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[IP] Ladder Diet

Some of you who like to look at yesteryear and diabetes may be
interested in the Ladder Diet that was used at the time insulin was
discovered (1921). A medical book had this in it and I copied it:

Ppg 147-150 The Pathology & Treatment of Diabetes Mellitus, George
Graham, Oxford Medical Pub 1923)

LADDER DIET Rx'd IN 1920s (Insulin discovered in 1921)

The treatment should be started with 1 or 2 hunger days

DAYS 1 & 2: As much weak tea, coffee, or fresh lemonade as desired. Meat
essence should be given at 2 meals

DAYS 3 & 4:
Breakfast: 2 eggs, butter 1.4 oz weak tea or coffee
Lunch: 1 egg eaten up in weak tea/coffee, 2 oz. Lettuce or tomato
Midday meal: 6 oz green veg, > oz butter, 10 oz meat essence
Tea time: 2 eggs, < oz butter, weak tea/coffee, 2 oz lettuce or tomato
Supper:  6 oz. Green vegetables, = oz butter, 10 oz meat essence, eight
agar bran biscuits may be eaten in the day.  One oz. of cream may be
exchanged for 1//2 oz butter.
Protein 35 gr; fat 70 g; sugar 14 g; caloric value 838

DAYS 5 & 6
If the urine contains no sugar, 2 oz meat or 3 oz fish may be added to
the midday meal for 2 days.
Protein 51 g; fat 94g sugar 16 g; caloric value 990

DAYS 7 & 8
If the urine contains no sugar for 2 days, 2 oz ham may be added to the
evening meal and 1 egg deducted from this meal.
Pro 54 g; fat 94 g; sugar 16 g; cal val 1138

DAYS 9 & 10
If the urine contains no sugar for 2 days, 2 oz bacon may be added to
the breakfast and 1 egg deducted from the breakfast.
Pro 57.7 g; fat 117.9 g; sugar 16g, cal val 1358

DAYS 11 & 12
If the urine contains no sugar for 2 days, add 4 oz milk over the whole
Pro 62.2g; fat 122.5 g; sugar 20 g; cal val 1428

DAYS 13 & 14
If the urine contains no sugar for 2 days, add = oz. Bread in two
portions < oz at the other 2 meals of the day, so the 1 oz. Of bread is
divided into four equal portions.
Pro 64.2 g; fat 122.8 g; sugar 35 g; cal val 1498

DAYS 17 & 18
If the urine contains no sugar for 2 days, add = oz bread in 2 portions
of < oz = 2 meals have = oz and the alternate meals < oz.
Pro 65.2g fat 123 g; sugar 42.5g; cal val 1533

DAYS 19 & 20
If the urine contains no sugar for 2 days, add = oz. Bread in two
portions < oz.  The patient will have = oz. Of bread at each meal. He
should be told that it is very important to divide up the bread into 4
equal portions & not take it all at 1 meal or two.
Pro 66.2; fat 60g; sugar 50g; cal val 1568

The patient should be kept at this level for another 4 weeks. If still
sugar-free, 1 oz. Butter may be added & the bread cautiously increased
up to 4 oz, = oz being added every 14 days.
Pro 70g; fat 144g; sugar 80g; cal val 1910

If all goes well, another oz. of butter may be added to raise cal val.
Pro 70 g; fat 184g; sugar 80g; cal val 2090

If sugar reappears when meat/ham/or bacon is added, 1 or 2 hunger days
should be repeated and the whole ladder reclimbed.

If sugar appears at any time after this point is reached, give one
hunger day and return to the full diet less some butter or bread. If the
nitro-prusside test for aceto-acetic acid is very intense at any time,
either give 1 or 2 hunger days or remove all fat from diet.

That is long, and if anyone has a comment, PLEASE just <snip> to the
part that is relevant. I'm glad we have pumps now! When I was dx'd in
1950 the exchange system and NPH had just been introduced. Between the
Ladder Diet and Exch Sys they used a Percentage Diet - I forget the %'s
but it was so much CHO, PRO, FAT.

Jan T-1 11/5/50, pmpg 8/23/83) Dialyzing 7/8/02
http://maxpages.com/bludasue  - http://maxpages.com/TSLandCLIP  -
http://www.picturetrail.com/dmBASHpics (evolution of pumps)

A diet is a weigh of life.

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