100 DIABETES MELLITUS 



a diabetic; some fat meats and fat fish contain 20 per cent, of fat or more (see 

 diet lists). 



As a working principle, let iis say that a diabetic should not eat more than 

 600 grams of meat {weighed after coohing), for most patients lose their appe- 

 tite if they eat more ; diabetics who are under close medical supervision may 

 be permitted more, but it is usually of no benefit. 



Eggs are very useful. On account of the large amount of fat in the yolk, 

 each egg has a value of 75 calories. If we allow more than two eggs, we 

 should subtract 50 grams for each egg from the amount of meat allowed. 



Fat foods are of the greatest value, for fat, as a rule, does not increase 

 glycosuria and has the enormous nutritive value of 9 calories, while starch 

 and albumin have only 4. In good sausage (poor sausage often contains 

 flour and but little fat !) there is 30 per cent, to 40 per cent, of fat; in good 

 cheese from 20 per cent, to 30 per cent.; poor cheese contains but little fat. 

 Butter contains 85 per cent, of fat; lard (butter or fat melted), bone marrow, 

 and vegetable oils almost 100 per cent. Bacon varies greatly in regard to the 

 amount of fat it contains; it averages about 92 per cent. An enormous calory 

 value may be obtained in the following foods: 100 grams of Holland cheese 

 (30 per cent, fat) gives 270 calories, without including the albumin; 100 

 grams of good butter, 720 calories. Fat and butter may be mixed with vege- 

 tables so as to make them contain 10 per cent., even 15 per cent, of fat; bacon 

 and oil in salad, up to 20 per cent, to 40 per cent. 



Cheese may be pulverized and added to soups and sauces, and also may 

 be .made into cheese cakes, cheese puddings, etc. 



Cream contains 25 per cent, of fat, and is, therefore, very valuable; the 

 slight amount of sugar it contains (3 per cent, milk-sugar) need scarcely be 

 regarded. Some cream contains even more fat than this (up to 40 per 

 cent). If it is dairied in a very cleanly manner, it is at first very grate- 

 ful to the taste, but after prolonged administration patients often do not 

 like it. 



Milk is in general use, and, even in the most severe cases, of great value. 

 But it must not be supposed that the milk-sugar is "harmless" to the dia- 

 betic, for it is not much less so than dextrose and cane sugar; but milk con- 

 tains very little sugar, only about 3 per cent. Its carbohydrate contents must 

 be reckoned, but it also contains 4 per cent, to 5 per cent, of fat. There are 

 several manufactured preparations of milk which contain a larger amount of 

 fat, and in which the sugar is decreased; there are even artificial milks free 

 from sugar — but my patients soon become tired of these preparations. 



Other fluids are to be estimated according to their carbohydrate value; 

 among wines only the southern wines and champagne contain more than 3 per 

 cent.; these contain 12 per cent. In beer the carbohydrate value is rarely 

 under 6 per cent. Beer is more harmful than this percentage would lead us 

 to suppose, as it contains the greater part of its carbohydrates as maltose; 

 this at once decomposes in the intestines into dextrose, and, for this reason, 

 the diabetic ingests in beer the most dangerous, most readily absorbable forto 

 of carbohydrate food. 



Among alcoholic liquors only rum, cognac, whiskey, etc., are to be con- 



