Search

The word mild in this context means that the blood sugar levels are not very much elevated above normal and so the condition does not give rise to troublesome symptoms. Indeed, as often as not there are no symptoms at all and the diagnosis is made by the chance finding of sugar in the urine. This may happen because the patient has been examined for a life insurance policy or because he has seen his family doctor and examination included a routine urine test. Mild diabetes usually comes on in middle age and is often diagnosed by chance in this sort of way. It must be stated, however, that although the term mild is true as far as symptoms are concerned, this form of diabetes can lead to considerable damage to the health of the patient unless it is adequately treated.

Sulphormethoxine is a sulphonamide with a prolonged action, which makes possible the treatment of some varieties of acute urinary tract infection with a single dose of 2 g. In a controlled trial on ambulant patients it was as effective as a seven-day course of ampicillin given in a dose of 500 mg. eight-hourly. The cure rate was 88% with both substances. Side-effects occurred in 3.8% of patients treated with sulphormethoxine and in 16.1% of those who received ampicillin. Sulphormethoxine is not recommended for acute pyelo nephritis. Dr. Gr?neberg was in receipt of a grant from the North-west Metropolitan Regional Board. Dr. I. Lennox-Smith, of Roche Products Ltd., kindly arranged for a supply of sulphormethoxine.

Summary A case of severe lactic acidosis is described in a diabetic taking phenformin who was otherwise healthy. Substitution of metformin for phenformin did not lead to a recurrence of the lactic acidosis.