On the Diagnosis and Treatment of Diabetes Mellitus, with Special Reference to the Usages of Insulin

The possibility of a diagnosis of diabetes usually arises on the finding of a reducible substance in the urine ; glucose is but one of these, and some test must be made to differentiate it from the others, of which the most frequent are :? Uric acid, hippuric acid, salicyluric acid present in salicylate therapy, glycuronic acid present after chloral, etc. ; alkapton, creatinine, lactose during lactation ; pentose?in pentosuria. A simple means of differentiation is possible in the fermentation test, provided certain precautions are taken :? (i.) Glucose fermenting bacteria are common in urine ; these bacteria will produce gas from other substances than glucose ; to destroy them the apparatus and the urine must be carefully sterilised by boiling. (ii.) There may be fermentable substances in the yeast itself ; an aqueous extract should be tested by fermentation of the yeast. (iii.) Brewer's yeast should be used; baker's yeast sometimes contains other fungi. A more accurate method is to prove the presence of the Dsazone derivative.