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Biomedical subjects

B Vialettes

Publications and source records attributed to B Vialettes.

157 records · Page 9Linked to original sources
PubMedDate not supplied

Islet transplantation in diabetic rats. Long-term follow-up of glucose tolerance.

Inbred Lewis rats made diabetic by streptozotocin were transplanted with 430-870 islets from syngenic donors via the portal vein. Though fasting plasma glucose was normal, the tolerance to glucose given intraperitoneally (IPGTT) or orally (OGTT) remained impaired one month after transplantation. The higher the number of islets, however, the better the glucose tolerance. The results of IPGTT and OGTT in each animal correlated. Fasting plasma insulin levels were within the normal range suggesting that the action of insulin on the liver and its degradation by the liver is impaired due to the limited number of hepatocytes subjected to high insulin concentrations. Eight months after transplantation, the plasma insulin and glucose responses to OGTT were still unchanged while those of the less physiological IPGTT were worse. Thus, the functional capacity of the transplanted endocrine tissue does not appear to change with time.

Animals↗
PubMedDate not supplied

Sustained initial remission induced by intensive insulin treatment in type I diabetes. Possible role of the genetic background.

A remission defined by the possibility of temporarily discontinuing insulin therapy while blood glucose remains normal is not infrequently observed after intensive insulin therapy in newly diagnosed acute type I diabetes in the South of France. In order to analyze possible factors of such a remission, 47 newly diagnosed ketotic diabetics under 35 years of age and of Caucasian origin were enrolled in a prospective study. They were given continuous s.c. insulin infusion for two weeks and oral agents were introduced on day 8. In 16 patients insulin could not be withdrawn. In 31 insulin was stopped for more than 3 months (mean 12.3, range 3-35) while blood glucose remained below 6 mmol/l fasting (mean 5.3) and 7.8 post-prandial (mean 5.1) and glycosylated Hb below 8.5% (mean 6). At presentation, diabetics who later went into remission and those who did not, showed no difference in age (22.3 vs 23.1 years), sex ratio, apparent duration of symptoms (1.4 vs 1.6 months), glycosylated hemoglobin (12.0 vs 13.1%) and basal or post-prandial C-peptide values or presence of islet cell antibodies. No differences were observed in the frequency of DR3 and DR4 antigens in the two groups but diabetics who developed a remission bore the A 19.2 antigen (9/31 vs 1/16) and the B18 one (11/31 vs 1/16) more frequently, A 19.2 and B18 being associated in 7 cases of this group. This increased frequency in the remission group of HLA antigens, more often observed in diabetics of Mediterranean origin, suggests that differences in the genetic background may be associated with a difference in the evolution of the disease.

Administration, Oral↗
PubMedDate not supplied

[Inflammatory rheumatism flare-up after surgical treatment of Cushing's disease: two cases].

The anti-inflammatory effect of natural glucocorticoids is often overlooked, as shown by these two cases of inflammatory rheumatism flare-up which occurred after surgical treatment of Cushing's syndrome. The disorder in the first case was exacerbation of a probable rheumatoid arthritis; in the second case an unlabelled inflammatory rheumatism appeared in a context of postoperative corticotropic deficiency. In both cases a purely substitutive hydrocortisone therapy resulted in dramatic regression of the articular symptoms. It is well known that rheumatismal manifestations may occur in patients with slow adrenal failure. The determinant factor seems to be a glucocorticoid deficiency, either isolated or associated with others, since cortisol exerts and anti-inflammatory activity. In patients with corticotropic deficiency following surgical treatment of Cushing's disease, the endogenous corticosteroid therapy of hypercortisolism is interrupted, allowing the aggravation or emergence of inflammatory rheumatism.

Adult↗
PubMedDate not supplied

A preliminary multicentre study of the treatment of recently diagnosed type 1 diabetes by combination nicotinamide-cyclosporin therapy.

The aim of the present study, a pilot trial, was to find out if nicotinamide (50 mg kg-1 day-1) in combination with cyclosporin A favours remission in recently diagnosed Type 1 diabetic patients, and if it postpones relapse even when cyclosporin A is administered in decreasing doses (trough blood level 300-500 micrograms l-1 until month 4, and 100-300 micrograms l-1 until month 9) and then discontinued. The criteria for inclusion in the study and the follow-up protocol were the same as those used in the Cyclosporin Diabetes France (CDF) programme in which all five of the centres involved in this study participated. The data of the present preliminary open study were therefore compared retrospectively with those of the placebo (CDF-placebo) and cyclosporin (CDF-active) group of the CDF programme. Clinical remission (fasting plasma glucose less than 7.8 mmol l-1, postprandial plasma glucose less than 11.1 mmol l-1, HbA1c less than 7.5% with neither insulin nor oral hypoglycaemic agents) was achieved within 6 months in 12 out of 35 patients (34%) vs 16 out of 63 (25%) in CDF-active and 11 out of 59 (19%) in CDF-placebo. Remission was achieved by month 9 in 6 out of 35 patients (17%) vs 13 out of 54 (24%) in CDF-active and 3 out of 52 (6%) in CDF-placebo. By 12 months remission persisted in 3 out of 35 patients (9%) vs 11 out of 63 (17%) in CDF-active and 0 out of 52 (0%) in CDF-placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Hemoglobin A1C determination and hemoglobinopathies: problems and strategies].

