Care for type 1 diabetes mellitus should both alleviate the physical complications of the disease and improve overall quality of life. The Wisconsin Diabetes Registry, comprising a population-based cohort that is followed longitudinally from diagnosis of type 1 diabetes, provided the authors with a unique opportunity to examine quality of life in children, adolescents, and young adults with type 1 diabetes and its relation to both sociodemographic and clinical risk factors. The authors analyzed data from 1987-2002 with a mean of 10.2 years' duration of diabetes (n = 569). They used ordinal-scaled self-rated global health as a measure of quality of life. In this paper, they propose a random-effects model for drawing inferences on individuals regarding the relation of longitudinally measured quality of life to multiple risk factors. Results showed that male gender, higher parental socioeconomic level, younger age at diabetes diagnosis, shorter diabetes duration, no hospitalization in the preceding 6 months, lower glycosylated hemoglobin level, and questionnaire responses by a person other than the subject were independently associated with better reported health. The authors found that individuals varied in their reported health even after adjustment for all identified risk factors. This could imply either that there is variability in perception even with the same health status or that there are independent unmeasured risk factors for poor health in persons with type 1 diabetes.

FOR THE WISCONSIN DIABETES REGISTRY PROJECTOBJECTIVE -To determine the risk of frequent and severe hypoglycemia and the associated demographic and clinical risk factors.RESEARCH DESIGN AND METHODS -Demographic and diabetes self-management factors were measured in 415 subjects followed prospectively for 4 -6.5 years of type 1 diabetes duration as participants in a population-based incident cohort. Blood samples were collected up to three times yearly to test glycosylated hemoglobin (GHb) levels. Reports of frequent (2-4 times/week) and severe (lost consciousness) hypoglycemia as well as other diabetes selfmanagement data were collected by questionnaires.RESULTS -Frequent hypoglycemia was common (33 and 35% of participants reported this on the 4-and 6.5-year questionnaires, respectively), whereas severe hypoglycemia occurred much less often. Better glycemic control (odds ratio [OR] 1.3 per 2% decrease in GHb, 95% CI 1.1-1.5) and more frequent self-monitored blood glucose (1.5 per blood glucose check, 1.3-1.7) were independently related to frequent hypoglycemia. The association of frequent hypoglycemia with intensive insulin therapy increased with age. Better glycemic control (1.5 per 2% decrease in GHb, 1.2-2.0) and older age were related to severe hypoglycemic reactions. No sociodemographic factors other than age increased the risk of hypoglycemia.CONCLUSIONS -Frequent hypoglycemia was common in a population representing the full range of glycemic control in the community. Intensive insulin management and blood glucose monitoring independently predicted frequent but not severe hypoglycemia. This information may be useful for updating patients such that minor changes in diabetes management might decrease the daily burden of this condition while maintaining intensive insulin therapy. Diabetes Care 24:1878 -1881, 2001H ypoglycemia is the most common acute complication of type 1 diabetes (1). Onset is usually rapid, and symptoms range from very mild to severe enough to cause brain damage or death (2,3). Results of the Diabetes Control and Complications Trial (DCCT) (4) increased emphasis on intensive insulin treatment but also drew attention to the accompanying risk of hypoglycemia with such therapy, particularly in adolescents.The frequency of and risk factors for moderate and/or severe hypoglycemia in young adults were described in studies conducted in clinic-or hospital-based samples (5-8), the DCCT (9), one national cross-sectional study from France, and a limited number of populationbased cohort studies (10 -12). From these studies, it is clear that a history of hypoglycemia (6,9,13) and intensive insulin therapy (9) is an important predictor.Findings regarding other factors such as age, sex, duration of diabetes, and glycemic control are not consistent across studies. The frequency of all levels of hypoglycemia has not been reported. Also, no large population-based cohort has been studied prospectively to determine the relationship of both intensive insulin therapy and glycemic control to frequent and severe hy...

Age at menarche was moderately delayed in young women with type 1 diabetes. Delayed menarche could potentially be minimized with improved GHb levels.

Communicability of rhinovirus type 16 or type 55 was studied in 24 childless couples; on partner (the donor) was infected with laboratory-grown virus. Initially, both partners lacked antibody to the challenge agent. Rates of transmission between partners were 41% and 33% for type 16 and type 55, respectively. These rates are similar to those determined in epidemiologic studies of natural rhinovirus infection. Although the mucosa of the anterior nares was shown to be highly susceptible to infection (less than one 50% tissue culture infective dose [TCID50]), transmission rarely occurred unless (1) at least 1,000 TCID50 of virus was recovered from the donor's nasal washing, (2) the donor had virus on his hands and anterior nares, (3) he was at least moderately symptomatic, and (4) he spent many hours with his spouse. Since person-to-person transfer of rhinovirus was so dependent upon time spent together and shedding of large amounts of virus by the donor, it seems possible that the chain of infection could be interrupted by environmental manipulation.