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Aims To characterize the frequency of joint symptoms in patients with Type 1 diabetes mellitus and to determine the subset of patients at risk of developing these symptoms. Methods We invited patients with Type 1 diabetes to complete a survey in which upper limb joint symptoms were scored using a composite of the Shoulder Pain and Disability Index and a visual analogue scale. Family or friends of the participants, without diabetes, completed control surveys. Results A total of 131 patients and 79 age- and sex-matched control subjects completed the surveys. Patients with Type 1 diabetes had higher composite symptom scores than did the control subjects [median (range) score 25 (0-208) vs 12 (0-145); P < 0.001]. Patients with long-standing diabetes had significantly higher median (range) scores than those with diabetes of shorter duration [diabetes >30 years: 63(0-208), 15-30 years: 46(0-168), diabetes <15 years: 17(0-143)]. Patients with diabetic nephropathy had higher scores than those without [median (range) score 103 (0-173) vs 22 (0-208); P = 0.007 between groups]. Neither blood glucose control nor age at diagnosis predicted higher scores. Conclusion Upper limb joint symptoms occur with greater frequency in patients with Type 1 diabetes. Longer duration of disease is the best predictor of symptoms. Blood glucose control does not appear to be associated with development of symptoms. [ABSTRACT FROM AUTHOR]

Presents letters related to medicine. Importance of medical staff awareness about major incident planning; Comments about drug treatment of hypertension; Difficulties faced in the identification of malnourished children by the World Health Organization.

Reports the cases of two patients with long-standing poorly controlled diabetes in whom nicotinic acid (NA) has been used to decrease the occurrence of hypoglycemic episodes. Medical records of the patients; Response of the patients to NA treatment.

Presents a letter to the editor in response to the article 'Nicotinic Acid as Therapy for Dyslipidemia in Non-Insulin-Dependent Diabetes Mellitus,' by Abhimanyu Garg and Scott M. Grundy.