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Biomedical subjects

B Willms

Publications and source records attributed to B Willms.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Effect of a change in posture on the diurnal variations of fructosamine concentration in diabetic patients].

Daily profiles of blood glucose, HbA1c, total protein and fructosamine were measured in 10 diabetic patients and the factor fructosamine x 7/g total protein was calculated. Measurements were done at 4 a.m. to be sure that the patients were sleeping for some time, during the day and the following evening at 11 p.m., when the patients were lying again, so that the influence of orthostasis, the difference between bed rest and walking could be demonstrated. The blood glucose profile was typical whereas the HbA1c concentration was very stable and constant. Total protein and fructosamine increased significantly by orthostasis; the correction of fructosamine by total protein diminished the differences, but did not completely eliminate the effect of orthostasis. However, fructosamine should be corrected by the total protein concentration in order to increase the diagnostic value of the parameter.

Adolescent↗
PubMed1988

[Allergy to human insulin. Case reports on 3 patients].

Allergy against human insulin was demonstrated in three diabetics who had not previously been treated with animal-derived insulin. In all three patients the allergy developed within a few weeks or months of starting insulin treatment. The diagnosis was confirmed by intracutaneous tests and determination of insulin-specific IgE antibodies. Desensitisation was necessary in one patient, in the other two the allergic symptoms were successfully treated by local measures. Two of the patients are at present well controlled on human insulin, while the third is still undergoing desensitisation. Such cases of primary allergy against human insulin have not previously been reported in the German medical literature.

Aged↗
PubMed1988

Preferential release of proinsulin relative to insulin in non-insulin-dependent diabetes mellitus.

A radioimmunoassay, using an antiserum that is specific for human proinsulin, has been used to study the response of serum proinsulin to low (25 g) and high (75 g) oral glucose loads in non-obese patients with non-insulin-dependent diabetes mellitus (NIDDM). Diabetic patients were treated by diet only (N = 8) or were receiving oral anti-hyperglycemic agents (N = 8) and therapy was not interrupted during the study. In the fasted state, proinsulin concentrations were higher (P less than 0.05) in the drug-treated patients (31 +/- 3 pmol/l (SEM)) compared with age- and weight-matched healthy subjects (22 +/- 2 pmol/l; N = 10), but concentrations in the diet-treated patients 25 +/- 3 pmol/l) were not significantly different. Following 25 g and 75 g glucose loads, the rises in serum immunoreactive insulin and C-peptide concentrations in both groups of diabetic patients were impaired and delayed relative to those in the control subjects. The responses of serum proinsulin, however, were not significantly different in the NIDDM patients compared with controls at any time point up to 180 min except in the case of drug-treated patients receiving 25 g of glucose who had elevated (P less than 0.05) proinsulin concentrations at 150 min and 180 min after ingestion. It is concluded that NIDDM is not associated with an exaggerated release of proinsulin in response to glucose compared with healthy subjects, but the islets have maintained the ability to release proinsulin better than the ability to release insulin.

Adult↗
PubMed1987

Physical factors influencing the blood glucose response to different breads in type II diabetic patients.

Blood glucose responses to test meals containing 75 g of different breads were compared in 103 type II diabetic patients under sulfonyl urea treatment. Nine breads differing in type of cereal, physical structure, and dietary fiber content were studied using pairwise intraindividual comparisons. It could be shown that the type of cereal and the fiber content had no significant influence upon the maximal or mean postprandial blood glucose increase. Coarse-grained breads, however, resulted in significantly lower blood glucose responses than breads that were finer grained or were produced from flour. Physical properties determining the access of intestinal hydrolytic enzymes to ingested carbohydrates seem to be major factors that influence postprandial blood glucose responses.

Adult↗
PubMed1985

[Hypoglycemia with loss of consciousness during insulin therapy as an initial symptom of Addison's disease. Report of 2 cases].

Within a six-month period, two type-I diabetics were admitted because of labile metabolic state with recurrent severe hypoglycaemia and unconsciousness. In both patients electrolytes were normal on admission. There were at first only few pointers to Addison's disease. But in both primary adrenocortical insufficiency was demonstrated to be the cause of the symptoms. Serological tests suggested an autoimmune genesis. Recurrent severe hypoglycaemia and unconsciousness in insulin-treated diabetics indicates that adrenocortical insufficiency should be excluded.

Addison Disease↗
PubMed1984

[New instrument for blood glucose determination. Results of a clinical trial of the Reflocheck].

Reflocheck, a new microprocessor-regulated apparatus determining blood sugar levels was tested in six laboratories. In the range of 20-450 mg/dl the apparatus gave precise results (co-efficient of variance 0.8%-6.4%), in good agreement with results by the hexokinase method. Reflocheck is an accurate and reliable instrument for the measuring of blood glucose levels.

Blood Chemical Analysis↗
PubMed1984

Effect of long-term fasting of obese patients on pancreatic exocrine function, gastrointestinal hormones and bicarbonate concentration in plasma.

