Medicine: Diabetes

According to Harvard’s Dr. Elliott Proctor Joslin, at least 2,500,000 people in the U.S. have or will have diabetes before they die. According to Toronto’s Dr. Charles Herbert Best, co-discoverer of insulin, most of these people may be able to stall off the disease or smother it in the early stages if they take proper measures. Last fortnight both men, greatest diabetes authorities in the world, met in the New York Academy of Medicine, told doctors how to hold down the rising diabetes rate.* Significant facts:

> Diabetes is a disease of combustion: carbohydrates are rushed through the body, poured out in the urine, without being properly digested or warehoused in the liver. Four groups of glands may be involved in this condition: the tiny islands of Langerhans in the pancreas, which secrete insulin, a hormone essential for carbohydrate digestion; the adrenals, thyroid and anterior pituitary, which seem to act antagonistically to the islets. Exactly how they work, or what causes them to go berserk, no one knows.

> The disease is hereditary. Plain overeating does not bring it on unless the glands are frail to begin with. Most people who develop diabetes are overweight, but when the disease begins, they lose weight, develop a voracious appetite, a quenchless thirst. In the advanced stages, the blood is heavily laden with sugar, pus germs flourish, fat metabolism goes awry, and a victim’s body is flooded with poisonous waste products.

> There is no cure for diabetes, but it can be throttled by injections of insulin. “Straight”‘ insulin usually is taken three times a day, before each meal. Protamine zinc insulin, a slow-acting variant, is injected in a larger dose only once a day. (Scientists are working hard on an insulin preparation that can be taken by mouth, but so far have been unsuccessful.) Some doctors prefer to treat mild forms of the disease by restricting carbohydrates.

> Most doctors advise two diabetics not to marry. Pregnancy is hazardous for diabetic women, and their children often develop the disease. But Dr. Reginald Fitz, a colleague of Dr. Joslin, urges potential diabetes victims to lead a normal life, marry whom they please. The disease may not appear till middle life, and once it begins, it can be controlled with insulin.

> To prevent the disease in children of diabetic families, Dr. Best last week suggested that they be given: 1) diets low in carbohydrates and proteins; 2) prophylactic injections of insulin; 3) large amounts of fat, to rest the pancreatic islets, provide energy.

* The U.S. diabetes rate had doubled from 12.7 deaths per 100,000 in 1906 to 25.6 in 1939. Reasons: 1) more people are examined for life-insurance policies now, so more cases come to light; 2) the population is growing older, and diabetes is a disease of middle life.