Knowledge of conditions associated with an increased prevalence of obstructive sleep apnoea (OSA) may help to identify patients with OSA and might give some insight into the pathogenesis of OSA and its sequelae. A number of earlier, smaller studies hinted at an association between diabetic cardiovascular autonomic neuropathy (AN) and OSA. The present study was, therefore, conducted with the aim of establishing the prevalence of OSA in diabetics with AN and of determining whether OSA is more prevalent in diabetics with AN, than in those without.We studied two groups of diabetic patients: 23 with and 25 without AN. All patients were evaluated for possible OSA (apnoea/hypopnoea index Š10) using initial ambulatory screening followed by polysomnography.Six patients with AN (26%) were found to have OSA, but none of the patients without AN met the diagnostic criteria (p<0.01). When the patients with OSA were compared to those without, no differences were found in terms of age, sex, body mass index or diabetes type or duration.In conclusion, about one in four diabetic patients with autonomic neuropathy suffers from OSA. Thus, obstructive sleep apnoea is more prevalent in diabetic patients with autonomic neuropathy, than in those without.

Between April 1987 and May 1990 a total of 212 consecutive patients with tumours in the head and neck region were admitted to a prospective study comparing planned prospective enteral nutrition via percutaneous endoscopically guided gastrostomy (PEG; n = 47) and oral nutrition (n = 134). The nutritional status (anthropometric and laboratory chemical parameters) and the quality-of-life index according to Padilla et al. [Res Nurs Health 6:117-126 (1983)] were determined prior to radiotherapy, 2, 4, 6 weeks later during radiotherapy and 6, 12 and 18 weeks after completion of radiotherapy. The quality-of-life score of the orally nourished patients decreased quickly during radiotherapy and improved only slowly afterwards. Although PEG patients had a worse starting score, their quality-of-life index did not deteriorate during therapy (statistically significant difference between the two groups). The same applies to the nutritional status. These results show that an early and constant enteral nutrition by PEG can stabilize the nutritional state and the quality of life of patients with tumours of the head and neck area during radiotherapy.

Until recently, medium chain triglycerides (MCT) have not been used in parenteral nutrition (PN) although they are considered to be ideal sources of energy on account of their biochemical properties. The tolerance and utilization of 10% fat emulsion with 75% MCT was tested on 10 healthy males after an overnight fast. During an infusion period of 6 hr the total fat supply rate was 0.12 g/kg body weight/hr. A commercial 10% fat emulsion (Lipofundin-S-10) served as control. The fat emulsion containing MCT was tolerated without any side effects. Compared with the commercial fat emulsion, the increase of triglycerides was markedly lower and clearing of the serum was completed earlier. By gas chromatographic analysis of the serum fatty acid pattern, medium chain fatty acids rapidly achieved a steady state. During infusion of the fat emulsion containing MCT, the production of ketone bodies was considerably higher although acidosis was not induced. The results obtained indicate that the fat solutions containing MCT bypass gluconeogenesis and are utilized quickly without side effects.

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