Abstract. To examine the short-and long-term influences of the Marmara earthquake, which occurred on August 17, 1999 in Turkey, on glycemic control and quality of life (QOL), HbA 1c, insulin requirement and QOL of 88 people with type 1 diabetes living in the quake zone were evaluated one year before (PreE), 3 months after (PostE) and one year after (FE) the earthquake. HbA 1c levels and daily insulin requirements increased significantly at PostE (HbA 1c from 7.4 ± 1.3% to 8.5 ± 1.8%, p<0.05; insulin from 0.58 ± 0.2 IU/kg/day to 0.77 ± 0.2 IU/kg/day, p<0.05). Mean total QOL scores at PostE were significantly lower than the scores obtained at PreE (62.7 ± 17.3 vs 74.2 ± 13.4, p<0.001). There were no significant differences between HbA 1c levels and total QOL scores at PreE and FE. People with type 1 diabetes living in the same house after the earthquake and not having enough food supply were reported to have lower QOL than people moving to another house and having enough food supply after the earthquake (p = 0.014, p<0.0001, respectively). The Marmara Earthquake had a negative impact on the glycemic control and QOL of the subjects with type 1 diabetes for the short term but prequake scores might be achieved after a long period.

The results of the study demonstrate that acarbose and gliclazide were reasonably effective in improving metabolic control in patients insufficiently controlled with diet alone, and both treatments were well tolerated. Because of its effects on weight reduction and PP hyperinsulinaemia, acarbose may be preferred as a first-line drug, particularly in the treatment of overweight type 2 diabetic patients.

We read with great interest the article by Wang et al. 1 We would like to draw your attention to the results of our study which evaluated the impact of Marmara earthquakes (Turkey) on 17 August and 12 November 1999, on the quality of life (QoL) of our type 1 diabetic patients using the WHO Well Being Questionnaire (W-BQ).The study included a group of patients (n = 77; males 47%; age 24.2 ± 8.5 years) who had participated in a previous QoL study in October 1998 and they were affected by at least one of the quakes. For the new study, data were collected in the third month following the second quake and compared to results of the previous ones. In addition, metabolic control (HbA1c), body mass index and daily insulin requirement were assessed before and after earthquakes. In the meanwhile, the type of effect by the earthquake, socioeconomically and/or physically, was investigated via a questionnaire which was completed by the patients.According to our results, W-BQ scores were affected inversely by the quake. Mean total W-BQ score was decreased from 69 ± 13 to 44 ± 14 (P < 0.001). However, depression and anxiety scores increased significantly (prior and after the quake; 34 ± 14 vs 54 ± 13; P < 0.001 and 41 ± 18 vs 70 ± 19; P < 0.001, respectively). Our results also revealed the scores for positive well-being and energy decreased from 64 ± 21 to 36 ± 20 (P < 0.001) and from 73 ± 18 to 62 ± 20 (P = 0.008), respectively. When the data were compared before and after the quakes there was no difference for body mass index (23 ± 1.4 vs 23 ± 2.8 kg/m 2 ). However, HbA1c (7.4 ± 1.5 vs 8.8 ± 2.5%; P < 0.001) and daily insulin requirement (0.58 ± 0.3 vs 0.75 ± 0.3 IU/kg per day; P < 0.001) were increased. Moreover, physical and/or socioeconomic impacts of the quake obtained from the questionnaire were not found to be changed in parallel to the psychological impact (DW-BQ scores) of the quake. Finally, we did not find any meaningful difference in W-BQ scores of the subgroups of those who were affected seriously or those who were affected minimally by the earthquake in terms of physical and socioeconomical levels. The fact may be explained by the limited number of injured people in the study cohort. Those who were not seriously affected still have a strong fear of a new quake. REFERENCE1. Wang X, Gao L, Zhang H et al. Post-earthquake quality of life and psychological well-being: Longitudinal evaluation in rural community sample in northern China.

Erythrocytes glutathione (GSH) levels were measured in erythrocytes from 33 subjects, at baseline and after 2-hour glucose loading in order to investigate the effect of glucose ingestion on the erythrocyte GSH. According to the World Health Organisation criteria 18 subjects had normal glucose tolerance (NGT)(mean age 48 +/- 10 years, 10 women, 8 men), 15 subjects had impaired glucose tolerance (IGT)(mean age 52 +/- 8 years, 9 women, 6 men). After 12-hour fasting, erythrocyte GSH levels were 40.5 +/- 8.06 and 39.27 +/- 10.26 mg/dl hemolisate in subjects with NGT and IGT, respectively (p = N.S). After 2-hour glucose loading, erythrocyte GSH levels decreased to 36.01 +/- 9.4 (p < 0.05) and 32.36 +/- 5.7 (p < 0.005) in subjects with NGT and IGT, respectively. The decrease in erythrocyte GSH levels in subjects with IGT was greater than in NGT individuals (p < 0.001). There was negative correlation between glucose, insulin, C-peptide, and erythrocyte GSH levels after glucose loading (p < 0.005). Our results suggest that glucose loading induce an oxidative stress in all subjects but this oxidative stress is greater in subjects with IGT than with NGT.

No abstract

No abstract

No abstract

No abstract