If the case is a mild one, this may be sufficient to free the urine from sugar, but the diet is given primarily to enable the physician to find out by means of urinalysis just how great is the functional impairment.

In some cases, which are mild in character, the urine is made free of both sugar and acetone without further dietetic measures. However, when a severe diabetes is manifested and a high percentage of glucose and in some cases acetone bodies are found in the urine a more rigid treatment will be found necessary.

Preliminary Diet.—Many physicians find it advisable, as has already been stated, to cut down the food allowance before stopping it entirely. In the Michael Reese Hospital this is done by first giving a practically fat-free diet, followed by one or two days in which three or four eggs, 250 to 300 grams (8 or 10 ounces) of 5% vegetables are given, after which it is found safe to institute the starvation treatment.

Sample Menus.—The following menus are given to illustrate the dietetic treatment which it is deemed advisable to institute in cases where the starvation treatment cannot be given at once:

After the test diet of forty-eight hours, the following régime is instituted:

Third Day

Key:
AProtein Gm.
BFat Gm.
CCarbohydrate Gm.
DCalories
ABCD
Breakfast:
½ grapefruit 5.0020
1 egg5.34.10 59
1 slice bread30 gm.2.6.3015.0073
Tea or coffee
Total for meal 7.94.4020.00152
Dinner:
Broth180 c.c.3.7.17.3418
Chicken (breast)90 gm.18.22.10 92
Spinach100 gm.2.0 3.0020
Potato (1 medium)90 gm.1.8.0915.6070
Lemon jelly90 gm.4.2 2.7027
Total for meal29.92.3021.60227
Supper:
Lamb chop50 gm.9.314.10 126
Asparagus100 gm.1.5 3.0018
Bread20 gm.1.6.2010.0048
Tea or coffee
Total for meal12.414.3013.00192
Total for day40.221.0054.60571

Fourth Day