Growth hormone replacement in a hypopituitary insulin dependent woman.
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Adult↗
Biomedical subjects
C Lowy
Publications and source records attributed to C Lowy.
Home monitoring of blood glucose: new approach to management of insulin-dependent diabetic patients in Great Britain.
The history of home monitoring of blood glucose by diabetic patients at St. Thomas' Hospital in London is reviewed. Initial successful experience with pregnant diabetic patients was extended to cover those with retinopathy and, subsequently, to all insulin-treated patients. Experience showed overwhelming preference by patients for blood glucose monitoring over urine tests and demonstrated improvement in blood glucose control. Experience in children 13 and older was equally (if not more) enthusiastic as in adults. Self-monitoring revealed many elementary mistakes in insulin therapy, which, when corrected, led to marked improvement in diabetic control with reduced frequency and severity of hypoglycemic attacks. Initial studies were made with Dextrostix and Eyetone. The need for a simple patient-oriented blood glucose machine was identified, and Glucochek was designed to meet it. Evaluation of Glucochek was satisfactory, and it was well liked by patients. It seems likely that blood glucose monitoring will replace urine tests in the majority of diabetic patients.
Adolescent↗
Hyperglycaemia; a risk factor for hypertension.
The epidemiological evidence for an association between diabetes mellitus and ischaemic heart disease is reviewed briefly. The relationship between blood sugar after challenge and blood pressure is described, with particular reference to studies in populations of U.S. and Jamaican adults and Dutch children.
Adult↗
Non-insulin-dependent diabetes: 10-year outcome in relation to initial response to diet and subsequent sulfonylurea therapy.
Thirty-eight non-insulin-dependent diabetic patients within 130% of desirable body weight were given a 100-g oral glucose tolerance test (OGTT) at diagnosis and after at least 1 mo of dietary treatment with energy and carbohydrate restriction. Thirteen "responders" showed an improvement in fasting blood glucose, glucose tolerance, and insulin secretion, with near-normalization of plasma, lactate, pyruvate, free fatty acids, glycerol, and ketone bodies. There were no significant changes in the 25 "non-responders." The responders were, at diagnosis, heavier than the non-responders (75.5 versus 64.3 kg, P less than 0.01). Twenty non-responders subsequently completed a prospective controlled study of glibenclamide, chlorpropamide, and placebo lasting for 16 mo with OGTTs at the end of each 4-mo treatment phase. The results showed that there were no significant differences between the metabolic effects of glibenclamide and chlorpropamide. On active treatment, insulin levels rose coincident with a fall in fasting blood glucose and an improvement in glucose tolerance and near-normalization of plasma lactate, pyruvate, free fatty acids, glycerol, and ketone bodies, all of which relapsed to initial values after placebo. Ten years after the initial study, 29 of the original patients were traced and reviewed and the outcome related to their earlier tests. Twenty-two percent of the responders and 70% of the non-responders were now on insulin (P less than 0.02); the initial insulin response to OGTT at the end of the diet treatment was significantly lower in those subsequently treated with insulin (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