GLYCOSURIA AND DIABETES BrMH 1507 with clinitest and if it is positive a glucose-tolerance test should be done. The people whose urine was negative to clinitest would be instructed to bring onehour postprandial specimens on two subsequent occasions. If either of these were positive a bloodsugar examination would be done, but if they were all negative the patient would be instructed to report back in six months. I suggest that such a scheme is possible and very worth while.
SummaryThe results of a comprehensive survey in Halstead, Essex, are reported. Out of 5,843 persons (95.3%/. of the population) included in the survey, 192 cases of glycosuria were discovered-38 known cases of diabetes and 35 newly discovered cases-a total incidence of 1.2%. The newly discovered cases were in subjects over 40 years, and the maximum incidence was in the 60-69 age-group.An attempt was made to classify the other cases of glycosuria into various types. If accurate comparisons are to be made it is essential that comparable methods of blood-sugar analysis and comparable diagnostic criteria are used. The survey confirmed the findings of other surveys that for every known diabetic there is another undiagnosed case. There may be as many as 300,000 undiagnosed cases in the country, and some suggestions are made for the institution of a large-scale postal diabetes detection drive.It would have been impossible to do this work without
A study of the clinical observations and the neuropathological findings in the brain of 16 juvenile diabetics dying of diabetic angiopathy after many years of diabetes is presented. A characteristic histological pattern was observed in all the cases consisting of diffuse degenerative abnormalities of the brain tissue, often with severe pseudoealcinosis or with atrophy of the dentate nucleus, demyelinisation of the cranial nerves, fibrosis of the leptomeninges and angiopathy. The degenerative changes were so pronounced that a dual pathogenesis seems likely; viz. an isehemia caused by the angiopathy and a primary diabetic abnormality of the brain tissue. The clinical symptoms of cerebral disease varied from insignificant to pronounced. A correlation was found between the symptoms and the number of areas of softening in the brain. The histological pattern differs from that seen in other clinical conditions and justifies the term diabetic eneephalopathy.
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