[The effect of posterior chamber lenses or YAG laser capsulotomy on sensitivity to glare and twilight vision in comparison to phakic control groups (corrected)]. / Der Einfluss von Hinterkammerlinsen oder YAG-Laser-Kapsulotomie auf Blendempfindlichkeit und Dämmerungssehen im Vergleich zu phaken Kontroll gruppen [corrected]

Patients who had undergone extracapsular cataract extraction with implantation of a posterior chamber intraocular lens, and normal subjects of corresponding age and vision were examined with the mesoptometer and nyktometer to compare their twilight vision and glare sensitivity. All the results were poorer in patients with intraocular lenses. Statistically, some of the differences in the results of examinations performed in the two groups were highly significant. As the controls were strictly matched in age and visual acuity, these results confirm other studies with similar objectives. Additionally, some patients with posterior chamber lenses were examined who had also undergone YAG laser capsulotomy for secondary cataract. Although the number of cases was too small for statistical evaluation, it appeared that in this group twilight vision and glare sensitivity could not be improved in the same way as daylight visual acuity by means of this treatment. These findings indicate that since intraocular lenses are increasingly being implanted in younger patients, special attention should also be paid to scotopic vision and glare sensitivity during examinations for drivers' licenses, particularly in cases of good daylight vision. Special examinations, e.g., with the mesoptometer or nyktometer, should be carried out in all such cases. Increased glare sensitivity in eyes with lens implants should also be taken into consideration with regard to the increasing importance of computer and TV screens.

Diet liberalization and metabolic control in type I diabetic outpatients treated by continuous subcutaneous insulin infusion.

In 10 type I diabetic outpatients treated by continuous subcutaneous insulin infusion (CSII), dietary habits and metabolic control were investigated. Under conditions of a conventional diabetes diet (including 5-6 meals per day and a strictly planned meal intake) as well as under a "less restricted diabetes diet" (e.g., free choice of number, timing, and amount of carbohydrate intake) near normoglycemia could be achieved. Mean daily blood glucose levels did not change significantly when the patients' nutrition was alternated between both diets. During the "less restricted diabetes diet," the patients opted for a rather high fat intake (51 +/- 5% fat, 34 +/- 5% carbohydrate, and 15 +/- 2% protein). Despite this unintended dietary behavior, serum lipids and body weight remained normal after an observation period of 4-6 mo. It is concluded that during permanent near normoglycemia achieved by CSII a partial liberalization of the diabetes diet does not introduce any short-term or long-term metabolic risk factors for cardiovascular diseases.

[Continuous subcutaneous insulin infusion brings about normal blood sugar in type I diabetes mellitus despite relaxing of diet instructions]. / Dei kontinuierliche subkutane Insulininfusion ermöglicht Normoglykämie bei Diabetes mellitus Typ-I trotz Lockerung der Diätvorschriften.

In 6 normal weight juvenile diabetic patients treated with continuous subcutaneous insulin infusion (CSII) we have investigated whether the restrictive management of the diabetes diet could be relaxed. On 2-3 days of a 4 week period the patients ate a) a conventional diabetes diet consisting of 3 main meals and in-between snacks of a prescribed carbohydrate content or b) a liberal diabetes diet in which the patients could choose the number of meals and carbohydrate contents. With both diets, mean blood glucose levels during the day were in normal range (96 +/- 3 and 101 +/- mg/dl, mean +/- SEM). On the liberal diet meal frequency and carbohydrate intake per day were significantly lower, the carbohydrate content per meal significantly larger when compared with the conventional diabetes diet. There was not difference in insulin requirements per day (basal rate plus premeal dosage). All the patients preferred the liberal diet. CSII allowed juvenile diabetic patients a more liberal management of their diabetes diet without negative effects on blood glucose control. Hence CSII improved the quality of life in these patients.