Temporal trends in spontaneous abortion associated with Type 1 diabetes.

The objective of this study was to investigate temporal changes in the reported rates of spontaneous abortion associated with Type 1 diabetes. Individuals from the Children's Hospital of Pittsburgh Type 1 Diabetes Registry for 1950-1964 (n=495) completed a self-report reproductive history questionnaire in 1981 that was updated in 1990. Data from both surveys, which proved to be valid and reliable, were utilized for this report. More spontaneous abortions (26.8 vs. 7.7%, P<0.001), stillbirths (4.7 vs. 1.2%, P<0.001) and induced abortions (7.0 vs. 0.9%, P<0.001) were reported for Type 1 diabetic women than for the non-diabetic partners of Type 1 diabetic men. A significant temporal decline in the rates of spontaneous abortion for Type 1 diabetic women was observed (< or = 1969: 26.4%; 1970-1979: 31.0%; 1980-1989: 15.7%; P<0.05). No differences were apparent for the non-diabetic partners of Type 1 diabetic men (< or = 1969: 4.2%; 1970-1979: 9.5%; 1980-1989: 5.7%; P>0.05). Temporal changes in medical care for women with diabetes (i.e. self-monitoring of glycemic control) may have contributed to a recent reduction in spontaneous abortions associated with maternal Type 1 diabetes.

Insulinoma in a 94-year-old woman: long-term therapy with verapamil.

Several drugs can be used to control hypoglycemia caused by insulin-secreting pancreatic tumors but none are reliably efficacious or free of side effects. We report the case of a woman with an insulinoma who refused surgical intervention and was successfully treated with the Ca2+-channel blocker verapamil.