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RIPPERGER: SWEETS FOR DIABETICS. [NewYobk Medical Jolbnai . this may be of diabetic nature. The affected indi- vidual may sooner or later become diabetic, though he need not be so at the time, nor even develop the disease. Glycosuria may manifest its deleterious conse- quences in two ways: First, through the loss of sugar, which circumstance, however, is not of much significance in the milder cases ; and, _ secondly, . through the hyperglycEemia always associated with it. So long as the diabetic excretes sugar, and so long as the amount of sugar exceeds the normal, so long will there be hyperglycaemia. Therefore, it can be positively maintained that the hyperglycaemia is responsible for the low resisting power of dia- betics against infections (Naunyn, Die Deutsche Klinik, ill). If now we briefly discuss the question as to the origin of the hyperglycaemia, generic bimatoprost as to the cause of this serious disturbance of the metabolism, and, further, as to the difference between a diabetic and nondia- betic glycosuria, we must say at the start that cheap bimatoprost a com- bimatoprost cost plete unanimity on this subject does not exist. According to Naunyn {ibid.), in diabetic individ- uals the organs concerned in the metabolism of sugar have suffered an impairment of their activity ; they either do not take up the sugar carried to bimatoprost 0.01 them bv the blood, or return it, to the blood because un- able to utilize buy bimatoprost online it. Hence there is an accumulation of sugar in order bimatoprost the blood, the before named hyperglycae- mia, which when it exceeds 0.2 to 0.3 per cent., buy bimatoprost uk leads to glycosuria. The normal absorption of sugar from the blood by the organs concerned in its metab- bimatoprost ophthalmic olism is therefore obstructed, and for this reason sugar is eliminated by the kidneys. Most of the other authors also attribute the cause of the sugar accumulation in the blood to an impaired oxidation, a faulty lumigan bimatoprost assimilation of sugar, and not to a primary increased production, and (G. bimatoprost online Graul, Ueber den Diabetes mellitus, Wiirzburger Abhandlungen, VII. y. von I^Iering, Lehrbuch der inneren Medizin, Jena, 1903. Penzoldt and Stintzing, Handbuch der spe- ziellen Therapie, II) consider diabetes mellitus, in brief, as a chronic disease, which consists in that the organism is no longer capable of utilizing sugar to the same extent as in the normal state. In this article the organic forms of diabetes, that is, cases in which the disease appears to be directly due to an affection of some organ, as the pancreas or the nervous system, will not be discussed, because of only secondary interest. The' main source from which the organism de- rives its bimatoprost synthesis sugar is starch, which is ingested in the form of bread, farinaceous foods, potatoes, and vege- tables. bimatoprost canada A small proportion of the sugar reaches the organism directly in the form of grape, milk. cane, or fruit sugar. Theoretical consideration of these facts alone must lead us to the basic principles of the dietetic treatment of diabetes, which was em- pirically established more than one hundred years ago by purchase bimatoprost the English physician Rollo. The medicinal treatment, as will be mentioned right here, is of subordinate significance. Of importance for the entire treatment of dia- betes are the following buy cheap bimatoprost fundamental maxims : " Dia- betic glycosuria if of long duration tends to in- crease, inasmuch as the tolerance of the bimatoprost 0.03 patient di- minishes," and " if the diabetic is sugar free in the aglycosuric state of diabetes his tolerance tends to increase." In other words, the main airn of treat- ment must be to keep the patient in an aglycosiiri." condition. This object is accoinplished by the with- drawal of sugar and, as far as possible, of order bimatoprost online sugar forming foods, the starches, bimatoprost price and also if necessary the restriction of albumens. Whether bimatoprost uk the amyla- ceous foods are to be excluded entirely or partially, permanently or temporarily, from the diet of the diabetic, whether in severe cases the ingestion of albuiTiens should also be reduced, is of no interest here. So much is true, that the use of sugar should be prohibited to all diabetics under all circumstances, and caution in sugar consumption or complete ab- stinence therefrom should be recommended in faini- lies in which the disease is hereditary. Although it can be easily understood why there are some weighty objections to the complete with- drawal of starches from the diet, particularly on ac- count of the danger of inducing nutritive disturb- ances, it would seem that purchase bimatoprost online a strict interdiction of sugar could be carried out with ease and without

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