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XYLITOL AND LOW DOSAGES OF INSULIN: NEW PERSPECTIVES FOR DIABETIC UREMIC PATIENTS ON CAPD

From the Nephrology and Dialysis Department, Umberto I Hospital, Venice-Mestre, Italy

The authors describe six months' experience with CAPD using xylitol in dialysis solution in four diabetic patients. The laboratory and clinical data thus obtained, demonstrate that this polyalcohol is an effective osmotic agent, which is particularly suitable for uremic diabetics because of its insulin-independent metabolism. Serum phosphates markedly decreased while lactic and uric acid showed a steady increase; the latter was more pronounced and required treatment with allopurinol. HDL cholesterol and triglycerides re turned towards normal levels mainly during the first four months. The daily absorption ofxylitol in amounts less than 150 9 was well tolerated by the patients, while greater amounts caused clinical symptoms such as nausea and vomiting. The main advantage of using xylitol in uremic diabetic patients on CAPD was the decrease in insulin requirements to those required for the metabolism of dietary carbohydrate only.

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