( Originally Published 1936 )
DIET ALONE IS SUFFICIENT FOR MOST DIABETES CASES
Most patients with diabetes can be treated quite satisfactorily with diet alone. Exactly what that diet should be can only be decided by a physician. This is not said just to boost the fortunes of the medical profession, a plot of which we are often accused when we make such a recommendation, but because it is true and sensible.
Each diabetic varies from every other one somewhat, the main variation being in the amount of starch he can consume. So that it will not do for Mr. Robinson to go on the diet the doctor prescribed for his neighbor, Mrs. Stoopnagle. He may be doing himself an injustice: He may be able to eat a good deal more than she can. Also he may be doing himself harm: Because he may be unable to eat nearly as much as she does.
These situations arise, as I know from my correspondence, and more today than ever, because people use the word "diabetes" in polite society now without any feeling of embarrassment. There was a time when it was taboo, either in ordinary conversation or in news-papers. That taboo has very sensibly been given up, as has the idea that diabetes is some sort of a dark disgrace, a secret to be hidden in the recesses of the mind. It is no more a disgrace than baldness or the necessity of wearing glasses, and people talk about it and so find out what the doctor is prescribing for their fellow victims. That one doctor is advising a certain course for a certain case, which is entirely different from what your doctor is prescribing for you is perfectly natural, and in accord with the character of the disease.
An idea that is frequently necessary to instill into a diabetic's consciousness is that adherence to diet will improve his condition. Diabetes is, in most instances, a painless disease, and pain is the symptom which causes most people to take care of themselves. If the diabetic will keep within his glucose tolerance, he will find that his tolerance will increase, and-he can eat more and hence be more comfortable. And that is another reason for periodical visits to the doctorŚto find out whether tolerance has increased or not.
Besides that, the continuation of the condition of excess sugar in the blood is liable to bring on the complications of diabetes, and as these include cataract, causing partial blindness, and gangrene of the toes, abscesses in the skin, and coma, it seems the part of common sense to stick to the dietary restrictions laid down.
What those restrictions are, cannot be put down as a blanket rule. When the tolerance is determined, the patient can, with the aid of manuals written for him, decide upon a set of menus, which in all cases can be sufficiently varied to meet any reasonable desires. There are many of these manuals, such as those of Joslin, John, Wilder, McHenry and Cooper, and the useful "Diabetic's Own Cook Book" of Mrs. Lyons. Most book stores keep a good stock of them.
A few dietary rules, however, apply to all diabetics. They should not eat substances which are quiškly converted into glucose, and hence overwhelm the system. Such substances are the simple sugars. Table sugar should always be avoided, as should candy and sweet desserts. Most fruits contain too much sugar for the ordinary case - especially apples, oranges and grapes. Although in some instances a small amount of orange is permissible.