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Biomedical subjects

A Secchi

Publications and source records attributed to A Secchi.

At least 127 records · Page 7Linked to original sources
PubMed1986

Effects of oral administration of maltitol on plasma glucose, plasma sorbitol, and serum insulin levels in man.

The present study was aimed to investigate the metabolic effects of acute and chronic oral administration of maltitol (4-O-i-D-glucopyranosyl-D-glucitol), a hypocaloric sweetener obtained from maltose by catalytic hydrogenation. Fifty grams of maltitol induced a increase lower glycemic and insulinemic than the same dose of glucose or sucrose. No variations of plasma glucose and serum insulin levels were observed after 180 min. A slight increase of plasma maltitol was observed 45 min after maltitol. The chronic administration of maltitol (10 g 3 X daily for 5 days) induced no variations of glycemia or insulinemia when compared with the same dose of sucrose. Plasma sorbitol levels were slightly higher after maltitol than after sucrose. Low amounts of maltitol were detected in the urine and feces.

Administration, Oral↗
PubMed1986

Impairment of lymphocyte-suppressive system in recent-onset insulin-dependent diabetes mellitus. Correlation with metabolic control.

Impairment of suppressor-cell activity may be important in the pathogenesis and maintenance of insulin-dependent diabetes mellitus (IDDM). In 23 recent-onset IDDM patients, lymphocyte sensitivity in vitro to theophylline was tested both in basal conditions and after improvement of metabolic control. This pharmacologic agent is mainly effective on a lymphocytic subpopulation with phenotypic and functional suppressive features. Peripheral blood lymphocytes from IDDM patients showed a loss of theophylline sensitivity, identified as inhibition of both E-rosette formation and blastogenic response to polyclonal mitogens concanavalin A (ConA) and phytohemagglutinin (PHA). An inverse relationship was demonstrated between the theophylline-induced suppression of ConA blastogenic response and blood glucose and glycosylated hemoglobin levels (P less than .01). Metabolic control seemed to be important even in relation to lymphocyte subpopulation distribution. In IDDM patients we found a significant (P less than .05) reduction of OKT4+ lymphocytes that is correlated with blood glucose and glycosylated hemoglobin levels (P less than .01). The improvement of metabolic control led to recovery of theophylline sensitivity. We suggest a deficiency in a suppressive system that could be involved in IDDM onset and the possible role of metabolic control in the impairment of some immunologic functions reported with this pathologic condition.

Adolescent↗
PubMed1985

Metabolic control of type I (insulin dependent) diabetes after pancreas transplantation.

A study was conducted of the circadian hormonal and metabolic patterns of 10 type I (insulin dependent) uraemic diabetic patients after pancreas and renal transplantation. A single 24 hour profile was obtained in each patient following as closely as possible his or her normal daily routine two to 15 months after transplantation. None of the patients were using insulin at the time of the study. Compared with a group of six normal subjects the transplant recipients had mildly raised blood glucose concentrations, hyperinsulinaemia between meals and at night, delayed postprandial insulin peaks, mild hyperketonaemia, and normal blood lactate and plasma glucagon concentrations. The findings showed that successful pancreas transplantation results in disappearance of the need for insulin and return to normal or near normal of the metabolic abnormalities of diabetes. The minor differences observed in comparison with normal hormonal and metabolic homoeostasis were probably due to intrinsic (reduced islet mass, denervation, peripheral hormone delivery) and environmental (immunosuppression, relatively impaired renal function) factors.

3-Hydroxybutyric Acid↗
PubMed1984

Thirty months' experience with cyclosporin in human pancreatic transplantation.

Between September 1978 and December 1983, 33 simultaneous kidney plus pancreatic transplantations were performed in Type 1 (insulin-dependent) diabetic patients with uraemia at the Herriot Hospital, Lyon. In eight patients grafted before June 1981, immunosuppressive treatment consisted of azathioprine, steroids and a temporary course with anti-lymphocyte globulins (protocol A). Since June 1981, the immunosuppressive treatment has consisted of cyclosporin administered according to two protocols: from the day of transplantation with temporary anti-lymphocyte globulins with or without steroids (protocol B, seven patients), or after an initial course with protocol A, with or without steroids (protocol C, 18 patients). Only slight differences in patient and pancreatic graft survival between the three protocols were observed at 3, 6 and 12 months, while an improved survival rate for both patients and pancreatic grafts was observed in protocols B and C at 2 years. Moreover the incidence of pancreatic rejection as a cause of loss of pancreatic function seemed to be reduced under protocols B and C.

Adult↗
PubMed1984

Renal glucose transport after kidney transplantation.

Tubular maximal transport of glucose (TmG), plasma glucose threshold ( PGT ) and fractional maximal tubular reabsorption (TmG/GFR) were measured in fourteen kidney-grafted patients. Seven patients showed decreased PGT and normal or decreased TmG/GFR (type A or B renal glycosuria (RG) ), whereas seven other patients showed normal values. No difference was found between the two groups with respect to parameters of renal function and to clinical parameters characterizing kidney transplantation. The only difference observed between the two groups was the rate of decrease of plasma creatinine levels during the 1st week after transplantation: it was faster in the group without renal glycosuria. No difference was seen between the two groups of patients with respect to the number of rejection episodes occurred over the first 12 months.

