Family Practice Vol. 5, No. 1, 68-74
© Oxford University Press 1988
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Selections from Current Literature: Diabetes Mellitus Update
Department of Family Medicine, State University of New York at Stony Brook Stony Brook, NY 11794, USA
Selections from the current diabetic literature define the several gaps in our knowledge but of more importance is the availability of methods to solve these several problems. The recent world wide adoption of standard classification and diag nostic criteria now permits accurate assessments of incidence and facilitates collaborative epi demiological studies. Evidence for prevention of complications by long-term glycaemic control is - not yet firm enough to warrant the risks and costs of aggressive therapy, but control of blood pres sure should be pursued with vigour.
Of considerable interest are current attempts to induce remission in both NIDDM and IDDM patients. The use of short periods of very low calorie diets for the former and cyclosporin for the latter show some promise but still must be considered experimental and not yet ready for ordinary clinical use. Pancreatic transplantation technical problems are being addressed suc cessfully, but although transplants are an unlikely solution for the vast number of IDDM patients, new insights into pathogenesis are fortunate byproducts of this experimental procedure. Lastly, the influence of the psychosocial com ponents, recent life events and social support networks require additional studies but there is early evidence of their effect on management. These recent developments are exciting con ceptually, but unfortunately do not yet signifi cantly change our current management of diabetic patients.