Our study indicates that in intertriginous regions, skin surface pH of diabetic patients is significantly higher than in normal control subjects and implies the significance of skin pH as a possible factor promoting host susceptibility to skin candidal infection.

We performed oral glucose tolerance tests in 158 Ethiopian immigrants to Israel. The subjects were less than 30 yr of age, had lived in Israel less than or equal to 4 yr, and originated from villages in the Gondar and Ambovar regions of Ethiopia. Most had been subjected to famine conditions in Ethiopia and/or extreme hardship in Sudan before or during immigration. All were lean. They revealed a profound change in dietary habits since their arrival in Israel, with consumption of large amounts of refined carbohydrate in place of spicy stews and injura (Ethiopian pita) that had constituted dietary staples in better times in Ethiopia. According to National Diabetes Data Group criteria, 14 (8.9%) of the subjects had diabetes, and another 14 (8.9%) had impaired glucose tolerance. In addition, 13 subjects had a dramatic increase in capillary blood glucose levels (greater than 300 mg/dl) 1 h after ingestion of 75 g glucose, despite fasting and 2-h values well within the normal range, and they complained of associated symptoms during the 1st h of testing. Eleven of 137 men and 3 of 21 women had diabetes; 7 (5.1%) of the men and 7 (33%) of the women had impaired glucose tolerance. These results indicate a high prevalence of diabetes among young adult Ethiopian immigrants of relatively short residency in Israel, for which the factors responsible warrant further investigation.

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Two patients suffering from benign and one patient suffering from malignant insulinoma experienced frequent incapacitating hypoglycemic attacks which did not respond to treatment with streptozotocin, diazoxide and/or diphenylhydantoin. Dl-propranolol, in dosages ranging from 30-240 mg/day, successfully abolished the symptoms of hypoglycemia, prevented recurrent hypoglycemic attacks, and normalized blood glucose levels concomitant with a reduction in pulse rate to 60/min. The main mechanism of the drug's effect seems to be the suppression of insulin release. However, other mechanisms may be involved such as increased peripheral insulin resistance. No side effects of treatment with dl-propranolol were noted. In patients suffering from insulinoma who are refractory to other forms of treatment, and for those who need symptomatic relief before surgery, dl-propranolol may play an important therapeutic role.