Diabetes of maximum severity with marked improvement

Abstract

Case on whom the following interesting observations were made is a man, nineteen years of age, with history of diabetes of six weeks' duration accompanied by extreme loss of weight (fifty pounds) and other classical symptoms of diabetes. Admitted to the hospital in condition bordering on coma. Sugar output stationary for five fasting days. Symptoms slightly worse. Alternate fast and protein feedings accompanied disappearance of sugar in three weeks. During this period exhibited excessive nitrogen loss (from 25 to 38 gm. daily). Extreme acidosis and a dextrose: nitrogen ratio for three consecutive days of over 3.65. Subsequently a tolerance of 250 gm. carbohydrate was obtained and four months after onset patient was tolerating 100 gm. carbohydrate on a mixed diet of protein, fat and carbohydrate, aggregating 2,500 to 3,000 calories daily. There was no acetone in the urine and the blood sugar remained normal (below 0.1 per cent.), the percentage when patient was first sugar-free having been .195 per cent., and on admission 0.312 per cent. Just before discharge from hospital developed a peritonsillar abscess. Tolerance for carbohydrate markedly diminished in this period but rapidly returned after infection had subsided. 3. Acute onset of diabetes of great intensity, subsequent rapid development of high food tolerance with normal blood sugar.