Controlled Versus Free Diet Management of Diabetes

Clinical experience has led the authors to believe that continuous aggressive treatment of diabetes, directed toward the maintenance of physiologic conditions including normal levels of blood sugar, is of the greatest importance in reducing the incidence and severity of degenerative complications. Ideal control implies that a quantitated diet providing ample minerals, vitamins and calories derived from the proper distribution of carbohydrate, protein, and fat has been so well utilized by adequate insulin effect that blood and urine tests for sugar are invariably normal. Although this ideal is rarely attained, a consistent, conscientious effort to reach it will usually result in reasonably good control. On the other hand, in recent years some have advocated plans of treatment which provide much less rigid control and thus by the authors' standards fall far short of being adequate therapy for diabetes.^1-6 These plans allow, in general, a free selection of diet as well as disregard of glycosuria and hyperglycemia as long as acidosis is absent.