Biomedical subjects

D C Simonson

Publications and source records attributed to D C Simonson.

75 records · Page 5Linked to original sources

PubMedDate not supplied

Non-insulin-dependent diabetes mellitus and elevated serum ferritin level.

An elevated serum ferritin concentration recently has been shown to be associated with coronary artery disease and its risk factors, including blood glucose concentration. The purpose of this study is to establish the prevalence of elevated levels of serum ferritin in patients with non-insulin-dependent diabetes mellitus (NIDDM) without hemochromatosis and to determine whether or not deferoxamine is of therapeutic value in treating such patients. The level of serum ferritin was measured in consecutive eligible patients with NIDDM seen at routine outpatient visits. Five patients with an elevated serum ferritin were treated with deferoxamine, 1 g intramuscularly, twice a week for 12 weeks. The level of serum ferritin was measured every 4 weeks, and the level of glycosylated hemoglobin was measured at baseline, at the end of the treatment, and 12 weeks after treatment was completed. The level of serum ferritin was elevated in 34 of 102 (33%) patients with NIDDM. The level of serum ferritin remained elevated in 30 of 32 (94%) of these patients on repeat testing. In three of the five patients treated with deferoxamine, the level of serum ferritin was normalized, but no patient had an appreciable change in dosage of medication for diabetes or glycemic control. Non-insulin-dependent diabetes is a condition frequently associated with elevated levels of serum ferritin. Treatment with deferoxamine intramuscularly was not effective in improving control of glucose in our patient group.

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PubMedDate not supplied

Etiology and prevalence of hypertension in diabetic patients.

Data from several epidemiologic studies have suggested that the prevalence of hypertension in patients with diabetes mellitus is approximately 1.5-2.0 times greater than in an appropriately matched nondiabetic population. In patients with insulin-dependent diabetes mellitus (IDDM), hypertension is generally not present at the time of diagnosis. As renal insufficiency develops, blood pressure rises and may exacerbate the progression to end-stage renal failure. In non-insulin-dependent diabetes mellitus (NIDDM), many patients are hypertensive at the time of diagnosis. The incidence of hypertension in NIDDM is related to the degree of obesity, advanced age, and extensive atherosclerosis that is typically present, and it probably includes many patients with essential hypertension. Several other pathophysiologic mechanisms also contribute to the genesis and maintenance of hypertension in the patient with diabetes. Hyperglycemia and increases in total-body exchangeable sodium may lead to extracellular fluid accumulation and expansion of the plasma volume. In some patients, alterations in the function of the renin-angiotensin-aldosterone system and vascular sensitivity to vasoactive hormones may also play a role. It has recently been suggested that hyperinsulinemia and insulin resistance may also contribute to the maintenance of an elevated blood pressure because insulin is known to promote sodium retention and enhance sympathetic nervous system activity. The evidence for these hypotheses and their respective contributions to the etiology of hypertension in IDDM and NIDDM are discussed.

Diabetes Complications↗

PubMedDate not supplied

Oral sulfonylurea agents suppress hepatic glucose production in non-insulin-dependent diabetic individuals.

In the present paper we have reviewed the literature concerning the mechanisms of action of the oral sulfonylurea agents on glucose metabolism. In addition, we report our results examining the effect of glyburide in 10 non-insulin-dependent diabetic patients. Before therapy the fasting glucose concentration averaged 198 +/- 19 mg/dl and the oral glucose tolerance test (OGTT) was markedly abnormal. Following 3 mo of glyburide therapy, the fasting glucose had declined to 141 +/- 16 mg/dl (P less than 0.01 vs. preglyburide) and the OGTT (absolute plasma glucose concentration) was improved (P less than 0.001). However, the incremental increase (i.e., above basal) in plasma glucose during the OGTT was not significantly altered. In the postabsorptive state the fasting plasma glucose concentration is determined by only two factors: (1) the rate of glucose entry into the body, which is essentially equal to the rate of hepatic glucose production (HGP) and (2) the rate of glucose removal from the body or the glucose clearance. In the basal state HGP was slightly increased compared to age-matched controls and averaged 2.35 +/- 0.28 mg/kg X min. Following 3 mo of glyburide, HGP decreased to 1.72 +/- 0.18 mg/kg X min (P less than 0.01) and the decrease in HPG was strongly correlated with the decrease in fasting glucose (r = 0.85, P less than 0.005). Basal glucose clearance in non-insulin-dependent diabetes was reduced compared to controls (1.22 +/- 0.04 vs. 2.32 +/- 0.03 ml/kg X min, P less than 0.001) but did not change after glyburide (1.25 +/- 0.10).(ABSTRACT TRUNCATED AT 250 WORDS)

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