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Biomedical subjects

A Aro

Publications and source records attributed to A Aro.

At least 145 records · Page 8Linked to original sources

Blood glucose and serum insulin responses to breakfast including guar gum and cooked or uncooked milk in type 2 (non-insulin-dependent) diabetic patients.

The post-prandial blood glucose and serum insulin responses to test meals, each including 300 ml fat-free milk taken separately with the meal or premixed before cooking into the meal consisting of oatmeal porridge, were studied in 10 diet-treated Type 2 (non-insulin-dependent) diabetic subjects. The modifying effect of guar gum on the responses was also studied by supplementing both types of test meals with 5 g granulated guar gum taken at the beginning of the meal. The blood glucose response was higher after the meal which contained cooked milk than after the respective meal with milk taken separately. The guar gum supplementation attenuated the blood glucose response after the meals, but the effect was more pronounced after the meal containing cooked milk. Post-prandial serum insulin responses were similar after all test meals. The results suggest that cooking may facilitate the absorption of lactose from milk-containing foods, and that supplementation with guar gum may counteract this response.

Adult↗

Remissions in newly diagnosed type 1 (insulin-dependent) diabetes: influence of interferon as an adjunct to insulin therapy.

We studied the effect of interferon as an adjunct to conventional insulin therapy on the early course of Type 1 diabetes in 43 newly diagnosed patients. Compared with conventional therapy, interferon administration slightly delayed the improvement of glucose homeostasis and the rise of high density lipoprotein cholesterol, while C-peptide secretion was unaffected. Independent of the type of therapy, 18 patients (42%) entered partial remission. The remission began 2.0 +/- 0.6 months (mean +/- SEM) from the start of therapy and lasted for 4.1 +/- 1.1 months. Seven patients (16%) were still in remission 1 year after diagnosis. The patients who entered remission had higher initial C-peptide secretion, lower glycosylated haemoglobin levels and better initial control than patients without remission. Thus, interferon provided no benefits as an adjunct to conventional insulin therapy in unselected patients with newly diagnosed Type 1 diabetes. An important factor for the development of remission was the presence of C-peptide secretion at the time of diagnosis.

Adolescent↗

Effects of guar gum in male subjects with hypercholesterolemia.

Fourteen male subjects with hypercholesterolemia received daily supplementation with granulated guar gum or placebo, 15 g/day, during 12 wk in a double-blind, cross-over trial. A statistically significant reduction in serum total cholesterol (7.27 +/- 0.24 versus 8.23 +/- 0.26 mmol/l, mean +/- SEM, p less than 0.01) which was mainly due to a reduction in low-density lipoprotein cholesterol concentration (4.70 +/- 0.19 versus 5.32 +/- 0.23 mmol/l, p less than 0.05) was observed after 6 wk on guar gum as compared with placebo. Between 6 and 12 wk on guar gum the serum cholesterol and low-density lipoprotein cholesterol levels increased in most subjects, and after 12 wk the difference from placebo was no longer statistically significant. Serum high-density lipoprotein cholesterol levels were unaffected by guar gum. Serum and lipoprotein triglycerides showed no significant changes during the study, and the body weight of the subjects remained unchanged. Serum calcium, magnesium, phosphate, and iron levels, and urinary calcium excretion were not affected by guar gum supplementation. No severe side effects were observed, necessitating reduction of the dose or stopping the treatment. It is concluded that the hypocholesterolemic effect of guar gum seems to decrease during prolonged dietary supplementation. Further controlled studies are needed before the dose response and the long-term effects of guar gum in hypercholesterolemia can be evaluated.

Adult↗

Factors predicting remission in type I diabetes.

The remission period often following the clinical onset of insulin-dependent (type I) diabetes, is characterized by residual B cell function, reduced insulin requirements, and good metabolic control. Known factors predicting remission include high age at onset, male sex, mild initial metabolic derangement and absence of frank ketoacidosis. It has been possible to increase the frequency of remissions by strict initial control of diabetes with intensive insulin therapy and by immunological manipulation with corticosteroids, cyclosporin A or plasmapheresis. Patients who have experienced a remission show higher plasma C-peptide levels even after the remission period, but there is no conclusive evidence so far about any beneficial effect of therapeutic intervention on residual B cell function beyond the remission period.

Blood Glucose↗

Effect of correction of hyperglycemia on left ventricular function in non-insulin-dependent (type 2) diabetics.

Systolic time intervals (STI) were recorded in 33 newly diagnosed non-insulin-dependent diabetics (19 men, 14 women, aged 44-64 years) before and after 3-8 months' dietary therapy. The mean (+/- SD) fasting blood glucose was 11.1 +/- 2.6 mmol/l before treatment and 7.8 +/- 1.8 at the second examination (p less than 0.001). Concomitantly with the decline in blood glucose concentration, the heart rate corrected pre-ejection period (PEP) decreased from 139 +/- 11.9 to 135 +/- 14.4 msec (mean +/- SD) (p less than 0.05), the heart rate corrected left ventricular ejection time (LVET) increased from 400 +/- 15.1 to 410 +/- 20.7 msec (p less than 0.0025) and the PEP/LVET ratio decreased from 0.39 +/- 0.06 to 0.36 +/- 0.06 (p less than 0.005). When the diabetics were divided into two groups according to the degree of the decline in blood glucose concentration, only those whose fasting blood glucose decreased by greater than or equal to 3 mmol/l showed significant changes in STI. No significant changes were observed in the mean heart rate or systolic blood pressure during the treatment. Cardiac dysfunction occurring in untreated non-insulin-dependent diabetics may be caused by metabolic factors and it may be reversed at least partially by correction of hyperglycemia.

