Two unsolved problems in diabetic management are discussed. One involves the question whether “normalization” of blood glucose remains a desirable goal in the treatment of the diabetic patient in the hope of preventing, ameliorating or postponing the macroangiopathic, microangiopathic and neurological changes associated with diabetes mellitus. Some findings are reviewed which support or refute the concept that there is a possible or probable correlation between derangements of insulin secretion and attendant abnormalities in intermediary metabolism and the chronic complications of diabetes mellitus. A conclusive answer to this question is unlikely to evolve until therapy is devised which will continuously achieve complete normalization of hormonal and metabolic abnormalities.
On the premise that the nature of the diet may have an effect on the development of some complications, the second problem discussed is the optimum composition of the diet which will be most beneficial to the diabetic patient from a prophylactic point of view.