THE purpose of this report is to summarize our experiences with the high carbohydrate-low calorie diet in 50 cases of diabetes where the patients followed treatment carefully for a period of five years. The data, as will presently be shown, clearly indicate that this diet, if followed carefully, leads in the majority of cases to marked improvement in carbohydrate tolerance. The dosages of insulin required eventually in these cases were found to be less than with all other diets which have been used hitherto in the treatment of advanced diabetes mellitus. In 12 cases, an incidence of 24 per cent, the insulin was discontinued entirely.

Our first experiences with the high carbo-hydrate-low calorie diet, and the conditions which led to its use, were reported in this Journal'in October, 1930. These observations and subsequent experience2,'4 make it necessary at least to modify the prevalent conception of the metabolism of diabetes mellitus. Since then a variety of other data, clinical and experimental, have accumulated in the literature which fit in with the experiences with this diet. The vari-ous findings will not be dealt with here. t Suffice it to say thatit now appears to be fairly well established that carbohydrates improve, whereas fats impair, carbohydrate tolerance; and that carbohydrates increase, whereas fats decrease, the sensitivity of the individual, animal and man, to insulin. Since the discovery of insulin a number of attempts have been made to use more liberal quantities of carbohydrates in the diet of the diabetic. The first reports were those of Sansum. Blatherwick and Bowden, 5 Adlersberg and Porges6 and Geyelin7 in 1926. The experiences with these diets in general fit in with the abovementioned clinical and laboratory experiments.