Indications of reduced pulmonary function in type 1 (insulin-dependent) diabetes mellitus.

Abnormalities of pulmonary function tests have been described in type 1 (insulin-dependent) diabetes mellitus (IDDM). To better characterise such abnormalities and to verify whether these latter are associated with the presence of diabetic microvascular disease we compared 23 non-smoking patients who had IDDM with 24 non-smoking healthy control subjects strictly matched for sex, age, and body mass index. Compared with controls, diabetic patients had a reduced forced vital capacity (FVC) (87.5 +/- 13.1% vs. 96.4 +/- 13.6% of the predicted; P = 0.03) and forced expiratory volume in 1 s (FEV1) (90.5 +/- 17.7% vs. 101.2 +/- 13.2% of the predicted; P = 0.02). While within the group of patients the presence of retinopathy and autonomic neuropathy were not associated with modifications of pulmonary function tests, those with altered urinary albumin excretion rate (AER > or = 20 micrograms/min; range 21-589) (n = 7) had a significantly lower pulmonary diffusion capacity (DLCO) than the 16 normoalbuminuric subjects (62.6 +/- 7.2% vs. 88.7 +/- 20.1% of the predicted; P = 0.01). Moreover, in the group of patients, DLCO was inversely related with AER (r = -0.43; P = 0.04). In conclusion, IDDM is characterised by reduced FVC and FEV1, while a significant decrease in DLCO may be considered as selectively associated with renal disease.

Multicentre comparison of the antihypertensive effect of acebutolol and hydrochlorothiazide in uncomplicated mild-moderate hypertension in the elderly.

To evaluate the efficacy of acebutolol, 400-600 mg/day in elderly hypertensive patients, and to compare it with hydrochlorothiazide 25-50 mg/day, 45 patients with mild-moderate uncomplicated hypertension were treated for 6 weeks in a multicentre, single-blind, randomized, crossover trial. Acebutolol decreased supine systolic blood pressure from 186.5 to 162.7 mmHg and diastolic blood pressure from 107.4 to 92.4 mmHg. Hydrochlorothiazide decreased systolic blood pressure from 185.0 to 166.4 and diastolic blood pressure from 107.2 to 96.4. There was no difference between the effects of acebutolol and hydrochlorothiazide on blood pressure during the trial. Both drugs proved to be safe and effective antihypertensive agents, provided the major contraindications for their use were taken into account. Beta-blockade by acebutolol was highly effective in treating mild-moderate arterial hypertension in the elderly.

[Glycosylated hemoglobins and the oral glucose tolerance test in evaluation of glucose tolerance]. / Emoglobine glicosilate ed OGTT nella valutazione della tolleranza glicidica.

We performed OGTT and glycosylated hemoglobin (HbA1) determinations in 62 subjects. In those with IGT we noticed significantly increased average levels of HbA1 in comparison to normal or borderline ones, but 65.3% of the subjects with abnormal OGTT according to Fajans and Conn's criteria and 83.3% of those scored as borderline, had normal HbA1. This latter group showed a positive significant correlation with sum and peak of plasma glucose concentrations at 60 and 120 min during the test. Our opinion is that the mutual presence of abnormal OGTT and of increased HbA1 levels allows a reliable diagnosis of IGT, and the presence of normal HbA1 must induce us to suspect a false IGT diagnosis. 18 normal subjects showed, moreover, a remarkable HbA1 increase 30 days after the glucose load, with a return to basal levels after 40 days, while in 8 subjects with IGT, HbA1 remained constantly unmodified after 30 and 40 days. This is probably a consequence of a difference in daily glycemic profile between individuals with normal glucose tolerance and others with a reduced one.