84 KOLLIN T. WOODYATT 



fact, carbohydrate, protein and fat are not the actual foodstuffs with which 

 we are dealing when it comes to the final metabolic processes. In the man- 

 agement of the diabetic food supply it is simpler to think in terms of the 

 chemical metabolism. Falta devised a formula in which he added the 

 carbohydrate of the diet to the urinary nitrogen times 2.8, or (following 

 Lusk's suggestion, 3.65) to show the total quantity of glucose entering the 

 body on a given diet from carbohydrate and protein. Then subtracting 

 from this the quantity of glucose excreted in the urine, he obtained a 

 figure for the quantity of glucose actually utilized. The quantity excreted 

 divided by the total quantity supplied gives a fraction which, multiplied 

 by 100, -was Falta's diabetic quotient 100 meaning a complete diabetes. 

 The latter has a limited value. The absolute quantity utilized is of more 

 interest. The principle is important and can be further developed as 

 already shown. 



4. Discussion of Hypothetical Diets. In this connection consider four 

 hypothetical diets, I, II, III, and IV, and analyze them from the view- 

 point of their possible effects on a certain diabetic patient weighing 50 kg. 

 Let it be assumed that each diet is completely digested, absorbed and catab- 

 olized, and that each is sufficient to cover the maintenance requirements of 

 the body, so that in discussing them one may waive endogenous factors. 



TABLE II 



Looking at these diets simply as so many different combinations of 

 carbohydrate, protein and fat, and going no further, they appear to be quite 

 dissimilar. Diet No. I is a fair example of the old-fashioned "rigid" 

 diet with almost no carbohydrate and the protein at 3 grams per kg. of body, 

 weight. Diet No. II is a high carbohydrate, low protein diet. It is 

 the kind of a combination that might possibly be given in a "rice cure," an 

 "oatmeal cure," or a "cereal cure." This diet would permit the patient to 

 enjoy 385 grams, almost a pint, of boiled rice or other cereal ; or, he could 

 have 154 grams of white bread. Diet III appears to be intermediate be- 

 tween I and II in all respects. It contains less carbohydrate than II but 

 more than I, and the fat is less than in II and more than in I. It 

 contains nothing that is not contained in higher quantities by one of the 

 other diets. Diet No. IV resembles II but might be suspected of having a 

 higher caloric value because of its fat. Diets I, II, and III each represent 

 1400 calories, while IV shows about 1700 calories. If in each diet we 

 estimate G, we find that I and II are alike in that each is capable of intro- 

 ducing about 105 grams of glucose into the metabolism. The patient capa- 

 ble of utilizing 105 to 110 grams of glucose per day might tolerate either 



