Diabetes Treatments of Yesteryear
One of my neighbors gave me an old home-health book called Know Thyself. It was published in 1911, and the introduction says, "To this book, father and mother can go as a rich treasure-house for wealth of knowledge and wisdom to guide and direct their children."
The authors caution mother and father to keep the book away from "tender youth," as it mentions salacious topics such as marriage and child-bearing. But I figured that now that I'm on Medicare, I might be allowed to read it, and I went to the index to see what they said about diabetes in 1911. This was about 10 years before the discovery of insulin.
The best drug treatment for diabetes, they suggest, is opium, or the opium derivative codeine, which should be given in increasing doses to 3 grains 3 times a day. I sort of thought hanging out in an opium den would be more interesting than taking pills, but I looked in the Yellow Pages and couldn't find any opium dens listed in my area of Vermont.
In those days, diabetes was diagnosed solely on the basis of sugar in the urine, and opium apparently really did decrease the sugar content of the urine in "mild cases" of diabetes, but not in "severe." The "mild" ones were probably type 2 and the "severe" ones type 1.
One paper notes that although the opium reduces the amount of sugar in the urine, it has no effect on the amount of sugar in the blood -- which of course is what we're interested in -- and may work by increasing the renal threshold, or the blood glucose level at which the kidneys secrete sugar.
Oh well. I can't find any opium dens anyway, so I decided to move on to the dietary recommendations of 1911.
The diet recommended by the book is strictly low-carb. You're allowed all meat but liver (not a great sacrifice for me) and oysters (I've had about 1 oyster in my life so far, so it wouldn't be difficult to give them up), and you can eat eggs, cheese, butter, and cream. "If it were possible to feed the patient upon an exclusively meat diet, the problem would be solved," they say. "But few could bear this for any length of time."
(The authors were most likely speaking about type 2 diabetes, not type 1, in which protein is converted to glucose, as they note that diabetes is most common in middle-aged men, and we now know that the majority of people with diabetes do have type 2. In those days they didn't distinguish the types except by referring to "mild" and "serious" diabetes.)
So because no one would want to live on an all-meat diet, they allow all green vegetables or green parts of vegetables and cooked unripe fruits. "Ripe sweet fruits are, as a general rule, unsuitable. . . . However, because fruits are so universally beneficial to the human system, it is better, unless it be an extremely severe case, to let the patient eat of most of the ordinary fruits." They also allow nuts except chestnuts.
As today, "the greatest difficulty is to find something to take the place of bread." They solved that problem by allowing "gluten bread," which was made with gluten flour and was probably similar to today's low-carb breads, although today's low-carb breads often include other carbohydrates such as oat bran, some whole-wheat flour and other starches in order to improve the taste and keep the product from being too dry.
Of the gluten breads and biscuits, they say, "But the best are tough, and the patients soon tire of it." They also allow "soya loaves" and bran bread and other "diabetic" treats like almond cakes and biscuits, coconut biscuits, "diabetic rusks," etc.
"Much ingenuity has been expended in the preparation of these foods. . . . by the exercise of a little forethought and with the help of a good cook, it is possible to obtain a considerable amount of variety, and a patient in comfortable circumstances need not fare badly at all."
What goes around, comes around. All of this must sound familiar to those of us on low-carb diets today. The only thing I'm missing is a local opium den and a good cook. I'd settle for the latter.