Patterns of prescription of hypoglycaemic drugs in Gran Canaria (Canary islands, Spain) and estimation of the prevalence of diabetes mellitus.

OBJECTIVE: To study the patterns of hypoglycaemic treatment in our community and to estimate the prevalence of known and drug-treated diabetes mellitus. METHODS: From all the diabetic patients who attended the Healthcare Centers of the National Health Service in Gran Canaria in 1999, a random sample of 2924 diabetic patients > 20 years old was selected. Data on age, gender, clinical onset of diabetes, and hypoglycaemic treatment were obtained. Data on drug consumption were supplied by the National Health Service. RESULTS: Of the DM-2 patients 4.4% (3.65-5.14) 84.2% (82.7785.42), 9.4% (8.34-10.45) and 2.1% (1.58-2.61) received diet only, oral drugs, insulin or combination. The duration of DM-2 was associated with more oral drugs and more insulin treatment, but the duration of DM-1 was not associated with intensive insulin therapy;<50% of the type 1 patients had >or=3 daily injections. The prescriptions of biguanides were scarce; over 1/3 of them were of buformin. DM-1 and DM-2 patients were treated with similar doses of insulin, but DM-1 patients had more insulin injections (2.56 vs 2.07, P<0.001), and more fast-acting insulins (65.2% vs 38.0%, P<0.001). The estimated prevalences of known and drug-treated diabetes in the Gran Canaria island were 5.95% (95% CI: 5.096.80%) and 5.73% (4.88-6.57%). CONCLUSIONS: Our prevalences of known and drug-treated diabetes is among the highest reported in European populations. The prescriptions of metformin and of combined therapy in DM-2, and of intensive insulin therapy in DM-1 are less frequent than expected, but nonetheless insulin therapy in DM-1 is more intensive and uses more fast-acting insulin than in DM-2.

Síndrome de secreción ectópica de ACTH "oculto": a propósito de un caso / "Occult" ectopic ECTH syndrome: a case report

Se define el síndrome de secreción ectópica de ACTH "oculto" como el hipercortisolismo dependiente de ACTH de origen extrahipofisario, sin que tras más de 6 meses se descubra su origen. Presentamos una paciente de 55 años diagnosticada de síndrome de Cushing y tratada mediante suprarrenalectomía bilateral en la que se descubre el tumor carcinoide secretor de ACTH 20 años después (AU)

["Occult" ectopic ACTH secretion syndrome: a case report]. / Síndrome de secreción ectópica de ACTH "oculto": a propósito de un caso.

The occult ectopic ACTH syndrome is ACTH-dependent hypercortisolemia of non pituitary origin, and of more than 6 months duration without the diagnosis of the origin. We report a 55 years old woman diagnosed of Cushing syndrome and treated by mean of bilateral adrenalectomy, in which is discovered an ACTH-secreting carcinoid tumor 20 years later.