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Biomedical subjects

A C Asmal

Publications and source records attributed to A C Asmal.

At least 37 records · Page 2Linked to original sources
PubMed1982

The insulin and glucose response to an oral glucose load in non-insulin-dependent diabetes in the young.

Non-insulin-dependent diabetes with age of onset under 35 years was studied in 85 Indian patients eighty-one per cent of the group were females, the mean age of onset of diabetes was 27 years while the mean duration was 6.3 years. the mean percentage desirable mass of the patients was 112%, obesity being present in 55% of the group. Eighty-two per cent of patients gave a positive family history; closer analysis revealed that 75% of the propositi had a diabetic parent and 41% a diabetic sibling; while three-generation transmission was present in 7%. Eighty-one patients consented to a 100 g oral glucose load. The insulin and glucose response during a 3-hour period revealed fasting hyperinsulinism with a delayed and attenuated insulin response, a much lower insulin area and higher glucose ares, a lower insulin-glucose ratio and a lower modified Seltzer insulinogenic index when compared with 50 non-diabetic reference subjects. There was no difference in insulin and glucose responses in obese and non-obese diabetics. However, subdivision of the group into those with moderate and those with severe diabetes demonstrated that the latter had significantly higher plasma glucose levels and lower insulin levels at all times, except in the fasting state, during which the insulin levels were not significantly different.

Adult↗
PubMed1982

Haemoglobin A1C levels in Black and Indian insulin-dependent diabetic patients of poor socio-economic status.

Haemoglobin A1C (HbA1C) levels were measured in 71 Black and Indian insulin-dependent diabetic outpatients. The mean HbA1C level was 13,7 +/- 1,8%, and levels showed a significant positive correlation with random plasma glucose values measured at the same time (r = 0,47; P less than 0,001). Unsatisfactory socio-economic circumstances may be responsible for the poor quality of control in these patients. In view of the difficulties inherent in assessing the quality of control in such patients, who are often unreliable as regards home urine testing, HbA1C estimation provides a singularly useful guide to the degree of hyperglycaemia.

Adult↗
PubMed1981

Non-insulin-dependent diabetes mellitus with early onset in Blacks and Indians.

Non-insulin-dependent diabetes mellitus (NIDDM) with onset below 35 years of age was studies in 43 Indian and 9 Black patients. NIDDM was diagnosed in 10.0% and 1.6% of diabetes in the respective racial groups. The mean age of the patients was 35.4 years and the mean duration of diabetes 7.5 years. Nearly 50% of patients were significantly obese, and more than 50% had a positive family history of diabetes. In all patients the diabetes was symptomatic at presentation, although frequently insidious in onset. In all cases the symptoms could be controlled without insulin therapy. Despite persistence significant hyperglycaemia in several patients, ketosis did not occur at any stage. Complications were detected in 40% of the Indian and 22% of the Black patients, but were unrelated to the duration of diabetes or severity of hyperglycaemia. Basal insulin levels and postglucose insulinaemic responses were lower in the Black than the Indian diabetes.

Adolescent↗
PubMed1981

Insulin-dependent diabetes mellitus with early onset in blacks and Indians.

Insulin-dependent diabetes mellitus (IDDM) with onset below 35 years of age was studied in 52 Black and 38 Indian patients. IDDM accounted for approximately 10.4% and 1.1% of diabetes in the respective racial groups. The mean age and body weight in the Black and Indian diabetics were 27.6 years and 24.7 years, and 60.2 kg and 54.7 kg, respectively. The duration of diabetes in the majority of Blacks was 1-4 years, and that in Indians 5-9 years. The initial presentation in more than 80% of the patients was acute, with severe keto-acidosis in 15%. A positive family history of diabetes was obtained in more than 50% of Indians and in less than 6% of Blacks. Complications were present in 33% of Indian patients and were related to the duration of illness and dose of insulin required. Basal growth hormone, cortisol, cholesterol and triglyceride concentrations in serum were higher in Indians than in Blacks, but the differences were not significant. The disease was unrelated to excess alcohol intake or to pancreatic calcification.

Adolescent↗
PubMed1981

Hypopituitarism. A 3-year study.

