THE METABOLISM OF THE CARBOHYDRATES 717 



even of burning the glucose which is derived from this foodstuff. By 

 persistence in the starvation, however, the ability of the organism to 

 utilize carbohydrate usually becomes so far restored that enough burns to 

 prevent acidosis. Every case of diabetes can not, therefore, be expected 

 to react in the same way to starvation, the determining condition being 

 the relation between the quantities of glycogen and fat stored in the body 

 at the outset of the fasting period. This relationship depends on the 

 nature of the previous diet. 



To sum up, "fasting will lower acidosis either in health or in diabetes, 

 if it has the effect of stopping a one-sided metabolism and throwing the 

 tissues on a more nearly balanced ratio of fatty acids and glucose" 

 (Woodyatt). A practical point may be noted here namely, that there 

 is likely to be more danger of serious acidosis developing during starva- 

 tion in fat than in lean diabetics. The importance of our appreciation of 

 these facts in the starvation treatment of diabetes will be self-evident. 



Insulin Treatment. As already pointed out, subcutaneous injections 

 of properly prepared extracts of pancreas remove all the cardinal symp- 

 toms of diabetes both in man and laboratory animals and also cause the 

 ketone bodies to disappear from the urine. Life has also been consider- 

 ably prolonged in depancreated dogs by such injections and the subjec- 

 tive symptoms and muscular vigor of diabetic patients markedly 

 improved. 



