Minerva

Estimates in the United States suggest that non-insulin dependent diabetes mellitus is typically present for 10–12 years before a clinical diagnosis is made (JAMA 1996;276:1261-2). Earlier diagnosis should reduce morbidity from complications such as retinopathy. A study in California (276:1246-52) has now shown that measurement of the glycated haemoglobin concentration is a more convenient and sensitive test than glucose tolerance and will identify people with unrecognised diabetes who need treatment.

Care of the survivors of major accidents and disasters such as the shooting at Dunblane in Scotland includes attention to their psychological trauma. An editorial in the “British Journal of Psychiatry” (1996;169:405-7) draws attention to the paradox that less attention is given to the victims of road accidents—simply because they are so frequent as to seem commonplace. More than half the total of injuries to pedestrians are to children, and these child victims often need prolonged psychological support. There is still a widespread but mistaken belief that mentioning or discussing psychological symptoms causes them to occur. It doesn't.

Guidelines for the more rational selection of patients for radiographic examination of their skulls have proved successful in cutting the numbers—but the patients may often be disappointed. A study at North-wick …