SUMMARY
Diabetes Mellitus is a disease in which the body becomes more or less unable to utilize the sugars and starches, consequently there is an abnormal amount of glucose in the urine.
Manufacture of Sugar in the body from other food constituents besides carbohydrates has been proved with regard to proteins, hence the intake of nitrogenous substances must be restricted in diabetes—to a less extent, however, than the sugars and starches.
Acetone Bodies.—Diacetic acid, oxybutyric acid, and acetone develop in diabetes as a result of the breaking down of the fats and the lack of certain neutralizing agents found chiefly in carbohydrate foods.
Acidosis is a form of intoxication due to the retention of these toxic acids in the body. If not combated and overcome, it will result in the diabetic coma which is fatal in so many cases.
Diet Treatments.—The best known treatments are those devised and used by Drs. Allen and Joslin “The Starvation Treatment for Diabetes Mellitus,” and the “High Fat Diet” formulated by Drs. Newburg and Marsh. All cases cannot be handled alike and it is for the physician to determine the treatment calculated to give the best results in the definite case.
Training for Diabetic Nursing.—So much depends upon the administration of the treatment in this pathological condition that in many hospitals special training is being given to the nurses in the care of diabetic patients that they may be able intelligently to carry out the necessary régime, both in the hospital and in private practice.
Symptoms.—She must be able to recognize symptoms both from the findings resulting from the urinalysis and from those manifested otherwise by the patient.
The Record.—She must keep an absolute record of all that occurs during the course of treatment and instantly report any unusual happening.
Urine Tests.—It is advisable to make the tests in the morning; those for sugar and diacetic acid should be made every day or, in some cases, every other day, as directed by the physician, and those for ammonia and albumen about once a week.
Weighing the Patient.—Patient should be weighed each day before breakfast, and the weight of the clothes also carefully recorded separately.
The Bowels must move daily, even if it is necessary to resort to mild laxatives or an enema.
Formulating and Calculating the Dietary.—The menus of the day must be formulated and the chemical composition and nutrient value of the foods calculated. The vegetables belonging to the five per cent. group should be in readiness and the amount to be used weighed after they have been boiled in clean, separate water to reduce their carbohydrate content still further.
Commercial Diabetic Foods.—It may be well to mention the danger of putting faith in the so-called diabetic foods so widely advertised. Some of these foods are of undoubted worth, but it is never safe for the nurse or the patient to judge of the merits of the various diabetic foods without first knowing their chemical composition, and not even then without the definite directions from the physician.
Diabetic Flours.—The diabetic flours used in the recipes included in this text have been approved by some of the leading specialists in diabetes in this country, but the nurse should not include them in the diet for her patient unless they are prescribed by the physician in charge.