A Monthly Publication of Medical Sciences
Diabetes mellitus is characterized by the continued presence of sugar in the urine, an increased secretion of urine, great thirst, voracious appetite, loss of weight, weakness, a dry and itching skin, boils, and often, in the late stages, gangrene of the extremities, cataract and a tendency to coma. The urine is pale in color, of sweet odor, high specific gravity and contains from a trace to a large per cent. of sugar, sometimes also acetone.
The onset of Diabetes mellitus usually is gradual, though, after some severe shock, occasionally it is sudden. While all ages, from birth, may be attacked, it is commonest between the ages of 30 and 60. In youth it is likely to be rapid and severe. Males are slightly more susceptible than females. It is likewise commonest in stout persons. The Hebrew race is particularly susceptible. Heredity is said to play some part in the development of the disease.
The dangerous factor is not so much the presence of sugar in the urine, as the inability of the body to appropriate the carbohydrates of the diet to advantage, resulting in faulty nutrition and a gradual undermining of the health.
Diabetes is increasing in prevalence, especially in the young, with whom it is a serious disease and especially likely to be fatal. The boils and the skin eruptions of young adults not infrequently are the effects of a diabetic condition and call for a careful examination and urine analysis, as early treatment is important.
Among the theories as to the cause of diabetes are that there is a disturbed function of the pancreas, as induced disease or injury of this organ causes sugar to appear in the urine; that during digestion the liver fails to change the absorbed sugar into glycogen and that the sugar remains in the blood and is then eliminated by the kidneys, or that the glycogen is changed back to sugar too rapidly and the same condition arises.
The overconsumption of carbohydrates may be a cause; but present-day investigators are suggesting that the overingestion of proteins is really more potent as a cause of the disease and that the overconsumption of meat in particular is responsible for this dangerous complaint.
Treatment must begin early if recovery is to be expected. When the disease has so advanced that the organs have degenerated, little hope of full recovery can be given by any method of treatment, but the method herein advocated should be tried.
To get rid of the excess of sugar in the blood, and incidentally to make the urine sugar-free, abstinence from food is essential. This should continue until there is no trace of sugar in the urine and for one day thereafter. In most cases it is better to take orange juice than the absolute fast, as the danger of acidosis developing on a strict fast is greatly reduced on the orange diet.
Exercise is recommended in this disease because by it the sugar in the body is thus burned up more completely than when the body is at rest. Daily long walks coupled with deep breathing are especially valuable. Calisthenics in which every muscle is used should be practiced daily according to the strength of the patient.
Although it is not a cure, insulin, a preparation of a substance obtained from the pancreas discovered by a Canadian physician, is used largely by daily hypodermic injections, in the treatment of some forms of diabetes, with the idea of keeping the sugar content of the blood down to normal. It is salutary in some cases, although temporary in its effect. Many physicians prefer pancreatic substance, dried and in capsule or tablet form, to be taken by the mouth.