In conclusion, in this prospective 2-year study, cholesterollowering therapy was associated with significant reductions in the progressive rise in serum creatinine and urinary protein excretion in 16 NIDDM patients with nephropathy. In addition to the results previously presented [1], these observations provide further support for the potential beneficial effect of cholesterol-lowering therapy on the progression of nephropathy in patients with NIDDM.
Yours sincerely, K. S. L. Lam, I.J. Lauder
Letter to the editors
Normal values of first-phase insulin response to intravenous glucose in healthy Italian children and adolescents
Dear Sir, Loss of first-phase insulin response (FPIR) to an intravenous glucose tolerance test (IVGTT) in first-degree relatives of diabetic patients with high levels of islet cell antibodies (ICA) and/or insulin autoantibodies, is highly predictive for insulindependent diabetes mellitus (IDDM) [1,2]. Normal values of FPIR for adult subjects have been established [1] but very few papers have been published on the paediatric population [3,4]. The present study reports normal values of FPIR to IVGTT in a large paediatric population.
Working in close collaboration 21 Italian paediatric diabetes units tested 138 healthy subjects (47 females and 91 males) aged 3-20 years (mean: 10 _+ 3.7 (SB) years), without endocrinopathy, short stature, obesity, family history of IDDM, history of drugs, history of hypoglycaemia or fasting plasma glucose more than 5.5 mmol/1. In all subjects sex, age, weight, height, BMI and pubertal stage (according to Tanner) were recorded along with fasting plasma glucose, HbA 1 c, ICA and antibodies against glutamic acid decarboxylase (GAD65). Subjects were divided into three groups on the basis of pubertal stage: Group 1 at stage I (n = 70), Group 2 at stages II-III (n = 41) and Group 3 at stages IV-V (n --27). Before the study, the protocol was approved by the local institutional review board for human experimentation in each centre, and parents gave their written informed consent.
The procedure for the IVGTT followed the guidelines of the National Diabetes Data Group [5]. FPIR was expressed as the sum of the insulinaemia values at 1 and 3 min. Fasting