It is evident to those who see a considerable number of patients with diabetes that, if the disease is classified according to its actual onset, two main forms are encountered. One form begins acutely and is ushered in with the abrupt appearance of the symptoms familiar to every physician. The course is usually downward; this form usually attacks persons less than 40. The other may be so gradual in onset and course in some instances that it is impossible to determine the date of origin. The presence of sugar in the urine is discovered quite byaccident. Diabetes which comes on insidiously is ordinarily associated with obesity and arteriosclerosis.
In taking the history of patients with acute diabetes, when the date of onset can be fixed with reasonable certainty, I was impressed by the fact that there are certain seasons of the year when the onset of the disease is more