268 HUMAN DIABETES 



Protein Destruction. In trying to come to some reason- 

 ably clear appreciation of the general course of metabolism 

 in diabetes we must take prominently in consideration what 

 is known of protein destruction in this abnormal condition. 

 While, as has been noted above, in the pancreatic diabetes of 

 the dog the decomposition of tissue proteins is apparently 

 markedly increased, in severe cases of diabetes mellitus (as 

 shown by the metabolic studies of Falta and Gigon) 64 the 

 destruction of protein does not proceed any more rapidly, 

 and in special cases may be slower, than in normal persons 

 who are examined under the same condition of nutrition. 

 This is all the more remarkable when one considers that the 

 diabetic patient undoubtedly fixes a distinctly smaller 

 amount of material as reserve carbohydrate, and that the 

 sugar excreted with the urine escapes combustion and can- 

 not, therefore, serve to save the protein. The loss is 

 apparently compensated for as far as possible by abundant 

 intake of food protein. That the carbohydrate group in 

 proteins is not of very great importance to the formation 

 of sugar in the body has been shown to be true in case of 

 human diabetes just as in other forms of glycosuria. 65 



Falta 66 based his calculations upon the "excretion coef- 

 ficient, ' ' that is, the ratio of sugar excretion, D, to the sugar 

 value of the transformed material. He obtains this by 

 the formula q= K JP. > in which N is the amount of urinary 



5r\l-KBL 



nitrogen and K the quantity of carbohydrate in the food 

 ingested. This method of calculation is based upon Eub- 

 ner's dictum that for each gram of transformed protein 

 nitrogen a maximum of five grams of sugar are produced 

 (that is to say, the sugar value of 100 grams of protein 

 would be roughly 16 X 5 = 80 grams of dextrose). 



That a combustible material like alcohol may serve to 



84 W. Falta and A. Gigon ( W. His's Clinic, Basel, and C. v. Noorden's Clinic, 



Vienna), Zeitschr. f. klin. Med., 65, 3-4, 1908. 



M Cf. E. Thermann (Helsingfors), Skandin. Arch. f. Physiol., 17, 1, 1905, 

 68 W. Falta, J. H. Whitney (v. Noorden's Clinic), Zeitschr. f. klin. Med., 



05, 5-6, 1908. 



