the most important of the tissue repairing elements, and a diet so arranged as to induce this negative balance, even though not lethal, must produce a severe grade of inanition.
The following experiments were undertaken in an effort to determine the minimum protein ingestion that will safely maintain nitrogen balance in patients with diabetes
MARSH PL, NEWBURGH LH, HOLLY LE. THE NITROGEN REQUIREMENT FOR MAINTENANCE IN DIABETES MELLITUS. Arch Intern Med (Chic). 1922;29(1):97–130. doi:10.1001/archinte.1922.00110010102008
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