Objective-To assess the family history of diabetes in type 2 black South African diabetics with emphasis on the parental phenotype. Design-Prospective case-control study in which family histories were obtained from patients. Setting-Diabetic clinic of a provincial teaching hospital in the Transkei region of South Africa. Subjects-A total of 1111 type 2 diabetics attending the diabetic clinic and 687 controls. Main outcome measures-History of diabetes in parents, siblings, maternal and paternal grandparents, aunts, and uncles. Results-Altogether 27.3% of diabetic subjects had a family history of diabetes compared with 8.4% in the control group (p<0.01). Among the group with positive family history 82.6% reported only one diabetic family member, while 17.4% reported at least two relatives; 6.6% had a diabetic relative from both maternal and paternal sides, and 87.8% had first degree relative with diabetes. Among them there was a significant maternal aggregation with 64.7% of patients having a diabetic mother compared with 27% who had a diabetic father (p<0.01). No maternal eVect was observed among the second and third degree relatives. Patients with positive family history had an earlier onset of diabetes than those without family history (p<0.01). Conclusion-These data suggest that type 2 diabetes is heritable in black South African diabetics. It is also likely that maternal influences may play an important part. (Postgrad Med J 2001;77:323-325)

SummaryGlycaemic control was assessed in type 2 black diabetics attending the diabetic clinic at a peri-urban hospital. Baseline glycosylated haemoglobin levels were measured and a subsequent estimation was carried out in those patients who attended a follow-up consultation to see whether current recommended targets for glycosylated haemoglobin levels were being attained. Out of 708 patients, mean age 56.3 years, 14.7% were insulin treated and 85.3% were non-insulin-treated. Tar

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Knowledge of time of elevation of serum bone ALP activity in normal pregnancy will be helpful in the interpretation of elevated serum total ALP activity during pregnancy.

The effects of carbamazepine monotherapy were investigated in 20 female and 21 male epileptic patients to determine whether treatment would induce an increase in serum alkaline phosphatase (ALP) activity, a known effect of many anticonvulsant drugs. Serum total ALP activity was increased in nine out of the 41 patients (22%), serum bone ALP activity was increased in 10 (24%), and serum non-bone ALP activity was increased in three (7%). There was no significant difference when the mean of the patients'. serum total ALP was compared with that of the controls.Twenty per cent of the patients with increased serum bone ALP had normal serum total ALP, indicating that increased serum bone isoenzyme activity may precede an increase in the total enzyme activity. This should be considered when interpreting results of increased total ALP in epileptic patients. MEASUREMENT OF TOTAL ALPThe serum total ALP was measured at 25°C according to the method of the German Society of Clinical Chemistry,6 using p-nitrophenol phosphate as substrate and diethanolamine buffer (Merck, Darmstadt, Germany). The method was adapted to the Guildford 3500 discrete analyser. PRECIPITATION AND CALCULATION OF BONE ALP ACTIVITYThe precipitation procedure and calculations were performed av described previously.79 An aqueous solution of wheat germ lectin (Sigma Chemical Company, Poole, Dorset) was prepared by adding 5 ml distilled water to 25 mg of lyophilised powdered lectin. This gave a concentration of 5 g/l (139 Mmol/l). To 1 ml of the aqueous lectin solution was added 40 ,l of Triton X-100 (BDH Chemicals Ltd, Poole, Dorset), so that when mixed with an equal volume of plasma the final incubation concentration of Triton X-100 was 20 pl/ml.Fifty microlitres of lectin-Triton X-100 solution was mixed with 50 p1 of serum and incubated for 30 minutes at 37°C. This solution was then transferred to a refrigerator and Alkaline phosphatase isoenzymes in epileptic patients kept at + 4°C for two minutes before centrifugation at 2000 x g for 10 minutes. The supernatant was removed, ALP activity determined, and the measured value was referred to as non-bone ALP. Bone ALP activity was calculated by subtracting the corrected value of non-bone ALP from the total ALP activity, as described by Behr and Barnet.9 Because the precipitation characteristics of the batch of wheat-germ lectin used were not checked, it was assumed for calculation purposes that there was a 100% precipitation of the bone fraction, and that the addition of Triton-X-100 would make precipitation of liver ALP fraction negligible. To calculate the total analytical recovery of isoenzyme activities, the precipitates were resuspended in 200 M1 of isotonic saline and the ALP activity then determined. Summation of the isoenzyme activities of the precipitate and supernatant, followed by an adjustment for sample dilution, produced the value for total recovery of isoenzyme activity.The significance of differences between the controls and patients receiving CBZ was tested using Student's t test. The...