The pharmacokinetics and the endocrine profile of a new low molecular somatostatin derivative, SMS 201\p=n-\995, were investigated in a group of 35 normal subjects. Clearance studies (n = 6) for this peptide showed a prolonged half-life in plasma, 113 min, following single sc injections of 50 or 100 \ g=m\ g. Arginine stimulation tests (n = 6) were conducted immediately and 180 min after sc injection of 50 \ g=m\ g of SMS 201\p=n-\995. The stimulatory effect of arginine on GH and insulin was counteracted by the peptide at the P < 0.001 and P < 0.02 significance level, respectively. Delayed arginine stimulation revealed a persistent blockade of the GH release (P < 0.02), whereas a recovery of the insulin response was observed. Plasma

(i) Routinely collected practice data can be used to evaluate quality of care; (ii) 40% of patients in primary care have cardiovascular disease or diabetes; (iii) even in high-risk patients, the majority does not achieve treatment goals; and (iv) achieving the treatment goals would reduce the proportion of high-risk patients from 20 to <5%.

Counterregulatory secretion of epinephrine occurs during severe insulin-induced hypoglycemia. Under these conditions (minimal plasma glucose 27.4 +/- 1 mg/dl) the decrease of serum potassium concentration (0.9 mVal/L) is mediated by two mechanisms: insulin-induced (0.48 mVal/L) and epinephrine-induced (0.42 mVal/L) cellular uptake of potassium. Epinephrine-induced serum potassium uptake appears to be more sensitive to beta-adrenoceptor blockade than glucose production. The intensification of insulin-induced hypokalemia by epinephrine is of clinical significance.

Human insulin (recombinant DNA) and purified porcine insulin were compared in healthy men. Intravenous insulin tolerance tests showed identical effects on plasma glucose when a bolus of 0.1 U/kg was injected. Following human insulin, hypokalemia and epinephrine secretion were significantly less pronounced. The differences in serum potassium concentrations are caused by a lower epinephrine response to hypoglycemia induced by human insulin in comparison to purified porcine insulin.