Studies in Pre-diabetes

MI& ORA remembered that prothrombin estimations are essential for their control.The possibility of an urgent operation being necessary in a patient on dicoumarol or allied drugs has always been a drawback to their use.This drawback is largely overcome by the use of vitamin Ki.In considering the use of such a potent drug as vitamin K1 it must be remembered that the prompt restoration of the prothrombin to a normal, or near normal, level in a patient requiring the use of anticoagulants will inevitably restore the dangers of thrombo-embolism.Vitamin K1 must therefore be used with caution and only in cases where the danger of severe prothrombin deficiency overrides that of thrombo- embolism.This statement applies to the doses of vitamin K1 used in this report.Further work is in progress with smaller doses of vitamin Ki, which it is hoped will over- come a dangerous prothrombin deficiency that may arise from anticoagulant therapy but will not restore the pro- thrombin to a level where thrombo-embolism is likely.In using large doses of vitamin K1 it must also be remem- bered that the patient may become refractory to anti- coagulants and require much larger doses of the anticoagulant drug after the administration of the vitamin. SummaryIn 18 patients, vitamin K1, in a single oral dose of 500 mg., was completely effective in restoring a safe prothrombin level after a severe and prolonged pro- thrombin deficiency due to such anticoagulant drugs as dicoumarol, tromexan, and phenylindandione.This effect was evident within eight hours, and the action of the vitamin was apparent within four hours.In three cases of frank haemorrhage due to anti- coagulant drugs, an oral dose of vitamin Ki was in itself sufficient to stop bleeding in a matter of hours.I wish to thank Roche Products Ltd. for the generous supplies of the vitamin K, used in this work, and in particular Dr. F.