Ebstein's Diabetic Diet

Early Breakfast

One cup of coffee or tea (black), without milk and sugar. White bread toasted, thirty to fifty grammes; or brown bread well buttered - butter, twenty to thirty grammes. The yolk of an egg, a little fat ham, or some German sausage, if required. If any food be needed between this meal and dinner, let it be a cup of broth, with the yolk of an egg.

Dinner

Broth, with yolk of egg or marrow (the marrow bone is boiled for half an hour, to solidify the marrow). Peptone may be added to the broth. Meat, one hundred and eighty grammes, free from bone, roasted, boiled, or stewed - beef, mutton, pork, veal, fowl, or venison (fat meat preferred). Gravies, to be made with cream or yolk of egg, not flour.- Fish to be served with melted 46 butter. Vegetables prepared with much fat; purees of leguminous plants; salads, dressed with vinegar and oil. The food should be well salted and spiced. After dinner, a cup of coffee or tea.

Supper

One cup of tea or broth. Meat (roasted), or cheese, or an egg, or fish, caviare. Bread, thirty to fifty grammes, with butter, twenty to thirty grammes. Apples, pears, and stone-bearing fruits are allowed in small quantities.

Beverages

Ebstein forbids absolutely the use of beer, limits the use of spirits, and allows about half a bottle of wine daily. If the patient can digest milk well, it is allowed in moderate doses, and cream is especially recommended.

In the following diet, recommended by During, it will be noticed that, contrary to some other symptoms, fat is excluded as much as possible.

During claims that prolonged boiling so alters the carbohydrates as to prevent them from being eliminated in the urine as sugar, and he gives his patients a diet consisting largely of rice and fruits which have been soaked in water and boiled for several hours. The details of his regimen are as follows:

Diiring's Diet For Diabetes

Early Breakfast

Milk, with a little coffee but no sugar (lime water, to prevent milk from souring in the stomach); stale white bread ad libitum, or, if it is not well borne, oatmeal, barley, or rice gruel made with water, a little salt, but no butter.

Second Breakfast

White bread, stale and well baked; an egg, lightly boiled; rice or oatmeal gruel, with or without milk, a breakfast-cupful; or half a glass of good red wine (with water in certain cases).

Dinner (Taken Between Two And Three O'Clock)

Soup, with rice, barley, or oatmeal; meat, roasted, two hundred and fifty grammes (game, ham, and smoked meats, as free from fat as possible, are permissible); no condiments, no fatty sauces; compote of dried apples, plums, cherries; dried peas or white beans in some cases; green vegetables, asparagus, French beans, carrots, cauliflower, cabbage (boiled in water with salt, not with fat or stock); dessert of a little raw fruit, apples, cherries, and one small glass of red wine diluted with water.

Supper (About 7 P. M.)

Gruel of barley, oatmeal, or rice, with salt (but no butter), and strained, which in some cases may be made with milk. Ice or iced water, to relieve thirst between meals.

Naunyn's Diet

Naunyn divides diabetes somewhat arbitrarily into three varieties - mild, severe, and intermediate. For the most severe cases he gives a diet of fat meat; the intermediate cases are treated at first on an exclusive diet of fat meat, then, as the sugar disappears from the urine, he adds eggs, milk, and a small allowance of bread to the diet. In mild forms he directs the use of a few green vegetables, salads, fruits, and other articles, unless the sugar reappears in the urine, when the patient is to be put back upon a rigid nitrogenous diet. He claims that in mild cases of diabetes patients do not require more than from sixteen to eighteen ounces of meat a day, with two or three ounces of bread and six or seven ounces of vegetables.

Hygienic Treatment

Patients should guard themselves as far as possible from catching cold, and when possible should live in a moderately warm and temperate climate. If their surroundings permit, it is important to take moderate exercise and to remain in the open air. Flannels should be worn next to the skin in winter, and the body should always be kept warm, for there is less heat-producing power than normally. The skin should be maintained in good condition by frequent warm baths or hot and cold douching, dry rubbing, or massage. All muscular and nervous or mental fatigue is to be avoided. It is claimed by Kulz that muscular exercise tends to increase the consumption of sugar or glycogen in diabetes and to lessen its elimination by the kidneys. This applies to the more robust cases only, for in the severe type of the disease with great emaciation much exercise becomes harmful or impossible.