United Kingdom prospective diabetes study 17: a 9-year update of a randomized, controlled trial on the effect of improved metabolic control on complications in non-insulin-dependent diabetes mellitus

Article Abstract:

Doctors may be able to tightly maintain blood glucose levels in patients with non-insulin dependent diabetes mellitus (NIDDM) at near-normal levels but with an increased risk for low blood sugar complications and weight gain. Researchers reported on the 9-year progress of an 11-year study evaluating the effects of aggressively reducing blood sugar levels (study group) as compared to standard treatment plans (control group) in 4,209 patients with NIDDM. Long-term blood sugar and hemoglobin A1c levels were significantly lower but still above normal in the study group compared to controls. However, the 6-year incidence of low blood sugar complications was higher for patients in the study group taking insulin (76%) and sulfonylurea (45%) as compared to controls (3%). Patients in the study group also gained more weight (5 kilograms (kg) to 7 kg) than the control group (3 kg). Overall, 20% of the patients had large vessel complications and 9% had small vessel complications.

Health aspects, Insulin

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Reduction of lower extremity clinical abnormalities in patients with non-insulin-dependent diabetes mellitus: a randomized, controlled trial

Article Abstract:

Instruction on self-foot-care may decrease the risk of amputation in patients with non-insulin dependent diabetes. Foot damage is common among diabetes patients and can lead to the amputation of the lower limbs. Among 395 patients with non-insulin dependent diabetes, approximately 50% received different types of instruction on self-foot-care and approximately 50% did not (control group). Forty-three patients did not finish the study. Patients instructed on self-foot-care had fewer serious foot lesions or other types of skin abnormalities than those in the control group. Only one patient in the instruction group had an amputation, compared with four in the control group. Individuals who received instruction took better care of their feet and were more likely to have a foot examination during an office visit.

Prevention, Foot manifestations of general diseases, Foot manifestations

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Quinine-induced hypoglycemia

Article Abstract:

Quinine may cause hypoglycemia in individuals who do not have malaria. Hypoglycemia is abnormally diminished concentrations of glucose (sugar) in the blood. A 66-year-old man had had episodes of perspiration, trembling, and weakness over a 2 1/2-year period. These episodes usually occurred immediately before or two hours after a meal. They would end no more than 10 minutes after the patient ate a candy bar. He had been taking 325 milligrams of quinine sulfate four times a day for leg cramps. He had also been taking drugs to treat obstructive pulmonary (lung) disease with asthmatic bronchitis. Tests revealed that he had quinine-induced hypoglycemia. Treatment with quinine has been known to cause hypoglycemia in malaria patients but not in healthy individuals.

Quinine

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