Why were "starvation diets" promoted for diabetes in the pre-insulin period?

Abstract

In the decade before the discovery of insulin, the prominent American physicians Frederick Allen and Elliott Joslin advocated severe fasting and undernutrition to prolong the lives of diabetic patients. Detractors called this "starvation dieting," and some patients did indeed starve to death. Allen and Joslin promoted the therapy as a desperate application of animal experimentation to clinical treatment, and texts still describe it that way. This justification was exaggerated. The public record contains only the briefest account of relevant animal experiments, and clinical experience at the time provided little indication that severe undernutrition had better outcomes than low carbohydrate diets then in use.