Leena Watts
In the early 20th century, prominent American physicians Frederick Allen and Elliot Joslin advocated for the use of starvation diets to treat diabetes. This method involved severe fasting and undernutrition to prolong the lives of diabetic patients. While this treatment was successful in eliminating glycosuria, it was difficult to follow and led to malnutrition and a higher risk of infection. Elizabeth Hughes, the daughter of U.S. Secretary of State Charles Evans Hughes, was one of Allen's patients who survived on a starvation diet for three years until insulin became available for human use in 1922. While starvation diets may have extended the lifespan of some Type 1 diabetics, they also resulted in the deaths of many patients, including 62 patients under the age of 15 in Joslin's care. Today, it is understood that severe calorie restriction can stunt the growth of children and reduce their resistance to infection.
| Characteristics | Values |
|---|---|
| Starvation diet for diabetes | Severe fasting and undernutrition |
| Promoted by | Frederick Allen and Elliott Joslin |
| Aim | To prolong the lives of diabetic patients |
| Effectiveness | Limited data suggests it extended lifespan in Type 1 diabetics |
| Drawbacks | Led to acidosis, coma, and death in some patients |
| Alternative methods | Low-carbohydrate diets |
| Calorie restriction | Beneficial for overweight diabetics but harmful for those with normal or lower weight |
| Children | May stunt growth |
| Patient experience | Unpleasant, difficult to maintain, and enervating |
| Elizabeth Evans Hughes | Survived on a starvation diet for 3 years until insulin was available for clinical trials in 1922 |
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What You'll Learn
The history of starvation diets for diabetes
Diabetes is an ancient disease, and for centuries, extreme diets and herbal remedies were used to treat diabetes symptoms. In the early 20th century, Frederick M. Allen and Elliott Joslin, two prominent diabetes specialists, advocated for starvation diets as a treatment for diabetes. This approach, also known as "starvation dieting," involved severe fasting and undernutrition to prolong the lives of diabetic patients. Allen and Joslin based their therapy on animal experimentation, particularly the effects of diabetes induced by partial pancreatectomy in animal models. However, critics argue that the clinical experience at the time suggested that low-carbohydrate diets may have been just as effective with fewer risks.
In 1913, Allen published a book documenting his work on diabetes, and in the same year, he began working at the Hospital of the Rockefeller Institute in New York. By 1915, he had treated 44 diabetic patients with an initial fast of up to 10 days, followed by severe calorie restriction. Joslin, who had established the first private practice dedicated to treating diabetes in the United States in 1898, also promoted Allen's starvation diets as the first effective tool to treat diabetes. Despite their popularity, these diets were burdensome and occasionally lethal, with a significant number of patients dying in Allen and Joslin's care.
During this pre-insulin period, starvation diets were considered a way to manage diabetes symptoms and extend life. In 1915, Allen first wrote about "total dietary regulation," emphasizing a very low-carbohydrate and low-calorie diet to clear glucose from the urine and extend life. This included strict calorie reduction for 1 to 4 days, with a diet of coffee and whiskey, followed by boiled vegetables, and a gradual reintroduction of protein and fat. However, these diets were not sufficient to sustain life, and patients on these diets wasted away, becoming susceptible to various infections.
The discovery of insulin in 1921 revolutionized diabetes treatment and reduced the reliance on extreme starvation diets. Insulin allowed diabetic patients, especially children, to consume enough calories to return to a healthy weight. Elizabeth Evans Hughes, an 11-year-old girl diagnosed with type 1 diabetes in 1919, survived on a starvation diet until she became one of the first recipients of insulin in clinical trials in 1922. Thanks to insulin, Elizabeth lived a long and rich life, travelling extensively and advocating for the liberating power of insulin.
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The dangers of starvation diets for children
Starvation diets for children with diabetes were promoted by prominent American physicians Frederick Allen and Elliott Joslin in the pre-insulin period. Allen and Joslin advocated severe fasting and undernutrition to prolong the lives of diabetic patients, including children. However, this practice was dangerous and often lethal, and it is now understood that such diets are not an effective treatment for diabetes.
The human body requires food and water to function properly. When the body does not receive enough calories, it starts functioning differently to reduce the amount of energy it burns. This can lead to a loss of muscle tissue as the body breaks it down to provide energy. In the case of diabetic children, severe calorie restriction could lead to a reduced resistance to infection, and potentially stunt their growth.
Elizabeth Evans Hughes, the daughter of a politically powerful American family, was diagnosed with acute diabetes at the age of 11 in 1919. She was treated with Allen's starvation diet, consuming only 800 calories or fewer per day, with occasional fasting days. She managed to stick to this diet for three years until insulin became available for clinical trials in 1922, and she became one of the first recipients. Hughes survived and went on to live a long and rich life, but many others were not so fortunate.
Allen's treatment was burdensome and often lethal, with a significant number of patients dying in his care. Between 1898 and 1916, 62 patients under the age of 15 died in Joslin's care. While the starvation diets may have helped some patients survive until insulin treatment became available, they caused harm and suffering. The diets were unpleasant, difficult to maintain, and enervating, leading to a poor quality of life.
In conclusion, starvation diets for children with diabetes are extremely dangerous and ineffective. They can lead to severe health issues, including a reduced resistance to infection, stunted growth, muscle loss, and even death. The development of insulin treatment has provided a much safer and more effective alternative to starvation diets, saving countless lives and improving the quality of life for people with diabetes.
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The effectiveness of starvation diets
Starvation diets are never a good idea and can have serious negative effects on the body and mind. In the pre-insulin era, starvation diets were advocated by some physicians for people with diabetes. However, this approach was highly controversial, and many patients died under this treatment.