The semiological value of hemoglobin A1c (HbA1c) as a retrospective and cumulative marker of glycemic balance in diabetic patients is greatly weakened in case of hemoglobinopathy. The presence of an abnormal hemoglobin raises methodological problems due to the interferences generated in most assay methods, but also alters the normal process of HbA glycation to HbA1c, and often induces a certain level of hemolysis, very variable and impossible to quantify. This paper reviews methodological and semiological problems related to the presence of abnormal hemoglobin species, and proposes a standardized strategy in case of hemoglobinopathies.

Artifacts↗
PubMedDate not supplied

Stabilization of severe proliferative diabetic retinopathy by long-term treatment with SMS 201-995.

Growth hormone and growth factors have been implicated in the pathogenesis of diabetic retinopathy. Hypophysectomy has been proposed as a treatment for proliferative diabetic retinopathy unresolved by panretinal photocoagulation (PPC). SMS 201-995, a long acting somatostatin analogue which slows down growth hormone secretion, may provide a non-invasive therapy for these rare cases. To assess this possibility, we studied the feasibility and efficiency of long-term SMS 201-995 treatment in diabetics. SMS 201-995 was injected subcutaneously with a continuous pump system at a dose of 400 micrograms/d into 4 insulin dependent diabetic patients suffering from proliferative diabetic retinopathy progressing despite a pan-photocoagulation. The mean age of these patients was 29 +/- 3 years and mean disease duration 18 +/- 3 years. Treatment periods lasted from 6 to 20 months (mean 15 months). Mean 24-hour growth hormone levels decreased by 57% after only one month of treatment (7.4 +/- 1.9 mU/l to 3.2 +/- 0.9 mU/l). The decline continued up to the third month. After the sixth month, signs of resistance to the drug were noted. The frequency of 24-hour GH peaks over 10 mU/l followed a parallel pattern. No rebound was observed when the treatment was progressively discontinued. In 2 patients neovascularization stopped. In the other 2 the process regressed. In all treatment had beneficial effects on the retina. Overall visual acuity improved (7.8 +/- 0.8/10e vs 5.5 +/- 0.8/10e). These effects were obtained within 3 to 6 months. Glycosylated haemoglobin levels did not change (8.8 +/- 1.3% to 9.0 +/- 0.8%). Insulin doses decreased 41% (46.5 +/- 1.7 U/d to 27.3 +/- 3.0 U/d). No severe hypoglycaemia occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Peripheral neuropathy and cyclosporin. Apropos of 2 cases].

We report two cases of peripheral neuropathy arose during treatment with cyclosporine. The first observation was in a 24 year-old female treated because of a recent diabetes mellitus, the second in a 52 year-old male whose treatment was given after a cardiac transplantation. Chronology, clinical presentation and morphological findings on nerve biopsy were very close in both cases ans intrinsic imputability was stated as "possible" according to the method used to assess unexpected or toxic drug reaction by the French Regional Drug Monitoring Centers. It remains to confirm with similar reports the putative part played by cyclosporine as strongly suggested in ours.

Adult↗
PubMedDate not supplied

Stress antecedents and immune status in recently diagnosed type I (insulindependent) diabetes mellitus.

It has been speculated that stressful life events can precipate some autoimmune diseases by altering the immune system. This study was undertaken to test this hypothesis in type I (insulindependent) diabetes. Thirty-two young patients (less than 40 years) with a recently diagnosed IDDM and 53 age-matched controls were interviewed according to a standardized questionnaire designed to identify, date, and weigh past stressful life events. In patients immunological status was assessed during the six months following the first manifestation of the disease by measuring anti-organ and anti-islet cell antibodies, T lymphocyte subsets, PHA mitogenic activity, IL2 production by blood mononuclear cells, IgG, IgA, IgM, and C3, C4 component fraction levels. The diabetic population experienced fewer life events, stressful or non-stressful, but in the 12 months preceding the onset of the disease, 50% of the diabetics endured at least one stressful life event as against only 18.8% of the controls (p less than 0.01). The only difference in the immunological status of the patients who had experienced a stressful life event in the previous twelve months and those that had not, involved PHA mitogenic activity which was significantly lower after a stressful event. While these findings do attest to a temporal relation between stress and type I diabetes in at least 1 out of 2 patients, they do not establish a causative connection.

Adolescent↗