PROPHYLACTIC TREATMENT - COMPLICATIONS OF DIABETES.
We can scarcely say anything of the prophylaxis of diabetes mel litus beyond laying down the most ordinary and every-day rules of a hygienic and health-preserving mode of life. Practically it is only under certain special circumstances that we can have to do with any prophylactic measures. In the first place we may consider those in dividuals in whose family there is a history of many members being attacked by diabetes in early life. Possibly in such cases the early and permanent withholding of carbohydrates, especially of sugar, from the diet may prevent the occurrence of the disease. But beyond the qualification "possibly" we cannot go.
Then again there may be a question of prophylaxis in the case of those individuals, especially men, who are driven into luxurious liv ing by their social position, who in the prime of life grow corpulent quite rapidly, and in whose family there is a history of many cases of diabetes. Very frequently these three factors are united. have already given. expression to the conjecture that there is a certain disturbance of carbohydrate change in many cases of obesity, even without an accompanying glycosuria. As it is very probable that once an anomaly in respect to sugar conversion has arisen, the in gestion of carbohydrates will make it worse and their withdrawal will improve it (see below), it is advisable to recommend in these cases also a gradual diminution in the amount of carbohydrates in the diet. An
ever-consumption of carbohydrates will be sufficiently prevented by the prohibition of sugar, farinaceous foods (such as the cereals, pud dings, maccaroni, nudels, and the like), pastry, preserves, and sweet champagne, and by the restriction of the daily amount of beer taken (from one to three glasses). Through these dietetic regulations, es pecially when supplemented by muscular exercise, the further prog ress of the obesity is arrested or at least retarded; sometimes there is even a gradual loss in weight. I would, however, warn the reader most earnestly against subjecting to an energetic reduction treatment all individuals whose own past or whose family history raises the suspicion of a developing diabetic diathesis. The patients are often thereby weakened and permanently invalided, and the disappearing obesity frequently enough gives place to diabetes.