Stomach Complications

After thus having touched on the fundamental principles of diet in diabetes mellitus, I would like to add a few words about it in those cases of diabetes which are complicated with affections of the stomach. Two groups of functional disturbances of the stomach are found most frequently in diabetes, hyperchlorhydria and achylia.

If hyperchlorhydria complicates diabetes the treatment is easy, as the diet is the same in both (principally fat and albumin). Even the medicinal treatment of hyperchlorhydria (alkalies, sedatives) influences also the diabetes favorably.

It is different in achylia gastrica complicating diabetes. As is well known, meat is not well borne in achylia gastrica, whereas a vegetarian diet (plenty of carbohydrate) usually agrees best with these patients. We are thus confronted by a dilemma. The diabetes requires a preponderance of animal, the achylia a preponderance of vegetable food. We must find a way to select the food so that while it is rich in protein and fat it still contains little meat.

In these cases a trial of the von Noorden oatmeal cure would be appropriate.

In numerous cases of such a combination of achylia and diabetes I have used the following diet list with advantage:

It is understood, of course, that this diet must be somewhat varied. I often use pea soups, although they contain a considerable amount of carbohydrates.

After the patient has lived on this diet for about one week, it is better to add for dinner some meat (chicken, calf's brain, sweetbread or chopped meat).

The main point in the treatment of these patients lies in the fact that they have to take more carbohydrates than usual and that they do better under this mode of treatment.

The urine naturally must also serve here as an indicator to determine whether or not the amount of carbohydrate is harmful.

Another class of digestive disturbances occurring in diabetics is that of catarrh of the stomach or bowel. We usually have to deal with acute affections of the stomach and bowel, or of both organs, produced by overfeeding with too greasy or too heavy food.

In these cases the dietetic treatment must be directed especially against the acute affections and we must leave the diabetes out of consideration.

A bland meager diet is the main thing (beef tea, gruels, milk, possibly raw eggs beaten up in milk or beef tea). When the acute stage of the digestive disturbances is passed we can slowly return to the antidiabetic diet.