No abstract

A 57‐year‐old morbidly obese man with type 2 diabetes for five years, poorly controlled on gliclazide therapy, was referred with hyperglycaemic symptoms including severe daytime malaise and weariness. Features of obstructive sleep apnoea syndrome (OSA) were identified, and confirmed by limited polysomnography. Treatment with nocturnal nasal continuous positive airways pressure (CPAP) was instituted with dramatic relief of daytime symptoms, including morning headaches and also nocturia, which might otherwise have been attributed to changes in blood glucose. Copyright © 2003 John Wiley & Sons, Ltd.

When symptoms occur in the presence of ventricular pre-excitation careful consideration should be given to the patient’s long term management. Bypass tract radiofrequency ablation may be offered as a potential cure for patients with intractable symptoms or in those at high risk of life threatening arrhythmias. In certain cases, ablation may be justified even when symptoms are minor and there are no adverse prognostic factors. Options for treatment are discussed and illustrated by two cases.

No abstract