( Originally Published 1929 )
DIABETES, though somewhat arrested through the agency of insulin is still a modern plague and bears an intimate relationship to obesity.
The over-consumption of food, particularly starches and sugars, may lead not only to obesity but to diabetes as well. Old people who remain thin are not so predisposed to diabetes as others. McLester, the great authority on nutrition, says, "The penalty of obesity, as Joslin calls it, may ex-plain inherited tendencies, for dietary faults and their penalties are common to families and races."
S. Franklin Adams of the Mayo Clinic declares:
"Of 1000 patients with diabetes whose records were examined, 579 gave a history of occasional or persistent overeating. One hundred and nine said that they ate sweets to excess; sixty-one ate inordinately of meat; only four admitted excessive use of alcohol, and one drank great quantities of grape juice. Joslin believes that it is the excessive amount of total food rather than the amount of carbohydrate which does the harm. He points out that the Japanese as a race consume a large amount of carbohydrate but that, in spite of this, they are not so prone to diabetes as are other races. Furthermore, he shows that when the disease does occur in a Japanese, it is usually mild. A recent report on the average diet of various countries indicates that in the United States consumption of food per capita is greater than it is in any other country. This may account, in part, for the alarming in-crease of diabetes in this country.
"Education should help in preventing diabetes, since obesity seems to be such an important pre-cursor of the disease. When people realize that a gain of weight is as significant a sign as acute pain is a significant symptom, timely steps may be taken to reduce the incidence of diabetes."
In reducing fat people with diabetes it must be remembered that the too rapid withdrawal of carbohydrates often hastens an impending acidosis. If fat is incompletely burned up in the body a condition termed ketosis results. Fatty acids accumulate and act as poisons which tend to bring on coma and may produce death. It has been said that fats burn in the body in the fire of carbohydrates and without such fire, it smokes. The fatty acids that thus form have been likened to the smoke resulting from a poorly adjusted carbureter.
It is very important to determine the amount of sugar in the blood of fat people for in this way the preclinical signs of diabetes can be determined. When sugar appears regularly in the urine the diabetes is fairly well advanced.
The close relationship between diabetes and obesity suggests that some day a substance may be found bearing the same relation to obesity as does insulin to diabetes. Then the treatment of obesity will be greatly simplified.