During a 3-year period of 16 Black and Indian patients were diagnosed as having hypopituitarism. Their ages ranged from 9 to 58 years; 9 were women. Headaches and visual disturbances constituted the commonest presenting symptoms, and this was related to the fact that tumours accounted for the hypopituitarism in 11 of the 16 patients. The commonest hormonal deficiency was of growth hormone and the commonest combined deficiency was of growth hormone and gonadotrophin. Hyperprolactinaemia was present in 4 patients. The spectrum of hypopituitarism ranged from 1 patient with monohypopituitarism to 2 patients who were deficient in all the hormones tested, the majority of patients, however, being deficient in only some of the hormones.

Adult↗
PubMed1980

Radio-iodine-induced hypoparathyroidism. A case report.

A 46-year-old Black woman who was treated with 131I for hyperthyroidism subsequently developed hypoparathyroidism, a very rare complication. The clinical and biochemical findings are presented and the relevant literature is discussed.

Female↗
PubMed1980

Gonadotrophin-sparing hypopituitarism. A case report.

A 32-year-old Indian woman presented with amenorrhoea and symptoms of inadequate secretion of the anterior pituitary hormones after the birth of her second child. Investigation 2 years later revealed deficient secretion of prolactin, thyroid-stimulating hormone, adrenocotricotrophin and growth hormone. However, there was an unimpaired response of luteinizing hormone and follicle-stimulating hormone to gonadrophin-releasing hormone. This patient unequivocally demonstrated preservation of gonadotrophin function in association with deficient secretion of the other anterior pituitary hormones.

Adult↗
PubMed1980

Autonomic neuropathy in non-insulin-dependent diabetes mellitus in the young.

Twenty-five cases of non-insulin-dependent diabetes mellitus in the young were investigated for autonomic dysfunction by simple electrophysiological tests to assess the integrity of the cardiovascular reflexes. The mean age of the group at the onset of symptomatic diabetes mellitus ws 27 +/- 0,7 years, and that at the time of investigation for autonomic dysfunction ws 34 +/- 1,3 years. Nine patients had clinical evidence of peripheral neuropathy, while only 3 of the 25 had symptoms of autonomic neuropathy. Fourteen patients showed an abnormality during one or more tests for autonomic function, and of this group 9 had unequivocal evidence of autonomic neuropathy. Only 3 patients displayed both sympathetic and parasympathetic impairment of autonomic function, being the only patients exhibiting symptoms of autonomic impairment. The remaining patients with autonomic dysfunction showed only parasympathetic dysfunction. This study demonstrates that subclinical autonomic neuropathy is not an uncommon occurrence in cases of non-insulin-dependent diabetes mellitus in the young and emphasizes the need for a greater awareness of this complication.

Adult↗
PubMed1980

Diabetic heart disease.

The fact that a significant proportion of diabetics die of heart disease has led to the belief that the excess mortality is due to coronary athersclerosis, yet many risk factors for the latter are common to diabetics and non-diabetics. In fact, heart disease in diabetes is not synonymous with coronary heart disease. There is evidence that heart disease in diabetes includes a variable combination of coronary atheroma, cardiomyopathy, micro-angiopathy and autonomioc neuropathy.

Coronary Disease↗
PubMed1980

Antihypertensive effects of sotalol and atenolol given once daily.

Twenty-five male patients aged 21 - 65 years and with supine diastolic arterial pressures of 96 - 120 mmHg entered an open, controlled cross-over study, in which the effects of single daily doses of sotalol and atenolol were compared. Data collected indicate that moderately elevated blood pressure is effectively controlled for 24 hours by single daily doses of both beta-blockers (sotalol 160 - 800 mg and atenolol 100 - 500 mg). No important side-effects occurred.

Adult↗
PubMed1980

Comparative study of plasma lipids, carbohydrate tolerance and coronary angiography in three racial groups.

Coronary artery disease (CAD) was investigated by selective coronary cine angiography in 94 White, 59 Indian and 17 Black patients, and correlated with plasma cholesterol and triglyceride levels and glucose tolerance. CAD was found in 94%, 97% and 82%, and hypercholesterolaemia in 68%, 61% and 50% of the Whites, Indians and Blacks respectively. In the White group, cholesterol levels correlated with both frequency and severity of CAD. Hypertriglyceridaemia occurred in 44% of the White, 47% of the Indian, and 23% of the Black group, but did not correlate with the extent of CAD in any. Diabetes was detected in 56% of the Whites and 47% of the Indians, but was absent in all the Blacks tested. Hypercholesterolaemia appeared to be the only risk factor common to all racial groups.

Adult↗