Science of food & cookery

In the treatment of diabetes mellitus, proper regulation of the diet is by far the most important consideration. The patient should by all means consult a physician and obtain instructions from him. These few suggestions are simply as an aid in following out these instructions. After the body has once lost its power to care properly for starches and sugars, it never completely regains that power; hence the patient must constantly observe caution in his diet and his habits of life. With proper care, many cases can live fairly comfortably. If the carbohydrates are too much restricted, leaving proteins and fats as the chief constituents of the diet, a condition of acidosis is likely to develop. To prevent this complication, and to build up the patient's tolerance for starches and sugars, is the aim of the dietitian. These patients should avoid worry, fatigue, chilling, indulgence in forbidden foods. In this condition, the body is unable to oxidize, or burn up, the sugars properly. These accumulate in the blood up to a certain point, and afterwards they are excreted in the urine. The presence of a high percentage of sugar in the tissues lowers the resistance to disease. The urine should be examined regularly, and the weight of the patient taken. In beginning treatment of these cases, their tolerance for starch and sugar is tested as follows: The individual is starved until the urine is sugar free; then foods low in carbohydrate, preferably green-vegetables, are given until sugar again appears. This is the point of tolerance, and the diet is arranged to contain carbohydrates within this limit, although the tolerance may often be increased in time. Anything above this amount is poison to the body. It is well, in almost all cases, to plan for at least one "green day" each week. On these days, only the vegetables in the 5% list are served, with salad dressing, and perhaps an egg, black cereal coffee, lemonade, etc. As a sweetening agent, saccharine or sweetina or other similar preparations may be used. As they are products of coal tar, and very concentrated, great care must be taken not to use them too freely, or the digestion will be upset and the appetite spoiled. In some of the milder cases, it is permissible to allow a small amount of carbohydrate food, as bread, potato, oatmeal, etc. ; while in others, it may be best to use breads prepared from gluten flour, soy bean meal, almond meal, etc. The attending physician's advice should be followed in each case. DIABETIC FOOD TABLE In order to determine the per cent of carbohydrate a patient is receiving, the foods are arranged into groups on the basis of the amount of carbohydrate they contain; and if it is desired to substitute one food for another, all that is necessary is to consult the food table. The following table1 (minus a very small assort- 1 "Diabetic Manual," by Joslin. ment of meat and fish included in the original), which has been used by well-known authorities on the subject, is most convenient. FOODS ARRANGED APPROXIMATELY ACCORDING TO CONTENT OF CARBOHYDRATE VEGETABLES (FRESH OR CANNED) per cent- 10 per cent* 15 per cent 20 per cent Lettuce Tomatoes String beans Green peas Potatoes Cucumbers Brussels Pumpkin