The Minnesota Starvation Experiment, conducted during World War II, provides insight into the effects of semi-starvation. The study involved 36 men and was divided into four phases: a 12-week control period, a 24-week starvation phase, and two recovery phases. During the starvation phase, participants' dietary intake was cut in half, resulting in an average weight loss of 25%. The rehab phase proved to be psychologically challenging, with extreme effects including self-mutilation. The study confirmed that prolonged semi-starvation led to significant increases in depression, hysteria, and hypochondriasis.
Starvation diets can cause a slowdown in metabolism as the body works to prevent further weight loss. This can lead to adverse health consequences, including a reduced ability to fight infections. Additionally, starvation can cause muscle loss and a decline in mental health.
Intermittent fasting is a modern form of dieting that involves short-term fasts and has gained popularity. While it may offer some benefits, such as increased fat-burning hormones, it is not a starvation diet and should not be confused with severe fasting or undernutrition. Intermittent fasting should still involve a balanced diet and adequate protein intake to prevent muscle loss and metabolic slowdown.
In conclusion, starvation diets are not effective and can be harmful to both physical and mental health. While calorie restriction can be beneficial for diabetics who are overweight, severe calorie restriction in normal or underweight individuals can be dangerous and may even stunt growth in children. It is essential to prioritize healthy, sustainable habits and work with healthcare professionals to establish safe and effective diets.
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The discovery of insulin
In the decade before insulin was discovered, starvation diets were promoted by prominent American physicians Frederick Allen and Elliott Joslin as a way to prolong the lives of diabetic patients. This form of therapy involved severe fasting and undernutrition, and some patients did indeed starve to death. For children, such diets could stunt growth and make them more susceptible to infections. Elizabeth Evans Hughes, an 11-year-old girl diagnosed with acute diabetes in 1919, was one of the few who survived this starvation treatment. She was able to stick to the diet for three years until insulin became available for clinical trials in 1922, becoming one of the first recipients.
In 1910, Sir Edward Albert Sharpey-Shafer suggested that only one chemical, which he named insulin, was missing from the pancreas of people with diabetes. The term insulin comes from the Latin word "insula," meaning "island," referring to the islets of Langerhans, which are clusters of specialized cells in the pancreas. In 1921, a young surgeon named Frederick Banting and his assistant Charles Best successfully extracted insulin from a dog's pancreas. They managed to keep another diabetic dog alive for 70 days with this extract.
The first human to receive an insulin injection was a 14-year-old boy, Leonard Thompson, who was dying from type 1 diabetes. Within 24 hours, his dangerously high blood sugar levels dropped, but he developed an abscess at the injection site. After further purification of the extract, Leonard received a second injection on January 23, 1922, which was a complete success, normalizing his blood sugar levels. This marked the first time in history that type 1 diabetes was not a death sentence. The discovery of insulin was announced internationally in May 1922, and insulin began to be mass-produced and commercially available in 1923. Banting and his colleague JJR Macleod were awarded the 1923 Nobel Prize in Physiology or Medicine for their life-saving discovery.
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The impact of starvation on the body
Starvation is a severe deficiency in caloric energy intake, below the level needed to maintain life. It is the most extreme form of malnutrition and can cause permanent organ damage and eventually, death. The symptoms of starvation can be broken down into three phases.
Phase one occurs when meals are skipped, and the body begins to maintain blood sugar levels by degrading glycogen in the liver and breaking down stored fat and protein. The liver can provide glucose for the first few hours, after which the body begins to break down fat and protein. The body uses fatty acids as an energy source for muscles but lowers the amount of glucose sent to the brain. This phase can be observed in anyone who skips meals, diets, or fasts.
Phase two can last for weeks, and the body mainly uses stored fat for energy. The breakdown occurs in the liver, turning fat into ketones. After fasting for about a week, the brain will use these ketones and any available glucose. Using ketones lowers the need for glucose, and the body slows the breakdown of proteins.
Phase three is more severe and can be fatal, resulting from long-term starvation. By this point, fat stores are gone, and the body begins to turn to stored protein for energy. This means breaking down muscle tissues full of protein, which break down very quickly. Protein is essential for cells to work correctly, and without it, they can no longer function. The cause of death due to starvation is usually an infection or the result of tissue breakdown, as the body becomes unable to produce enough energy to fight off bacteria and viruses.
The body's response to starvation can vary depending on factors such as age, body weight, access to water, and underlying health issues. Children, for instance, are at a greater disadvantage during starvation because they have fewer body-fat stores to draw from and higher metabolic needs due to growth. In the context of diabetes, starvation diets were once promoted in the pre-insulin period as a means to prolong the lives of diabetic patients. However, this approach resulted in some patients starving to death, and it was recognized that severe calorie restriction could stunt growth in children. Today, it is understood that calorie restriction can be beneficial for diabetics who are overweight, but it may lessen resistance to infection in those with normal or lower weight.
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Frequently asked questions
A starvation diet is an extremely low-calorie diet. It involves severe caloric restriction most days and complete fasting on some days.
Before insulin was discovered in 1922, there was no effective treatment for diabetes. Starvation diets were used to prolong the lives of diabetic patients, particularly those with acute diabetes.
Starvation diets were often lethal to children with diabetes. However, some children, like Elizabeth Evans Hughes, survived on a starvation diet until insulin treatment was developed. Elizabeth lived on this diet for 3 years.
Starvation diets can stunt a child's growth and lessen their resistance to infection. They are also unpleasant, difficult to maintain, and enervating.