Adult↗
PubMed1983

Endocrine responses of type 1 (insulin-dependent) diabetic patients following successful pancreas transplantation.

The aim of the present study was to evaluate the insulin and glucagon responses to various stimuli in patients following pancreatic transplantation. Four Type 1 (insulin-dependent) diabetic patients with end-stage renal failure who had received a cadaveric segmental, neoprene-injected, pancreas transplant, in association with kidney transplantation, were investigated. Free-insulin, pancreatic glucagon, and growth hormone concentrations were measured after both oral and intravenous glucose tolerance tests, and following tolbutamide, arginine and arginine plus somatostatin infusions. Tests were performed 1 month (three cases) and 30 months (one case) after surgery, when no insulin administration was required. Four non-diabetic kidney grafted patients, matched for duration of graft survival and immunosuppressive treatment (steroids, azathioprine and anti-lymphocyte-globulins), served as control subjects. Impaired glucose tolerance was present in all diabetic and control patients. This was possibly related to immunosuppressive treatment. In comparison with control subjects, insulin release was normal in response to arginine and tolbutamide but was reduced in response to oral and intravenous glucose, while glucagon and growth hormone release were similar in both groups. Somatostatin was less effective in diabetic patients than in control subjects in suppressing insulin and glucagon release.

Adult↗
PubMed1983

A method for early detection of graft failure in pancreas transplantation.

Pancreatic transplantation is intended to normalize carbohydrate metabolism in insulin-dependent diabetics by restoring endogenous insulin release, and it is usually performed together with kidney transplantation in patients with end-stage renal failure. A major problem in these patients is the daily control of the grafted pancreas because traditional measurements do not appear to be adequate to evaluate pancreatic function. Aiming at early detection of graft failure, we have analyzed in 8 such patients and in 20 nondiabetic kidney-grafted patients (a control group) the following variables: 24-hr glycosuria (absolute values, or values after natural logarithmic transformation) and 24-hr urinary C-peptide excretion (corrected for 24-hr urinary creatinine). These measurements, considered alone, did not detect pancreatic graft failure; for instance, glycosuria can depend on immunosuppressive steroid treatment, and it was often found even in the control group. On the contrary, the ratio Ln 24-hr glycosuria: 24-hr urinary C-peptide varied from 0.00 to 0.18 in the control group and in normally working pancreatic grafts; when the pancreatic grafts failed, however, as confirmed by arteriographic evidence, histologic findings, or dynamic endocrine tests, this ratio rose far higher than 0.18, reaching values as high as 12.2. Use of this ratio provides a simple technique for daily evaluation of pancreatic graft function and for early detection of graft failure.

Diabetes Mellitus↗
PubMed1983

Study of hypoglycemic patients by the glucose clamp technique using the artificial pancreas.

Using the artificial pancreas, blood glucose levels were maintained at 80 mg/dl in nine hypoglycemic patients (four with histologically proven insulinomas and five with nontumoral hypoglycemia) and in four normal subjects during a 24-h fast. The amount of glucose used, serum insulin levels, and glucose clearance were higher in patients with nontumoral hypoglycemia than in normal subjects and highest in the patients with an insulinoma. Surgical or pharmacological treatment resulted in normalization of all parameters. In contrast to the 72-h fast, the 24-h glucose clamp technique allowed the study of hypoglycemic patients without inducing hazardous hypoglycemia.

Adenoma, Islet Cell↗
PubMed1983

Progress in segmental neoprene-injected pancreas transplantation. Advantages and disadvantages of using Cyclosporin A.

We performed 39 neoprene-injected pancreatic transplants (38 segmental and 1 total) in 37 insulin-dependent diabetic recipients from October 1976 to May 1983. The best results were obtained when the pancreas was transplanted simultaneously with the kidney (25 cases). The use of Cyclosporin A (CyA) for immunosuppression did not reduce the early pancreatic failures, but it seems to have slightly improved the long-term survival. The glycaemic control was better in patients treated by CyA alone than in those receiving steroids. The main side effects of CyA were nephrotoxicity and some immunoglobulin abnormalities with or without lymphoproliferative disorders occurring after treatment with CyA and ALG.

Adult↗
PubMed1982

Insulin given intranasally induces hypoglycaemia in normal and diabetic subjects.

Regular or crystalline insulin with sodium glycocholate as surfactant administered intranasally to normal volunteers induced hypoglycaemia and an increase in serum immunoreactive insulin concentrations. Serum C-peptide concentrations decreased or remained unchanged. Insulin administered intravenously to three of these subjects yielded a potency ratio of 1:8 for intranasal and intravenous insulin. In four insulin-dependent diabetics a cross-over study was performed on different days, insulin being administered once intranasally and once subcutaneously in a ratio of 1:9. In these patients the intranasal insulin was more effective than the subcutaneous insulin in preventing hyperglycaemia after breakfast. In four other insulin-dependent diabetics 11-hours monitoring was performed twice on two different days, insulin being administered in divided dosage sufficient to achieve a reasonable glycaemic profile. The administration during the morning, whereas subcutaneous insulin was more effective than intranasal during the afternoon.

Administration, Intranasal↗