Ten type 1 diabetic patients recorded their daily home blood glucose values, pre- and post-prandially, for 12 weeks. Blood was collected weekly for HbA1c and total haemoglobin measurement. A rolling 28-day mean of all blood glucose values and a glycation index (the ratio of the HbA1c to the rolling mean blood glucose) were calculated. In the pooled patients' data, there was a large scatter of results about the HbA1c versus mean blood glucose regression line. There was less variation in the results of individual patients. The glycation indices showed marked inter-individual variation, and in 60% of patients there was an inverse relationship between glycation index and mean blood glucose, suggesting a non-linear relationship between mean blood glucose and HbA1c. Patients should be monitored on the basis of their own previous results, and in some patients blood HbA1c may be a less sensitive index of mean blood glucose concentration at higher glucose levels.
Pao2 6b5 3-3 Pao2 303 __ 5.Q b7 9.3 4-5 ..7 I> 4.0Q 3.5~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-2-5 2-7 2-9 32 3-53 3-7 40 2-7 29 32 3 53 37 40 P50(74) (kPa) FIG. 2-Calculated relationships between P50 (7-4) and Pvo2 for Pao2 of 13-3, 9 3, 6-7, and 5-3 kPa. Oxygen capacity of 200 ml/I blood and arterial pH of 7-40 are assumed. In (a) arteriovenous content difference (a-v) is 60 mlll and in (b) 40 ml/I. Conversion: SI to Traditional Units-lkPa-7-5 mm Hg. (McKenzie et al., 1964). If high-concentration oxygen therapy could provide a Pao2 of around 13-3 kPa (100 mm Hg) in such shocked patients the transport of oxygen to the cells of the body could be facilitated by an increase in P50, which would then allow oxygen to be delivered with a higher PiTo2 (fig. 2 b). This would cause an improvement in the Po2 gradient driving diffusion of oxygen from capillaries to the site of oxygen usage in the cellular mitochondria (Flenley, 1967). This suggestion now awaits direct trial when a therapeutic agent to raise P50 becomes available. (LHRH) was tested in 12, and eight showed subnormal values. Of eight biopsy specimens obtained four showed acidophil granules on light microscopy, and in five granules of various sizes were seen on electron microscopy.
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