In this discussion we shall presuppose an understanding of the handicaps of the diabetic patient in addition to his carbohydrate intolerance. We refer to the high incidence of arteriosclerosis, particularly in the coronary vessels and the vessels of the kidneys; the susceptibility to and seriousness of infection both in the field of operation and in the urinary tract; the effect of prolonged or acute sepsis on the diabetic state, and the frequency with which pressure, of little consequence to the non-diabetic patient, may result in an area of necrosis, particularly on the heels and over the sacrum.
We also assume a careful evaluation and treatment of the patient's general condition, with particular reference to his state of nutrition and any vitamin or other deficiency which may exist.
Operations of Election.
—It is our aim, in general, to send the diabetic patient to the operating room well fed, with