r
658 INSULIN IN HOSPITAL AND HOME
The Blood Sugar at the Beginning and in the Course of
Treatment
It was our expectation that the fasting blood sugar would be
much higher at the latest observation than at the beginning of
treatment, first because of the increase in total glucose in the diet,
and second because the last blood sugar test was made so long,
as a rule 14 hours or more, after the last dose of insulin that its
effect would have disappeared. On the contrary the latest aver-
age percentage of blood sugar is 0.19 per cent., while the first was
0.24 per cent. Whether a series of data compiled a few months
later with these same patients would present such favorable
results, time alone can answer.
Urinary So~gar
Comparatively few cases began insulin when the percentage
of sugar in the urine was high. Response to dietetic treatment is
so rapid that patients were made sugar-free, or nearly sugar-free,
as a rule in the first few days in order to save insulin. A con-
siderable number did not yield to dietetic treatment, yet during
the week preceding the commencement of insulin, fasting was
employed on but 9 days with 8 patients. With the 53 cases, de-
scribed in Table 1, during the present observations fasting was
not employed. The average percentage of sugar in the 24-hour
quantity of urine at the beginning of treatment with insulin was
0.8 per cent. and at the latest observation was 0.2 per cent. As
48 of these patients are now undergoing treatment in their own
homes, this percentage of sugar is perhaps greater than would be
the case if they were still in the hospital.
Weight
The maximum weights of adult patients are easy to secure, but
with children are obtained with far more difficulty. In Table 1,
therefore, we have been obliged to omit data which we should
have been glad to include regarding patients under 15 years
of age. For the other patients the rule holds that overweight
preceded diabetes. In 19 instances of the 29 cases in which the
maximum weight is known, it was above standard. It was not as
much above standard as one often sees, but this is not strange,
because the patients were younger than the majority of diabetic