Dose-effect titrated treatment with either metformin or glyburide promotes equal degrees of glycemic control. The former, but not the latter, is able to achieve this control without increasing body weight or hyperinsulinemia. Near-normal glycemia can be obtained by a combination of metformin and sulfonylurea, even in advanced NIDDM.

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Abstract. Norlund A, Apelqvist J, Bitze Ân P. Objective. To determine costs of illness for adult diabetes mellitus (DM), including complications caused by DM. Design. A population-based multicentre crosssectional study including an interview and a physical examination of patients identi®ed as having DM. The patients' medical records were analysed regarding diagnoses and complications attributable to DM. Setting. Eight health care centres of six primary care districts in Southern Sweden. Subjects. 1677 adults aged 25+, cared for at the health care centres, entered the study.Main outcome measures. Utilization of health care and care from relatives and the municipality, absence of short-and long-term sickness, cost of illness. Results. The average annual direct and indirect costs for an adult with DM were calculated to be 61 700 Swedish Kronor (SEK) or 2.5 times higher than earlier estimates. The incremental cost of DM was 34 100 SEK. The cost distribution was 28% for health care, 31% for the municipality and relatives and 41% lost productivity. Conclusions. Calculations for the cost of illness of DM are underestimated if comorbidity caused by DM is not considered. When DM-related complications are included to identify the actual burden of disease to society, the cost of illness as a result of DM in Sweden is substantially higher than previously estimated.

Breast milk and plasma levels of paracetamol were monitored in 3 lactating women after ingestion of a single 500 mg dose of paracetamol. The paracetamol concentrations were consistently lower in milk, with a mean milk/plasma AUC ratio of 0.76. This value was in close agreement with the milk/plasma partition ratio of 0.81 found in vitro, and could be related to quantitative binding differences between the two fluids. The half-lives of paracetamol in plasma and breast milk were almost identical, with an overall mean of 2.7 h. As less than 0.1% of the maternal dose would be present in 100 ml milk, breast feeding need not be discontinued due to paracetamol treatment in conventional dosage.