Management of diabetes : treatment by dietary regulation and the use of insulin a manual for physicians and nurses based on the course of instruction given at the Presbyterian Hospital, New York / by George A. Harrop, Jr.

  • Harrop, George A. (George Argale), 1890-1945.
Date:
1924
Catalogue details

Licence: In copyright

Credit: Management of diabetes : treatment by dietary regulation and the use of insulin a manual for physicians and nurses based on the course of instruction given at the Presbyterian Hospital, New York / by George A. Harrop, Jr. Source: Wellcome Collection.

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    done by the cautious addition of a unit or two of insulin at those times of day when the level is much higher than it should be. The practical management of cases of diabetes may be best illustrated by a consideration of several representative cases. The food and urine chart of Case I shows the method used in an adult patient with diabetes of moderate severity. Case I. The patient was a man of thirty-five, weighing 70 kg., (154 lbs.) and he was 179 cm. (71.5 in.) in height. According to the rule given at the end of the last chapter, he should have weighed no + [(71.5 — 60) X 5.5] = 173 lbs. He was, therefore, 19 lbs. under ideal weight. Before onset of his disease eighteen months ago, he weighed 196 lbs.; so his weight on admission indicates a loss of 42 lbs. in eighteen months. He was given a diet consisting of 1 gm. of protein per kg. body weight, an equal amount of carbohydrate, and sufficient fat to make up 23 calories per kg. body weight. On the third day of this preliminary diet he ex¬ creted 61.6 gms. of glucose. Since 1 unit of insulin has not been found to cause the utilization of over 4 gms. of carbohydrate, the initial dosage of 9 units which he was given was quite within the margin of safety. In fact it was only with 17 units on the seventh day that his urine became sugar-free. For unknown reasons patients being treated with insulin may excrete small amounts of sugar