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Established urodynamic and electrophysiological techniques have been applied to assess the frequency and extent of autonomic and peripheral neuropathy in 60 subjects with diabetes mellitus; 38 were diabetics with suggestive symptoms and the others were representative newly diagnosed (11) or treated (11) diabetics. Objective evidence neuropathic bladder dysfunction was detected in 43 of them (71.7%). The commonest abnormality was a hypotonic, insensitive large capacity bladder, which condition was usually asymptomatic. Less freuqently (15%) was this complicated by bladder decompensation and sphincter involvement, resulting in excessive residual urine and infection; some of these had bladder paralysis with chronic painless retention of urine (7%). Electrophysiological studies found a sensory defect in the lower limbs in all tested patients (100%), and in 41 patients (69%) as associated motor conduction abnormality, which was more frequent and marked in the lower than the upper limb. These functional abnormalities appeared to be related to the severity of diabetes, but less to its duration. Indeed of 11 newly diagnosed diabetics tested 7 had a peripheral neuropathy and 4 urodynamic abnormalities. The high incidence of bladder dysfunction and peripheral neuropathy in this series indicates the frequency of subclinical diabetic neuropathy and a factor needing more emphasis in diabetic uropathy.

Abstract. Free fatty acid and triglyceride metabolism was studied in diet‐responsive and insulin‐dependent diabetics and in non‐diabetic obese patients before and during treatment. Free fatty acid turnover was elevated in diabetics and in most obese patients, and was decreased by diabetic control; it showed no significant change in the obese patients during caloric restriction. Plasma triglyceride levels exceeded 160 mg/100 ml in 20 of the 34 diabetics, and gross lipaemia occurred both in insulin‐requiring and diet‐responsive patients. The fractional turnover of injected triglyceride was low in 20 of 33 measurements on untreated diabetics, and was negatively correlated with endogenous triglyceride levels. The fractional turnover increased significantly during diabetic control. These findings are compatible with the view that diabetic hypertrigly ceridaemia may be due in part to impaired removal of triglyceride from plasma.

shown an increase in the excretion of the 17-OHCS as well as of the 11-deoxy-17-oxosteroids in the first three days and a return to normal in about a week. A decrease in androsterone and aetiocholanolone excretion while there is an increase in 17-OHCS excretion after resection in lung cancer seems to be an unusual response to surgical stress and indicates a separation of the factors controlling the excretion and possibly the secretion of the precursors of the 17-OHCS and the 17-OS. This dissociation of the factors that control the excretion of the 17-OS and the 17-OHCS as a response to surgical stress may persist for several months both in breast cancer (Bulbrook and Hayward, 1967) and in lung cancer (Rao, unpublished), and may be a characteristic of neoplastic disease in general.I thank Miss Margaret L. Hewit, who carried out many of these steroid determinations with the help of Mr. G. Lynam and Mr. A.