Taste loss associated with captopril treatment.

Dietary fibre and ketone bodies: reduced urinary 3-hydroxybutyrate excretion in diabetics on guar Dietary fibre is known to modify carbohydrate absorption and metabolism in both normal and diabetic individuals.'-3Except for reports on the action of certain forms of fibre in reducing serum cholesterol concentrations,3 however, no attention has been given to other changes in lipid metabolism.Since urine testing for ketone bodies is still a major part of the clinical assessment of the diabetic, we have looked at the effect of guar gum on the output of 3-hydroxybutyric acid (3-OHB) in diabetic volunteers.If both 3-OHB and glucose outputs were reduced at the same time then this would suggest a general improvement in diabetic control rather than carbohydrate malabsorption. Patients, methods, and resultsNine diabetics (4 men, 5 women aged 42± (SE of mean) 5 years) were studied.Their blood and urinary glucose data have been reported2; two were taking oral hypoglycaemic agents and seven insulin 36 ± 6 U/day.Their mean weight was 106+ 5 % of desirable weight.Seven patients were studied in hospital on metabolically controlled diets: identical two-day rotating menus were provided over both consecutive test and control five-day periods (the order being randomised and separated in five studies by a weekend).Two were studied as outpatients and kept the same meal plans throughout.During the control period patients took between 14 and 26 slices of crispbread per day with meals, and during the test period they took guar crispbread of the same composition except that it also contained 1 g guar/slice.Serum was obtained on the last day of each period and complete 24-hour urine collections were made throughout for analysis of creatinine (Technicon, SMA 12/60).4Urinary 3-OHB, the ketone body least likely to be affected by storage, was estimated by an enzymatic technique modified for use with the Guildford 3500 enzyme analyser.5The significance of differences was calculated using Student's t test for paired data.The mean 3-OHB and glucose outputs over the last two days on guar were much lower than during the control period (see table ).Calculated as Percentage change in 24-hour urinary glucose and 3-OHB outputs for last two days on guar compared with control period Last two control days % Change on guar Case 3-OHB Glucose no (mmol/24h) (mmol/24h) 3-OHB Glucose 1 .