the above results, based upon purely clinical observations, would seem to support Allen's view that blueberry leaf extract has a stabilizing influence upon the carbohydrate tolerance of certain cases of diabetes. that is cannot take the place of insulin need not be gainsaid. but if it can be shown to permit to dosage or frequency of administration of insulin to be decreased,or cases, or allow for added carbohydrate intake without increasing insulin,its use is justified. judgment regarding the value of a therapeutic agent of this sort is truly difficult and one must weight the evidence carefully before arriving at conclusion.
the fallacy of basing opinions upon a small number of observation is also realized. As everyone familiar with the malady knows,the course of diabetes is variable. There exist all grades of severity between the case which can be readily controlled by minor dietary restrictions and that which cannot be balanced even with large doses of insulin. That carbohydrate tolerance does improve as a result of, or in spite of,insulin is common experience. An example is shown in Table V, in which the daily amount of insulin was reduced from fifty-five unit to zero in the course of about eight weeks had any treatment been employed other than that which was used in the cases, one might have been led to quite erroneous deduction.
Tangible evidence in favour of the regeneration of pancreatic islet tissue as a result of insulin has been furnished by Boyd and Robinson. it is also true that the daily insulin requirement of many patients remain unaltered or even need to be increased. such cases have been reported by Newburgh Harrison and Brace. efficient diabetic therapy is a composite process to which many factors contribute. whereas insulin acts as a specific under certain conditions, the mainstay of diabetic treatment still lies in the realm of dietary regulation. the importance of under nutrition has been emphasized by Rabinnowitch. other factors which are known to influence carbohydrate metabolism in the diabetic,such as muscular exercise ,infections,an altered basal metabolism, and time, should be given their proper due in any individual case.