Jan. 29.
Carbohydrate, 20 grams.
Protein, 45 grams.
Fat, 200 grams. No glycosuria.
Jan. 31.
Carbohydrate, 30 grams.
Protein, 45 grams.
Fat, 200 grams. No glycosuria.
At entrance his ammonia was 1.7 grams per day; after the starvation days it ran from 0.9 grams to 0.3 grams per day. The acetone was a little stronger than at entrance; the diacetic absent except on three days.
On Feb. 5 he was still sugar-free having been so since his starvation days two weeks previously, and weighed 127 pounds, a gain of seven pounds since entrance. At no time did he receive over 2150 calories.
This was a very satisfactory case; no doubt the carbohydrate could have been raised to 50 or 60 grams, but he was doing so well that we felt it unwise to go any further.
Diabetes in children is likely to be a good deal more severe than it is in adults. Still, in the few cases that have been treated with the starvation treatment at the Children's Hospital, the results have been very satisfactory, as far as rendering the patient sugar-free is concerned. Most diabetic children, however, are thin and frail, and they have no extra weight to lose, so it does not seem so desirable to bring about any very great loss of weight, which is quite an essential part of the treatment for most adults. The few children that have been treated have borne starvation remarkably well. It is too early, and we have seen too few children treated by this method, to say what influence it may have on the course of the disease, but it can certainly be said that it is very efficacious in rendering them sugar-free.
Case 8. M. M., female, 12 years, entered the Children's Hospital April 1, 1915. She had probably had diabetes for about 6 months, and had been on a general diet at home. (See charts on pp. 31-36.)
On the ordinary diet of the ward she showed 8.7% sugar, no acetone or diacetic acid. Weight, 52-1/4 pounds,—a very thin, frail girl. She was starved two days, taking about 1-1/2 oz. of whiskey in black coffee each day.