European Stars And Stripes (Newspaper) - August 21, 1978, Darmstadt, Hesse                                Poge 18 the stars and stripes i modern Medicine   recent newspaper stories have not Only created stir among the general but created much confusion and doubt in the minds of people with Dia these based on a report from a group of centers collaborating in the treat ment of were published across the nation with headlines that repeated one Basic theme insulin seen no help in preventing complications of the report indicated that diabetic patients followed Over a period of years seemed to have no fewer complications of diabetes when August 1978 debate on insulin use in diabetes still rages they kept their blood sugar under close control with insulin than comparable patients whose blood sugar allowed to stay quite High the implication of the newspaper stories was that this was dramatic showing that insulin didst prevent the kidney and arterial problems distressingly common among people who have severe diabetes for Many this recent research significant As it actually added no real news to a debate that has been continuing in medical circles for at least 40 severe diabetes smoking and taking the Pill linked to brain Haemorrhage new York Natl women who both smoke and take birth control pills Are about 22 times More Likely to sustain a commonly fatal Type of brain Haemorrhage than Are women who do a new medical study has the scientists in a recent Issue of the British medical the thai Oral contraceptives should not be used by i women who go smoking and the Pill have Long independently linked to an increased of death from cardiovascular 5 new study confirms the belief that the two l pose a risk far greater than either the study indicates that the two factors act multiplying one another of a on the women who smoked Cigar l but did not take the Pill sustained brain Jorr Hages limes More frequently than i women who neither smoked nor took the women under reversed i did not smoke but did use the had a Rorr Hage rate times the effects of either Factor acted ind Epen the combined risk would be expected she the sum of the two or in t was nearly or this or effect is Lilar to what is already known about the t of heart attack among women who smoke i use Oral new study involved a Type of bleeding i the brain which is known As Subarich the immediate cause of i bleeding is not but is believed to Dve weaknesses in the Walls of blood ves i that permit them to rupture under certain it is not known whether Tobac co and contraceptive drugs cause the weak Ness or act upon a congenitally caused weak v the new report was made by Diana Petitti and John of the Kaiser per Manente medical Center in Walnut an epidemiologist specializing in the hazards of Oral is there on assignment from the Public health services Center Lor disease control in Atlan their report is a product of continuing evaluation of the effects of birth control plus on the study began in 1969 when nearly California mostly suburban and Middle were enrolled Fol lowing comprehensive physical Examina the women have been surveyed each year to revise their status As users or nonus ers of birth control As smokers or non smokers and on a variety of other factors including major Between 1969 and of the women sustained sub arachnoid each Vic Tim was then matched with All the other women in the study of the same age and whose status on the Pill and smoking were this meant each victim was compared to Sev eral Hundred other women born in the same about 36 percent of the victims were both users of Oral contraceptives and Only percent of the controls were by calculating these percentages with the sizes of the two the researchers established the relative risk to be times greater in one group than the results from the under production of insulin by the when scientists Andl Macleod first used insulin to treat human diabetes in the they found that it rapidly lowered the blood sugar level to Normal and thus prevented what then the leading cause of death in diabetics coma and acid oils due to enormously ugh blood sugar what  be proved and still Hast been is whether lowering the blood sugar to near Normal can prevent the deterioration of Saab blood vessels Arterioles throughout the Over the Yean tends to produce loss of kidney nerve and plications of some researchers argue that Art Foles damage May be Comet dental certain such As Bostons Bosun have been Strong advocates of tight control of Irth frequent and careful insulin dosage designed to keep the blood sugar As Cloee to Normal As other diabetes such As the late Henry have argued that insulin is helpful Only in preventing death from acidosis and and has no effect on the so called complications of the specialists have argued that insulin should be merely to keep the blood sugar level below that which would cause symptoms or coma and aside from tight control is an unnecessary imposition on the lifestyle of the the new collaborative research merely adds evidence to one Side of tile debate that has been going on for so it is unlikely that the advocates of tight control will be convinced by the spokesmen at the Joslin clinic have already questioned the results of the the individual diabetic should not be astounded that the report was issued or that scientific debate continues Over such a fundamental neither should the individual patient whose personal physician has been an advocate of tight control of diabetes be prompted to aban Don Bis or her treatment without discussion with the what the report does Indi Cate is that for some patients for whom tight control provide constant demoralizing restrictions in everyday a More variable diet and insulin schedule May perhaps be just As Safe As tight my own feeling is if blood sugars close to Normal can be established with a simple in Sulin regimen and a moderate it is Best to keep the blood sugar level dose to  dear Ann Yon doing Days tin u always had a Tobey current i have 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