Several studies have clearly shown the impact of modernization on the prevalence of diabetes mellitus in susceptible communities. Saudi Arabia has faced a rapid development program over the last two decades. In a recent study, we found a high prevalence of diabetes mellitus in urban Saudi Arabia. A total of 5222 rural subjects of both sexes were involved in a study of the prevalence of diabetes mellitus in the western region of Saudi Arabia. Random capillary blood glucose, body weight and height, and income were recorded. The results showed an overall prevalence of 4.3%. There was a rise of prevalence with age and higher-income groups. Prevalence also differed with sex. The overall prevalence in women (5.9%) was twice that for men (2.9%; P less than .001). Obesity occurred in 41.2% of our diabetic subjects compared to 29.3% in nondiabetic subjects (P less than .001). Multiple logistic regression analysis with body mass index (BMI) as the dependent variable showed that sex and income status were significant factors (P less than .0001 and P less than .04, respectively). When blood glucose was fixed as the dependent variable, the analysis showed that age, income, and BMI were significant factors (P less than .004, P less than .0001, and P less than .045, respectively).

The value of glycosylated fibrinogen as an index of short-term diabetic control was compared with indices of long-term (glycosylated haemoglobin) and intermediate-term (glycosylated albumin) diabetic control, respectively. In this study, percentages of these glycosylated proteins and fasting plasma glucose concentration were determined in 95 healthy non-diabetic subjects and 48 diabetic patients (22 well-controlled and 26 poorly-controlled) after an overnight fast. The differences in the percentages of glycosylated fibrinogen, haemoglobin, and albumin between non-diabetic subjects (4.7, 6.4, and 2.0), well-controlled diabetic patients (6.9, 9.5 and 2.9), and poorly-controlled diabetic patients (11.3, 15.8, and 5.1) were statistically significant (p less than 0.05). The percent glycosylated fibrinogen exhibited significant association with severity of hyperglycaemia when diabetic patients were divided by 2, 4, and 6 standard deviations above the mean of fasting plasma glucose of non-diabetic subjects. There were significant correlations between glycosylated fibrinogen and fasting plasma glucose (r = 0.83, p less than 0.001), glycosylated haemoglobin (r = 0.94, p less than 0.001) and glycosylated albumin (r = 0.92, p less than 0.001) for all subjects studied. In ten newly diagnosed diabetic patients after 6 days of treatment, only the decrease in glycosylated fibrinogen (33.4%) was significant (p less than 0.05), but not that of glycosylated haemoglobin (4.8%) or albumin (8.0%). It is suggested that glycosylated fibrinogen provides the clinician with earlier objective evidence of the metabolic response to therapeutic intervention, and might be regarded as a short-term (2-3 days) index of blood glucose control.

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A rapid, highly sensitive high-performance liquid chromatographic method has been developed for the determination of phenobarbital, carbamazepine, phenytoin and its main metabolite, 544-hydroxyphenyl)-5-phenyl hydantoin, in 50 pl of serum. Serum protein was precipitated with an acetonitrile solution containing 5-(4-methylphenyl)-5-phenylhydantoin as the internal standard. The drugs were eluted from a 5 pm, C-18 reversed-phase column at 40 "C with a mobile phase consisting of an acetonitrilemethanolphosphate buffer of pH 4.8 (22 + 28 + 50% VIV), at a flow-rate of 1 ml min-1 with UV detection at 214 nm. Each analysis required no longer than 12 min. Quantitation was achieved by the measurement of the peak-height ratio and the relative and absolute recoveries varied from 94 to 109%. Within-day coefficients of variation ranged from 1.2 to 3.22% and between-day coefficients of variation from 2.0 to 3.4% in subtherapeutic, therapeutic and toxic concentrations. Keywords : High -perf0 rma nce liquid ch rom a tog rap h y; p h en o ba rbita I; ca rbam azep in e; p h en ytoin; 5-(4h ydroxyphen yl)-5-phen ylh ydantoinPaper A51299

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