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Relation of Glycosuria to the Ingestion of Fat and Alcohol

diabetes and noted

RELATION OF GLYCOSURIA TO THE INGESTION OF FAT AND ALCOHOL.

a. Fat.—Up to the present time the influence of carbohydrates and albumin upon the excretion of sugar has alone entered into consid eration. But it is of the utmost importance to know how fat acts in this respect. Fat is an invaluable nutrient material for the diabetic— it is his sheet-anchor. This is owing, in the first place, to its high nutritive value, and secondly to the fact that its ingestion never in creases the glycosuria. This observation has been often made in cases of diabetes by Cantani, Ebstein, von Mering, F. Hirschfeld, Weintraud, and others, and has also been noted in experimental diabetes following extirpation of the pancreas and in phloridziu poisoning.

b. Alcohol.—The use of alcohol is recommended in almost all treatises on diabetes. But caution in this respect is necessary, and one should never exceed the use of moderate amounts, observing care fully the influence of the alcohol upon the glycosuria and upon the general condition of the patient. Increase of glycosuria after the

ingestion of alcohol has been noted only by some of the older writers, and their conclusions are based upon inexact observations. Kiilz has made a study of this point, and has never seen any bad results follow the drinking by diabetics of one bottle daily of some strong dry wine; in one carefully studied ease of this sort, the glycosuria even fell. I myself have often seen either no effect or a slight im provement, but have never observed any appreciable increase in the glycosuria when the use of alcohol was kept within moderate limits. For a further discussion of the effects of alcohol the reader is referred to the section on Treatment.