Dr. Harold Rifkin*, has previously set forth the reasons why we should try to keep the diabetic patient's blood sugar as near normal as possible. What are the generally accepted standards of good diabetic control? Marble 1 considered control of the insulin-dependent diabetic good if the whole blood glucose before meals was not over 130 mg% ( = serum glucose 150 mg%), the 24-hour urinary glucose did not exceed 5% of the carbohydrate intake, and there was no ketonuria; Oakley et al2 defined

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... actory control as blood glucose before meals of less than 150 mg% with no hypoglycemia; Lewis et al,3 in a recent paper dealing with pregnant diabetics, recommended fasting blood glucose below 100 mg% and blood glucose two hours after break fast below 160 mg%. In some diabetics we can accomplish this type of control; in others we cannot. The maturity onset diabetic has some endogenous insulin under autoregulatory feedback control and, with a judicious diet or with the addition of a sulfonylurea drug or some exogenous insulin, near normal blood sugars can be achieved. However, in the juvenile or young adult onset diabetic, with little or no endogenous insulin, it is very difficult, even with complicated schedules of administration of insulin, to get blood sugars anywhere near normal without producing hypoglycemia. A reasonable goal for every diabetic would be to maintain blood sugars as near normal as possible without producing hypoglycemia and without requiring a program so restrictive that it interferes with the quality of life.