Restricted diet for diabetes - 1866

This was written by George Harley, MD (1829-1896) while at University College Hospital, London.

... let me explain that by the term restricted diet we mean not only the avoidance of all sugars, and substances containing saccarine matter, but also of all kinds of food convertible during the process of digestion into sugar. The foods convertible into sugar in the digestive canal are those containing starch (not gums), such as arrowroot, tapioca, sago, flours of all the different kinds of cereals (wheat, barley, oats, peas, beans, etc.), potatoes, carrots, beetroot. parsnips, turnips, and other edible roots.

Green vegetables, on the other hand, such as spinach, cabbage, turnip tops, Brussels sprouts, and lettuce need not be forbidden, as they contain too small an amount of starch to do much injury.

As for animal foods, on the other hand, every imaginable fish, flesh, and fowl may be indulged in, so that even on the most restricted diet the patient has still a large margin for selection - beef, mutton, pork, venison, poultry. game, and wild fowl, oysters, lobster, crabs, prawns, salmon, cod, turbot, etc., Iceland and Ireland Moss, calf's foot or gelatine jellies, butter sauces and salad oils. The only true hardship, in fact, the patient suffers is the deprivation of ordinary bread, and that appears to be a more severe one than most people imagine. I have known patients in whom the craving became at last almost intolerable, its as if nature were crying out for some indispensible element of food. In order to mitigate this hardship, a great number of plans of depriving bread of the forbidden element, starch, have been suggested, and many of them have been in a great measure successful. Thus, we have bran, gluten and glycerine breads and biscuits constantly kept in stock by many of our London bakers.

After a time patients get very tired of these substitutes, so it is as well to know that we may occasionally indulge them with well done toast, or very crisp pulled bread, the extra heat having destroyed a considerable portion of the starch normally contained in the article.

Even in the most favourable cases for restricted diet, we must never allow ourselves to be deluded into the idea that, because we are mitigating the symptoms, and reducing the amount of sugar in the urine, we are necessarily curing the disease, or we shall frequently be be doomed to sad disappointment. In keeping the patient on restricted diet, we are merely witholding from him the straw and mortar out of which the bricks are made - not removing the makers - so that, as soon as the straw and mortar is refurnished to them, they will again be found at work as actively as ever.

We've come a long way baby....ahh...pass the mutton please.