In the setting of a controlled randomized trial, the immediate feedback of HbA1c results at the time of patient encounters resulted in a significant improvement of glycemic control at 6-month follow-up and persisted for the 12-month study. The introduction of this assay was positively received by both patients and physicians.

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The new cyclopropane-containing steroid phrygiasterol (1) and steroid glycoside phrygioside B (2), along with previously known borealoside C (2a) and (20R,24S)-5alpha-cholesta-3beta,6alpha,8,15alpha,24-pentaol (3), have been isolated from the Pacific starfish Hippasteria phrygiana. On the basis of spectroscopic analyses, using 1D and 2D NMR techniques and some chemical transformations, the structures of 1 and 2 have been established as (20R,24R,25R)-24,26-cyclo-5alpha-cholesta-3beta,6alpha,8,15alpha,16beta,27-hexaol (1) and the sodium salt of (20R,24S)-24-O-(3-O-methyl-4-O-sulfate-beta-d-xylopyranosyl)-5alpha-cholesta-3beta,6alpha,8,15alpha,24-pentaol (2), respectively. Compound 1 inhibited the growth of Ehrlich carcinoma cells with an IC(50) of 50 microg/mL, whereas 2 induced apoptosis of the same cells (EC(50)=70 microg/mL) and inhibited Ca(2+) influx into mouse spleenocytes (EC(50)=20microg/mL).

Two new steroid sulfates have been isolated and a new minor steroid sulfate identified from the starfish Pteraster tesselatus. The structures of the new steroids were established on the basis of spectroscopic data as the 3,21-disulfate of (20R, 25R)-24-methyl-5alpha-cholest-24(28)-ene-2beta,3alpha,21,26-tetraol (1) and the 2,21-disulfate of (20R,25R,S)-cholest-5-ene-2beta,3alpha, 21,26-tetraol (2). The new minor steroid proved to be the 3, 21-disulfate of (20R,25R)-5alpha-cholestane-2beta,3alpha,21, 26-tetraol (3). All the compounds have structural features characteristic for ophiuroid-type steroids.