"We reported briefly the results of an investigation of the effect of a diet whose energy came largely from fat, to which was added sufficient protein to maintain nitrogen balance and the minimal carbohydrate necessitated in making up a diet that a human being can eat over a long period of time. It was shown that with such a diet, glycosuria was avoided in severe diabetics, and that acidosis was not produced. The twenty-eight cases contained in Table 1 show that a high fat diet such as we have used is capable of bringing the blood sugar down to normal and keeping it at that level during the period of observation."

The first paper stated the method employed and, in a general way, the results obtained. Freedom from glycosuria, however, does not necessarily mean normal glycemia. In this communication we shall deal with the effect of this type of diet on the blood sugar. Blood sugar determinations, sufficiently numerous to permit drawing conclusions concerning the effect of the diet on glycemia, are available in forty-five cases. We include in this group every case in which such a series of determinations has been made, and have omitted only those whose blood sugar determinations have been too few to be of significance. A few patients left the hospital on higher diets than those shown in the tables, but as corresponding blood sugar determinations are not available, the tables for such individuals stop with the last blood sugar reading. These cases are presented in four groups. The first three groups (Tables 1, 2 and 3), consisting of forty cases, show a satisfactory response of the blood sugar to the treatment. The fourth group (Table 4) comprises the five cases in which blood sugars did not reach a desirably low percentage. Of the forty satisfactory cases, those complicated by chronic nephritis have been brought together in Table 2, and those in which diets varied at times from our standard are presented in Table 3.

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