No abstract

No abstract

Serum total cholesterol and triglyceride levels were measured in 12 patients before and 3.6 and 9 months after treatment with amiodarone. In addition, we monitored serum T4, T3, reverse T3 and TSH levels. Amiodarone and its desethyl metabolite levels were measured on each occasion. Serum total cholesterol and T4 levels rose from 5.95 mmol/l, and 102.7 mmol/l respectively at baseline to 6.95 and 115.8 at 6 months and reverse T3 increased at 3, 6 and 9 months from baseline. Serum triglycerides did not change. No relationship existed between cholesterol, T4 and T3 and amiodarone (or its metabolite) levels nor between cholesterol and thyroid hormone levels. These data demonstrate that amiodarone therapy is associated with an elevation in serum cholesterol. This may have clinical implications in view of the current widespread use of the drug.

The characteristics and outcome of 700 consecutive cases of diabetic ketoacidosis (DKA) in Libyan diabetic patients studied over a six month period are reported. Moderate to severe diabetic ketoacidosis was included (M:5 1, F:49). Seventy-eight percent of the episodes were in patients with known diabetes. Ninety-five percent ofpatients with DKA were classifiedas having type 7 diabetes mellitus. Compared to female patients, the male patients had a significantly lower Body Mass Index (BMl) (20.9 vs 22.5 Kc#&, p < 0.001) and more clinically underweight male subjects were identified (20/ 57 vs 6/49, p c 0.01) . The most common cause of DKA was stopping insulin therapy, which occurred in 4 1 % of the episodes, followed by first presentation and infection. A trend towards more male subjects stopping insulin was observed. Mortality was 2%. We conclude that the rnajorify of cases of DKA in Libyan diabetic patients is potentially avoidable by simple education and is associated with a low mortality. Sex-relatedfeatures of patients with DKA are suggestive of a 'male affitude diabetes syndrome ' . Practical Diabetes Int 1999; 16(6): 171 -1 73

It has previously been suggested that amiodarone, used widely to treat refractory cardiac arrhythmias, may induce glucose intolerance. In view of this, we have undertaken a prospective study in a group of 10 patients with normal glucose tolerance profiles requiring amiodarone therapy for control of supraventricular or ventricular dysrhythmias. The patients were followed for a total of 9 months, and glucose tolerance tests and glycosylated haemoglobin were done at 3 monthly intervals in all patients. Both fasting blood glucose levels and glucose tolerance tests were entirely within normal limits in all patients at each stage during the study. Glycosylated haemoglobin did rise significantly at 6 months, but this did not exceed the normal range in the majority of patients and the rise was not sustained at 9 months. In this prospective study therefore, there is no evidence of either glucose intolerance or a diabetogenic effect during prolonged therapy with amiodarone.