Adult↗

Hormonal effects of beta-receptor blockade during exercise.

The effects of two different beta-receptor blocking agents, beta 1-selective metoprolol (150 mg/day) and non-selective propranolol (120 mg/day), on hormonal responses to physical exercise (30 min bicycle ergometer test) were compared with placebo within a double-blind, cross-over design in 7 healthy male volunteers. Plasma prolactin levels decreased from the initial values during and after exercise during treatments with placebo and beta-receptor blocking agents, but they were constantly higher with the two beta-blocking agents than with placebo. Exercise did not affect plasma testosterone levels, but during propranolol they remained higher than during placebo and metoprolol. The plasma LH and FSH levels were not affected by exercise, nor were they significantly modified by beta-blockade. The results of this study as well as those of previous studies indicate that beta-receptor blocking agents interfere with physiological endocrine functions and that the non-selective agents may have more distinct effects in this respect.

Adrenergic beta-Antagonists↗

Pharmacokinetics of propranolol and sotalol in hyperthyroidism.

The elimination and bioavailability of two beta-blocking agents, propranolol and sotalol, were studied in 10 thyrotoxic patients, both before and after treatment with iodine-131. Each subject received in random order propranolol 160 mg and sotalol 160 mg as single oral doses both while hyperthyroid and after euthyroidism had been achieved. The pharmacokinetics of sotalol was not affected by hyperthyroidism, whereas serum propranolol concentrations were significantly lower during hyperthyroidism than in the euthyroid state. During hyperthyroidism, the bioavailability of propranolol was significantly reduced (p less than 0.05) and its clearance was increased (p less than 0.005), whereas there was no difference in its serum t 1/2. This indicates that the bioavailability of propranolol in hyperthyroidism is reduced by a mechanism which may depend on increased first-pass metabolism in the liver, or on an increased distribution volume of the drug. Both propranolol and sotalol caused a slight decrease in serum tri-iodothyronine concentration. As the effects of beta-blocking agents on the symptoms of hyperthyroidism are correlated with the serum concentration of the drugs, sotalol, with its long half-life and unaltered elimination in hyperthyroidism, has certain advantages over propranolol in the treatment of thyrotoxicosis.

Adult↗

Metabolic and hormonal response to physical exercise during beta 1-selective and non-selective beta-blockade.

The effects of a beta 1-selective (metoprolol, 150 mg per day) and a non-selective beta-blocking agent (propranolol, 120 mg per day) on metabolic and hormonal responses to physical exercise (a 30 min bicycle ergometer test) were investigated against placebo in seven healthy male volunteers with a double blind cross-over design. The blood glucose level remained unchanged during placebo, it tended to increase during metoprolol, whereas it decreased during propranolol. Both metoprolol and propranolol counteracted the exercise-induced increase in plasma free fatty acids and caused a slight decrease in muscle glycogenolysis. The increase in blood lactate concentration during exercise was not influenced by beta-blockade. The secretion of glucagon and cortisol was not modified significantly by beta-blockade, whereas the growth hormone response to exercise was promoted equally by both beta-blocking agents. It has been assumed previously that, during treatment with beta-blocking agents, diminished hepatic gluconeogenesis, caused by the lack of lactate or free fatty acids, may result in a decline in blood glucose levels. The present results indicate that an inhibition of beta 2-mediated hepatic glycogenolysis by propranolol may also influence blood glucose homeostasis during exercise.

Adrenergic beta-Antagonists↗

Modification of the metabolic and hormonal response to physical exercise by beta-blocking agents.

Beta-blockade is known to induce muscle fatigue and tendency to hypoglycaemia during prolonged exercise. In addition, beta-blocking agents influence the secretion of many hormones, which regulate glucose. We have investigated the effects of a beta 1-selective (metoprolol) and a non-selective (propranolol) beta-blocking agent on muscle glycogenolysis, blood glucose and lactate levels, plasma levels of free fatty acids and on secretion of insulin, growth hormone, glucagon and cortisol during physical exercise in a double blind cross-over study in seven healthy male volunteers. They participated in three bicycle ergometer tests each lasting for 30 minutes under treatment of placebo (C), metoprolol (M) or propranolol (P). A biopsy was obtained from the vastus lateralis muscle before and immediately after the exercise for muscle glycogen assay. The glycogen concentration after exercise tended to be lower in C than in M or P experiment. The blood glucose level decreased during P and at 30 min there was a significant difference between P and C. The blood lactate was significantly lower before exercise during P than C or M. The increase of blood lactate during exercise, however, was not inhibited by P. Both beta-blocking agents counteracted the increase of FFA during exercise. There was a marked increase of growth hormone secretion during beta-blockade. The secretion of glucagon and cortisol were slightly increased by P and M, but the plasma insulin level was not affected by beta-blockade.

Adult↗