THE ROLE OF EXCESSIVE CARBOHYDRATE INTAKE IN THE ETIOLOGY OF DIABETIC COMA1

Abstract

ALTHOUGH the etiologic factors which may be responsible for the development of diabetic acidosis and coma have received much consideration, they are far from clear. Of the many possible factors, agreement exists only with reference to the fact that either infection or insulin deprivation can precipitate diabetic acidosis. Many authors state unequivocally that the ingestion of excessive amounts of carbohydrate is an important factor in “breaking the control” of a diabetic and in the development of acidosis. Thus, in 1937, Joslin (1) asserted that dietary indiscretion was the most common etiologic factor in diabetic coma. More recently, Martin, Drury and Strouse (2) stated that, “The margin of safety in the patient with severe diabetes who has wide variations in the blood sugar content during the day and night is too small. A little excess food may give rise to a hyperglycemia, suddenly associated with ketosis, as we have noted in several patients entering the diabetic service in coma. Careful inquiry has s...