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Benign Cases - Complications of Diabetes

glycosuria, mild and life

BENIGN CASES - COMPLICATIONS OF DIABETES.

The mild forms of diabetes compatible with a long life are by far the most frequent. They belong almost exclusively to the middle and later periods of life, and affect by preference, though by no means invariably, corpulent individuals and those suffering from the gouty diathesis. The manner in which obesity and gout stamp their char acteristic imprint upon diabetes has been described in previous sec tions, to which the reader is referred (see pp. 66, 68, and 71).

The benign cases have certain peculiarities in common. The time of their onset is seldom known. The glycosuria is discovered acci dentally or after an examination of the urine suggested by certain complications. Pruritus, furunculosis, disturbances of accommoda tion, neuralgia, and impotence are the complications most commonly encountered. The glycosuria yields at once to a withdrawal of the carbohydrates from the diet, and usually there is even a certain toler ance of moderate amounts of starch. This tolerance is subject to considerable variations, and often remains at a high figure for weeks and months. A few weeks of strict dieting, intellectual rest, a so journ in a pleasant locality, and the like, work a marked change for the better, while imprudence in eating, overwork of body and mind, etc., lead to a deterioration in the general condition, insomnia, lassi

tude, and an increase in the glycosuria. After long years of varying health the tendency to excretion of sugar diminishes as a rule and may even wholly disappear. Not infrequently albuminuria appears, and finally the well-known symptoms of contracted kidney take the place of those of diabetes.

The complications and secondary affections, appearing frequently at the beginning of the disease in mild form, are in its later stages little to be feared with the exception of those conditions which are dependent upon arteriosclerosis, especially peripheral gangrene, car diac asthma, and apoplexy.

These forms of the disease may, through neglect and gross dietetic abuse, lead to a loss of strength and an unfavorable termination de spite their benign tendency. Danger threatens especially on the side of the heart; diabetic intoxication with coma may ensue, but it is rare. The same is true of the transformation into the rapidly progressive malignant varieties.