~The Record.~--She must keep an absolute record of all that occurs during the course of treatment and instantly report any unusual happening. ~Urine Tests.~--It is advisable to make the tests in the morning; those for sugar and diacetic acid should be made every day or, in some cases, every other day, as directed by the physician, and those for ammonia and albumen about once a week. ~Weighing the Patient.~--Patient should be weighed each day before breakfast, and the weight of the clothes also carefully recorded separately. ~The Bowels~ must move daily, even if it is necessary to resort to mild laxatives or an enema. ~Formulating and Calculating the Dietary.~--The menus of the day must be formulated and the chemical composition and nutrient value of the foods calculated. The vegetables belonging to the five per cent. group should be in readiness and the amount to be used weighed after they have been boiled in clean, separate water to reduce their carbohydrate content still further. ~Commercial Diabetic Foods.~--It may be well to mention the danger of putting faith in the so-called diabetic foods so widely advertised. Some of these foods are of undoubted worth, but it is never safe for the nurse or the patient to judge of the merits of the various diabetic foods without first knowing their chemical composition, and not even then without the definite directions from the physician. ~Diabetic Flours.~--The diabetic flours used in the recipes included in this text have been approved by some of the leading specialists in diabetes in this country, but the nurse should not include them in the diet for her patient unless they are prescribed by the physician in charge. PROBLEMS (a) Outline test diets for determining the severity of the disturbance. (b) Give examples of diets used in testing for tolerance of carbohydrates, fats, proteins. (c) Give an example of a diet order showing the use of the high fat method of feeding. Why is it used? FOOTNOTES: [137] Allen's Paradoxical Law, quoted from "Treatment of Diabetes Mellitus," p. 18, by Joslin. [138] "Treatment of Diabetes Mellitus," p. 305, Joslin. [139] "Food for the Sick," by Strouse and Perry. [140] Courtesy of Dr. Joslin and Thomas Groom & Co., Boston. [141] The giving of coffee or clear broth, with or without whisky, does not materially affect the starvation and serves to make the patient more comfortable during this trying period. [142] Dr. Joslin has given a very complete schedule in his "Treatment of Diabetes Mellitus," from which the above schedule is taken. [143] Hill and Eckman's "Starvation (Allen) Treatment of Diabetes." [144] See 5% vegetable, p. 383. [145] Table used by Dr. Joslin in his treatment of diabetes mellitus. It is convenient, and many changes in the diet may be made by substituting one food for another of like carbohydrate content. This table can be purchased on cards from Thomas Groom & Co., Boston, Mass.