Berge, Kenneth G.

The ability of oral antibiotic treatment to control diabetic diarrhea was documented by a double-blind study involving a patient with this condition. When the patient was given Mysteclin-F, the diarrhea subsided promptly, only to recur when a placebo was substituted,. The erratic behavior of diabetic diarrhea is indicated, however, by the fact that a remission eventually occurred, and no further treatment was required. Although not all patients with diabetic diarrhea respond to antibiotic treatment, its trial merits consideration forthose patients who are refractory to the simpler forms of treatment.

Disturbances of gastrointestinal function have frequently been observed in association with diabetes mellitus. The disorders which have been reported include gastric atony and dilatation, postprandial abdominal cramping, severe constipation, and intractable diarrhea characterized by watery stools, nocturnal exacerbations and fecal incontinence. These disturbances have been attributed by many investigators to alterations in gastrointestinal motility secondary to visceral diabetic neuropathy. The purpose of the present report is to call attention to a group of patients with diabetes mellitus and neuropathy who exhibited diarrhea and steatorrhea which apparently could not be attributed to external pancreatic insufficiency.

Triamterene (2,4,7-triamino-6-phenylpteridine) was employed alone and in combination with hydrochlorothiazide in the treatment of patients with group 1 and 2 hypertension. In 21 patients, triamterene alone had an inconsistent antihypertensive effect on the systolic blood pressure, which was minimal in most patients. In 16 patients the combination of triamterene and hydrochlorothiazide (2:1 by weight) reduced the systolic blood pressure slightly more than did hydrochlorothiazide alone. Triamterene alone or in combination with hydrochlorothiazide produced an increase in the concentration of potassium in serum. Side effects due to triamterene were similar to those noted with thiazide diuretics. In addition, five patients had a decrease in blood hemoglobin concentration, and two patients had reversible alterations in liver function during triamterene therapy. Triamterene may be a useful adjunct for thiazidetreated hypertensive patients by decreasing the likelihood of complicating hypokalemia.

Nicotinic acid was administered orally to 33 patients with hypercholesterolemia in doses varying from 1.5 to 6.0 Gm. per day for periods of 3 months to 1½ years. Significant, sustained, and reproducible decreases in the concentration of cholesterol and total lipids in the plasma and of serum beta-lipoprotein cholesterol were observed in a majority of patients. This form of therapy appears to be effective, practical, and probably free from serious harmful effects.