Studies on the Water Metabolism in Diabetes Mellitus

Dilution test: No remarkable difference between normal individuals and the patients of Type I was observed. The amount of urine output was approximately 1000 c. c., the specific gravity gradually decreased and the body weight was invariable or slightly lost. On the contrary, in Type II there were no striking increase of output and fall of specific gravity except 2 cases. The results of the above experiment correspond to that of Klein, 16) Gerbi19) and Ralli.20) Moreover, it is interesting that the same results were obtained in the experiment performed without giving water; and it is assumed that in severe cases of diabetes the water intake has no influence upon the urine output and the fluid taken is stored in the body. After recovery from diabetic symptoms by the suitable treatment, the urine output increased in every case, especially remarkable in severe cases notwithstanding the total daily amount becoming small, although we found no great difference in comparison with the results before the treatment when there was no recovery. Concentration test: In every case the rise of specific gravity was observed, while in Type II it is so high previously as a rule that it was not so marked. The amount of urine is comparatively small in Type I. As Kailhack21) described, we found, out a close relation between the amount of urine output and urine sugar, that is, when the former was large the latter was simillarly large and we noticed the decrease of the former together with that of the latter after recovery with the diabetic treatment. Discussion: As many authors stated, no established theory on the disturbance of water metabolism has been found. They thought to find out the causal meaning in the disturbances of kidney function caused by glycosuria, 22) in diabetic aeidosis, 3)6) in the failure of the intermediary water metabolism in the tissues, 15) in saline action, 23) in the insufficiency of nutrition of capillary wall due to the disturbance of carbohydrate assimilating process7) and in hypophysis.24) In severe stage of diabetes, there occurs the profound dehydration from the excessive loss of water, and it is easily assumed that in the dilution test done under this condition the administrated water is stored in the body, and that by the administration of bread this stored fluid is excreted in a large quantity of urine which goes in parallel with the rise of blood sugar and the increase of urine sugar. After all, severe diabetic patients have a tendency to stor