Islet-cell antibodies in diabetes mellitus

Islet-cell antibodies (I.C.A.) were found in 38% (319/829) of insulin-dependent diabetic patients, in 5% (6/112) of insulin-independent diabetics, and in 1.7% (3/177) of non-diabetic subjects. In the insulin-dependent group I.C.A. were found in 85% of patients immediately after the onset of symptoms and they became less common as the duration of disease increased I.C.A. were equally common in both sexes and the decline in their prevalence was independent of age. The antibodies were directed against cytoplasmic components of islet cells but not against insulin itself. The appearance of I.C.A. probably follows cell damage occurring before the onset of symptoms. By contrast, thyroid and gastric autoantibodies were more common in older patients and females. There was no correlation between the presence of these antibodies and I.C.A. in patients with either diabetes of recent onset or longstanding disease.

Volume holographic recording characteristics of an organic medium

Volume holographic recording characteristics of camphorquinone in a rigid, acrylic polyester host are presented and related to the observed photoinduced refractive index changes. The dependence of the holographic recording on camphorquinone concentration, temperature, and light intensity is discussed in detail. The holograms are permanent and develop to their final efficiency slowly at room temperature. Heating after exposure can be used to accelerate fixing of the hologram.

Is glucagon important in stable insulin-dependent diabetics?

The role of glucagon has been evaluated in the everyday regulation of carbohydrate and lipid metabolism in insulin-dependent diabetic patients. Plasma concentrations of glucagon, growth hormone, cortisol, glucose, and free fatty acids and blood concentrations of glycerol, 3-hydroxybutyrate, acetoacetate, alanine, pyruvate, and lactate were measured in 38 fasting diabetic subjects deprived of their usual morning dose of insulin. The measurements were repeated in 25 of these patients after a further 3 hours of insulin deprivation and in 6 patients again at 6 hours. There was no correlation between the initial fasting levels of plasma-glucagon and those of the other biochemical measurements including glucose and ketone bodies. Furthermore, no correlation was found between changes in these measurements and in plasma-glucagon over a period of 3 or 6 hours. These findings suggest that glucagon is unlikely to play a role of primary importance in blood-glucose homoeostasis or ketone-body metabolism in ambulant insulin-dependent diabetic patients.

Register of newly diagnosed diabetic children

In November 1972 the British Diabetic Association sponsored a register to which notification was invited of all new cases of diabetes occurring in children aged 0-15 years in Great Britain and Ireland. More than 2000 cases were notified in the first two years. Notification suggested that there was a minimum yearly incidence of 7-67 cases per 100 000, though incidences varied from year to year and by geographical area. Several reports of simultaneous onset of diabetes in sibs of different ages provided evidence of clustering. A seasonal variation in incidence was found in children aged 5-15 years with peaks in the autumn and winter. The age distribution was bimodal with a main peak at about 11 years and a secondary peak at about 5 years. The sex ratio showed a male excess from 0-4 years and from 11-15 years and a female excess from 5-10 years. Overall there were slightly more male cases. Altogether 11% of patients had a first-degree relative with diabetes. The register and several investigations based on it will continue.

Lactic acidosis occurring during phenformin therapy

A case of severe lactic acidosis is described in a diabetic taking phenformin who was otherwise healthy. Substitution of metformin for phenformin did not lead to a recurrence of the lactic acidosis.

Assessment of the need for continued oral therapy in diabetics

Hypoglycaemic agents were replaced by placebos in diabetic patients attending a hospital clinic. Of 62 patients observed, 43 (69%) relapsed within six months but blood sugar control remained unchanged in 19 (31%) during the period of observation.

Pheniformin in insulin-dependent diabetics

Forty-one diabetic patients on insulin were given 100mg. of phenformin daily for six weeks, either before or after a period of six weeks of inert capsules, in a double-blind cross-over trial. Eleven patients while on phenformin noticed hypoglycaemic effects and reduced their insulin on average by almost 20% without resultant rise in blood sugar levels. Twenty-eight patients felt no untoward effects and maintained their usual insulin dose. Phenformin led to improved control of the diabetes, with a significant decrease in blood sugar levels and a significant reduction in the variability of the weekly blood sugar readings. There was no increased ketosis, no change in cholesterol, and no significant loss of weight.

Tertiary hyperparathyroidism with fluctuating serum calcium levels

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Hypogonadism and muscular dystrophy

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Clinical application of "Dextrostix" in estimating blood glucose levels

1. In its present form Dextrostix does not provide a reliable measure of blood glucose. 2. When modified and simplified it proved of great value in the management of diabetes in certain clinical situations.

Acromegaly Hyperparathyroidism and Diabetes Mellitus

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Addison's Disease Presenting as Psychosis

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