The CCK- and secretin stimulated pancreatic volume, bicarbonate and enzyme secretion was investigated before and during fasting for 20 days in 12 obese subjects. Pancreatic function tests were performed at the start of the fasting period and on the 10th and 20th day. In an additional and comparable group of 8 obese patients plasma concentrations of cholecystokinin (CCK), gastrin and insulin as well as metabolic parameters (bicarbonate, beta-OH-butyrate and free fatty acids) have been measured before and during total fasting. During three weeks of total fasting the average overweight of the patients undergoing pancreatic function tests was reduced from 49 to 31% (-11.5 +/- 1,5 kg). A significant reduction of volume, bicarbonate, trypsin and amylase secretion occurred already after 10 days of total fasting. After 20 days these parameters were further significantly reduced compared to the 10th day. All mentioned parameters were found at the lower limit of the normal range at the end of the fasting period at 20 days. The only exception being lipase secretion; the decrease of this enzyme was not significant at the 5% level. No significant reduction of basal plasma concentrations could be observed for CCK and gastrin during the course of total fasting. The plasma insulin levels were significantly reduced after 7 days whereas at 10 and 20 days insulin concentration was not significantly lowered compared to day 1. A small but significant decrease in the blood bicarbonate concentration could be observed after 7 days of fasting which remained constant up to the end of the study.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxybutyric Acid↗
PubMed1982

[Treatment of unstable diabetes with a portable insulin-infusion pump (author's transl)].

A portable insulin-infusion pump (Promedos Siemens) was used in 19 patients with unstable or brittle diabetes. Continuous insulin supply was via the intravenous route in nine, subcutaneously in ten patients. The insulin pump was used in those patients in whom, after hospitalization for two to three weeks, the diabetes remained poorly controlled. In all patients the carbohydrate metabolism was normalised. Subcutaneous insulin infusion was as effective as the intravenous one. In all instances it was possible, partly by transferring insulin uptake during the day and night to two subcutaneous injections, to improve conventional control even after the infusion period was over. Continuous, regulated insulin supply - intravenously or subcutaneously - is superior to conventional subcutaneous administration. Portable insulin infusion pumps can be used in individual patients even without glucose sensing.

Adolescent↗
PubMed1982

[Self-control of blood sugar (author's transl)].

Nine well-trained insulin-dependent diabetics checked their blood sugar using a test strip (Haemo-Glukotest 20-800) and three reflectometers (Reflomat, Dextrometer, Glucosemeter) in order to compare the accuracy of the three instruments with that of the test strip. 227 single checks were carried out, and the blood sugar was checked by means of the hexokinase method. The correlation of the four methods with the hexokinase method was comparable: Reflomat r = 0.95, Dextrometer r = 0.94, Haemo-Glukotest 20-800 r = 0.93, Glucosemeter r = 0.91. Classification of the results into various measuring ranges yielded a comparable accuracy of all four methods between 40 and 250 mg/dl; above 250 mg/dl, there was a considerable decrease in accuracy even of the reflectometers. Hence, the reflectometers do not offer any significant advantages over the visual Haemo-Glukotest 20-800 readings as far as self-control of blood sugar by the diabetic is concerned.

Adult↗
PubMed1982

Exocrine pancreatic function in insulin-dependent diabetes mellitus.

Exocrine pancreatic function was studied in patients with long-standing insulin-dependent diabetes mellitus using the secretin-pancreozymin test (n = 53), and estimation of immunoreactive trypsin (n = 43) and pancreatic isoamylase (n = 43). The secretin-pancreozymin test was abnormal in 23 patients (43%). The abnormalities found were a decreased output of lipase (37%), amylase (36%) or trypsin (26%) and bicarbonate (15%). Serum immunoreactive trypsin was below normal in only 6 (14%) and pancreatic isoamylase in 29 (67%) patients. There was no correlation between impairment of the secretin-pancreozymin test and decreased serum enzyme levels. It is concluded that an impairment of exocrine pancreatic function is frequent in insulin-dependent diabetics but that a decrease in serum enzymes, especially in pancreatic isoamylase, does not reflect an impairment of pancreatic function in these patients.

Adult↗
PubMed1981

Effect of exogenous insulin on fasting serum levels of gastric inhibitory polypeptide (GIP) in juvenile diabetes.

The effect of insulin on fasting levels of immunoreactive gastric inhibitory polypeptide (IR-GIP) has been examined in insulin-dependent, juvenile-type diabetics who were well-controlled with two doses of an intermediate insulin. After withdrawal of the evening insulin injection the fasting blood glucose and serum IR-GIP levels were elevated and decreased significantly following intravenous insulin towards normal values. There was a significant positive correlation between levels of blood glucose and serum IR-GIP before and during insulin application. It is suggested that fasting serum GIP levels increase in case of insulin deficiency because basal GIP secretion is suppressed by normal insulin levels.

Adult↗