RESPONSE TO INSULIN AS AN INDEX TO THE DIETARY MANAGEMENT OF DIABETES

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Abstract
A group of diabetics was intensively studied over a 3 yr. period to determine the effect of high and low carbohydrate diets on the individual carbohydrate tolerance in each case. These diabetic patients fell roughly into 2 classes, the relatively insulin-sensitive and the relatively insulin-resistant. The resistant type tended to be older, obese, often had hypertension and were less subject to acidosis and coma; the sensitive type were usually younger, thin or of normal nutrition, and had low blood pressures and a marked tendency to acidosis. 7 of the 8 sensitive patients failed to gain tolerance on high carbohydrate diets. Relatively high fat was well borne. The 7 resistant patients all gained tolerance on high carbohydrate diets, but tended to lose tolerance when given high fat. The sensitive type responded to insulin tolerance tests like partially de-pancreatized animals; the resistant group responded as if the insulin production were adequate in amount but operating under the handicap of inhibiting factors.[long dash] Studies such as these should prove useful in indicating the type of diet which will lead to maximum individual carbohydrate tolerance.