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Joint and Pulmonary Changes in Diabetes-Reply

Bruce Buckingham, MD; Nick Anas, MD; Christy Sandborg, MD; Jouni Uitto, MD, PhD; Ann Kershnar, MD
Am J Dis Child. 1987;141(3):245. doi:10.1001/archpedi.1987.04460030022014.
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In Reply.—We appreciate the additional information offered by Dr Madácsy. His findings1 were consistent with those of our studies.2 As he suggested, we did analyze our data to compare the vital capacities between diabetic patients with LJM and those without LJM, but we found no significant difference between the two groups by Χ2, multiway table, or linear regression analysis. In a previous study of three diabetic patients with severe LJM, we performed detailed pulmonary function tests, including spirometry, body plethysmography, nitrogen washout curves, and arterial blood gas measurements.3 In these patients, we demonstrated decreased vital capacities, decreased total lung capacities, an abnormal slope of phase III of the nitrogen washout curve, and abnormal oxygenation; however, the patients had normal airway resistance and normal PEF50 and, therefore, had no evidence of obstructive airway disease. To examine a large number of children (N = 375) at a

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