The Memphis and Atlanta continuing care programs for diabetes. II. Comparative analyses of demographic characteristics, treatment methods, and outcomes over a 9-10-year follow-up period.

A total of 1467 black patients (911 in Atlanta, 556 in Memphis) were selected (1969-70) and followed longitudinally and prospectively until death (404 patients) or through 31 December 1979, when 676 were alive and active and 387 were lost to follow-up. The women/men ratio in each cohort was 4.7/1. Women had more excess body wt than men at maximum weight and at time of diagnosis. At selection, the Atlanta cohort was older (60.2 vs 56.8 yr), had diabetes longer (7.5 vs 5.2 yr), and had a higher initial mean random plasma glucose (MRPG) level (217 vs 195 mg/dl) than the Memphis cohort. The Atlanta cohort was on sulfonylurea/phenformin therapy, which was discontinued at entry. After 9-10 yr follow-up, the MRPG level was not significantly different from the initial level in either cohort, and the Atlanta cohort level was still significantly higher (221 vs 185 mg/dl). Mean weight loss after 9-10 yr follow-up was significantly greater in Atlanta (17.7 vs 6.8 lb). Those under good control in 1979, as indicated by random plasma glucose (RPG) of less than 150 mg/dl, lost more weight (means: Atlanta, 23 lb; Memphis, 8.7 lb) than those under poor control in 1979 (RPG greater than 300 mg/dl; means: Atlanta, 14.7 lb; Memphis, 1.3 lb). In the pooled alive and active cohorts (1979), 29.1% were under good control (RPG less than 150 mg/dl); 52.9%, fair control (RPG = 150-300 mg/dl); and 18.0%, poor control (RPG greater than 300 mg/dl). Of the 639 alive and active patients, paired plasma glucose levels were less than 200 mg/dl in 207 patients in 1969-70 and less than 200 mg/dl in 322 in 1979.(ABSTRACT TRUNCATED AT 250 WORDS)

A cohort study of mortality in two clinic populations of patients with diabetes mellitus.

Mortality rates of two cohorts of patients with diabetes mellitus are estimated and compared. The Atlanta cohort is defined as all black patients receiving care at the diabetes clinic of Grady Memorial Hospital for the first time during calendar year 1971. The Memphis cohort is defined as all black patients referred from the City of Memphis Hospital outpatient clinic to a decentralized neighborhood clinic operated by the Memphis and Shelby County Health Department during September 1969 through August 1970. The Atlanta program discontinued all prescriptions of oral hypoglycemic drugs and emphasized instead an aggressive diet therapy. The Memphis program has used diet therapy but also insulin and/or oral hypoglycemic agents according to current guidelines. The ratios of observed to expected deaths (standardized mortality ratios) were remarkably similar for the two cohorts. In both cohorts the standardized mortality ratios were greatest for the youngest patients and for those patients whose duration of illness was longest. Nine-year survival rates, estimated by the life-table method and adjusted for differences in frequency distributions of entry age and duration of diabetes, were also similar for the two cohorts.

[Influence of various tasks on activation and self-evaluation in a test with equal psychomotor performance]. / Der Einfluss unterschiedlicher Aufgabenstellung auf Aktivierung und Selbsteinschätzung in einem Test mit gleicher psychomotorischer Leistung

In two tests, healthy individuals had to perform one tapping-task each. In the first test they had to knock as quickly as possible (without feedback via the motor performance), while in the second test the motor performance of the first experiment was reproduced precisely by means of feedback allowing them to evaluate the result of their action. In the second experiment, the individuals were significantly less activated, and they felt the second task was easier, requiring less performance. The effect of feedback upon the course of activation, and the role of sensation of activation by the individual in judging his own performance are described.