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DIABETES MELLITUS–PROBLEMS OF PRESENT-DAY TREATMENT

1933; Elsevier BV; Volume: 186; Issue: 5 Linguagem: Inglês

10.1097/00000441-193311000-00001

1538-2990

Herman O. Mosenthal, Charles Bolduan,

Diabetes and associated disorders

Currently about 2000 deaths are registered in New York City annually. The death is about 50% higher than it was only 20 years ago. Approximately the same condition exists in all the large cities of the US and throughout much of the civilized world. The discussion analyzes these facts and presents possible remedial measures for them. For persons of both sexes the death in New York City rose from 2.2/100000 population in 1871 to 29.3 in 1932. The total number of deaths rose from 25 in 1871 to 2116 in 1932. The term diabetes death rate is actually only a record of death of persons who have had mellitus and is not a true indication of the deaths actually caused by that disease. In a sense it reflects the incidence of diabetes. A change in the trend of the mortality occurred in nearly all age groups about 1900 most probably due to the introduction of the international classification of the causes of death by the Department of Health of New York City in 1901. After 1920 there is a marked improvement in the death in females under 45 and in males under age 65. This may be definitely attributed to the effective use of insulin. In women over 45 years the rise in the death continues its previous upward trend despite insulin while in men this is true only in the age group of 65 years and older. This increase in deaths of older females is so great that it outweighs the favorable influence of insulin in the older age and sex groups and results in a distinct rise of the mortality as a whole. The more common and the growing incidence of in women may be ascribed to 2 factors: the greater participation by women in industrial activities and their more frequent subscription to life insurance both of which entail physical examinations; and the injurious effect of pregnancy upon the carbohydrate tolerance has a greater chance to manifest itself as now compared to former years because of the aging populations. For these reasons it is believed that the rising incidence of in New York City is more apparent than real. It is not possible to accomplish much in the area of prevention of until more complete and reliable information is obtained concerning the onset of at differnet ages and in the 2 sexes and concerning the etiology of the disease. The part played by heredity menopause pregnancy gall stones glandular activities nervous disorders and other possible causes of call for further investigation. The methods and objectives of treatment available today are adequate to keep diabetics from dying of diabetes. In order for treatment to be universally applied the treatment should be simplified and more responsibility should be assumed by the physician and less by the patient than is often advocated.