Ethyl chlorophenoxyisobutyrate (CPIB) effects in iuvenile-onset diabetes mellitus Ethyl-a (p-chlorophenoxy)isobutyrate (Atromid-S or CPIB) Department of Medicine, University of Pittsburgh, and the Medical Center and Shadyside HospitalsEthyl-a (p-chlorophenoxy )iso butyra te (CPIB or Clofibrate) available with and without androsterone as Atromid and Atromid-S, respectively, reduces hyperlipidemia in man toward or to normal,2, 3, 4, parent amelioration of diabetes has been observed chiefly or entirely in the adultonset type.The studies herein described point to a hypolipidemic trend during CPIB therapy in young adults with diabetes of juvenile onset. We have been unable to demonstrate, however, a definite antidiabetic action of the drug in such patients. Evaluations with a battery of indices during the above therapeutic trials indicate minimum effects, if any, on endocrine, metabolic, hematologic, hepatic, and other parameters. Serum uric acid did decrease.

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According to our studies and those of others, traumatic perforalion of the esophagus is on the increase; 2,4-19,20 due primarily to the increased frequency of esophageal instrumentation in the diagnosis and treatment of lesions of the esophagus and stomach. Seybold et al, 19 in a study of 50 cases at the Mayo Clinic, reports 21 in the 36 years prior to 1942 and 29 cases in the 7 years through 1949-a seven fold increase.

The data herein presented or reviewed indicate that the prevalence of concomitants or complications of diabetes such as hypertension, obesity, retinopathy, neuropathy, etc. may vary greatly from clinic to clinic. Though variable diagnostic criteria, observer error, ethnic or national differences may account for some of the disparity, selection of patients through death, economic factors, etc., which results in clinic rosters which are not representative of the total diabetic population also plays a role of undetermined significance. Hence definitive statements concerning the relative predisposition of males and females to concomitants or complications of diabetes must await standardization of population and criteria, data on incidence as well as prevalence, and expression of such data on a cumulative basis. Until then we can only speak of findings in limited populations because we have as yet no basis for intergroup comparisons. DIABETES 15:507-10, July, 1966.Among current patients in our diabetic clinic obesity and hypertension are more common in women, and shin spots and absent pedal pulses are more frequent in males. The prevalence of retinopathy, Achilles tendon areflexia, decreased vibration perception, orthostatic hypotension, and peripheral neuropathy is about the same in the two sexes. Comparisons with other centers (tables i and 2) 1 ' 16 reveal wide differences in the reported frequencies of these manifestations in the two sexes and in diabetics as a group. Such differences are however of unproved validity because of obvious limitations in the data stemming from nonuniformity of criteria, patient selection, estimates limited to prevalence,