Improvement of lipid status in diabetic boys: the 1971 and 1979 Joslin Camp lipid levels.

Since 1972, young type I diabetic patients seen by Joslin Clinic physicians have been advised to use a low cholesterol diet with a high proportion of polyunsaturated fat. Mean fasting cholesterol and triglyceride levels at admission to the Joslin Boys Camp for the years 1971 (N = 129) and 1979 (N = 79) were compared. In 1979, the mean cholesterol level was lower by 44 mg/dl (P less than 0.001) and the mean triglyceride by 21 mg/dl (P less than 0.001) compared with 1971. The incidence of hyperlipoproteinemia decreased from 21.6% to 7.6% with a complete disappearance of types IV and V during the same period. A decrease in the development of arteriosclerotic cardiovascular diseases in type I diabetic patients might be anticipated from this diet modification.

Hemoglobin A1c compared with three conventional measures of diabetes control.

Control of diabetes was studied during an 8-wk camp program in 18 insulin-dependent counselors with a mean age of 19.3 yr and a mean duration of diabetes of 11.4 yr. A composite score was obtained for each subject derived from three factors: percent sugar-free urine tests, 24-h glucose excretion as percent of carbohydrate intake, and mean preprandial blood glucose (MPBG). The mean hemoglobin A1c (HbA1c) at the end of the period was 8.3 +/- 1.6% (+/ SD) (normal range, 4-6%). Scores ranging from 24 (fair control) to 45 (excellent control) showed a significant inverse correlation with HbA1c (r = 0.807, P less than 0.001) and MPBG (r = -0.674, P less than 0.01). HbA1c showed a significant correlation with the MPBG (r = 0.693, P less than 0.01). The HbA1c level was predicted better by percent sugar-free urine tests than by the 24-h glucose excretion. Thus it appears that accurate quantification of control may be obtained by using a scoring system. Critical comparison of HbA1c levels to various glycemic indices may provide useful alternatives for estimating diabetes control.

The determination of glycosylated hemoglobins in rats using high pressure liquid chromatography.

Glycosylated hemoglobins (GHb) or fast hemoglobins (FH) are minor components of hemoglobin that so far have been quantified in men, monkeys, and mice, and they are elevated in diabetic subjects of all these species. Since the rat is a useful model for experimental diabetic studies, hemolysates from streptozotocin-induced diabetic rats were analyzed for FH fractions using a high pressure liquid chromatography method. In a long-term study (3 mo), the maximal increment of the FH fractions was achieved after 5 wk of diabetes (from 5.67% +/- 0.41% SD to 10.80% +/- 0.74%) supporting the notion that the biosynthesis of these compounds occurs continuously during the lifespan of the red cell. In a short-term study, however, an elevation of the FH by 11% after 2 days and by 26% after 6 days of diabetes was noticed suggesting that a rapid increase of the FH may occur in relation to rapid changes of the glucose level.

["Paralytic shellfish poisoning" (author's transl)]. / Epidémie d'intoxication par les moules

In October 1976 an epidemic of 120 cases of paralytic shellfish poisoning was recorded in western Europe. Analysis of the 23 cases seen in Swizterland shows the following data; paresthesia of mouth and lips (100%); cerebellar syndrome (86%) with giddiness, ataxia, dysmetry and floating sensation; paresia or paralysis (62%); digestive symptoms (14%); no death. The mean incubation time is 3 hs 30 min; mean duration of the symptoms is 2 days. Half of the patients complain of asthenia and moderate memory disturbance lasting up to 3 weeks. The severity of the illness is in relation to the amount of ingested neurotoxin. The epidemiologic study shows that all European cases were due to consumption of mussels from the Atlantic coast of Spain.