DIABETES MELLITUS 



By B. NAUNYN, Strassburg 



Contents: I. Glycosuria and Diabetes. II. The Various Forms of Dia- 

 betes; Predisposition. III. Mild and Severe Forms of Diabetes; Course, 

 Symptoms and Complications. IV. Theory and Treatment. V. Prac- 

 tical Management. VI. Tables; Diet Lists; Scheme of Food Values; 

 Dietetic Rules for Diabetics. 



I. GLYCOSURIA AND DIABETES 



Glycosuria, Levulosuria, Laetosuria and Pentosuria. Physiologic and Alimentary 

 Glycosuria. Alimentary Glycosuria e saccharo; Non-Diabetic and Diabetic Forms. 

 Spontaneous Non-Diabetic Glycosurias. 



By the term "glycosuria" we mean the appearance in the urine of true 

 grape-sugar (dextrose, glucose), which is dextrorotary. We also speak of 

 " levulosuria," when we mean the excretion of levulose, a fruit sugar which 

 is levorotary. "Laetosuria" means the excretion of milk-sugar (lactose). 

 A sugar containing five atoms of carbon, in its molecular composition known 

 as pentose, may also appear, hence the term " pentosuria." 



Laetosuria may occur during pregnancy and in nurslings, and has nothing 

 in common with diabetes. Pentose may be found in the urine after the inges- 

 tion of cherries, plums and beer, and occasionally also in diabetic urine, but 

 its role in diabetes is quite obscure. 



On the other hand, there are cases of diabetes mellitus in which levu- 

 losuria takes the place of dextrosuria and levulose plays the part in the 

 disease which ordinarily is assumed by dextrose. Such cases are, however, 

 very rare, not more than half a dozen being known. 



Glycosuria (dextrosuria) is the cardinal symptom of diabetes mellitus, 

 but not every case of glycosuria is of a diabetic nature. There is a so-called 

 physiologic glycosuria; in other words, a normal individual may excrete dex- 

 trose in his urine, but the quantity is always extremely small. Disregarding 

 for the present so-called alimentary glycosuria, the percentage of sugar in the 

 urine of healthy individuals is seldom more than 0.05 per cent., although it 

 may reach 0.1 per cent, or even 0.3 per cent. 



It is fortunate that the amount of sugar in normal urine does not react 

 to the ordinary tests. Trommer's (or Fehling's) and also Fischer's test only 

 give a positive reaction in urine when the amount of sugar present is abnor- 



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