t C1PF1. The actual articles of food
representing the carbohydrate in the diet for the first
day are given under the heading of carbohydrate, for
convenience described C1, 2, 3, etc. The articles
referred to under protein and fat are under that
heading, which for the same reason is described as PF1,
2, 3, etc. Certain cases of diabetes can proceed
steadily day by day from C1PF1 to C12PF12, without
showing sugar. If sugar does appear in the urine, drop
back two days in the carbohydrate group, wait till sugar
free, then advance in the protein and fat group until
sufficient calories are obtained. Thus, if sugar shows
on C7PF7 the diet prescribed would be that included in
C5PF7 and thereafter progression could be made in the PF
group until twenty-five to thirty calories per kilogram
body weight were furnished the patient.

Occasionally the patient becomes sugar free on Test Diet
2, 3, or 4. It is then unnecessary to begin with
Maintenance Diet C1PF1, but instead with a maintenance
diet which contains a value for carbohydrate similar to
that of the test diet upon which the patient became
sugar free.

If the protein and fat are too high for the individual
on a given day it is easy to advance the carbohydrate
and decrease to an earlier day on protein and fat.

The plan is arbitrary and the majority of cases will
demand some modification. It is arranged to enable
patient or nurse to see in advance the general plan of
treatment.

(Courtesy of Dr. Joslin and Thomas Groom & Co., Boston.)

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 gr