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Biomedical subjects

D Toussaint

Publications and source records attributed to D Toussaint.

At least 73 records · Page 4Linked to original sources
PubMed1985

Peroneal motor nerve conduction velocity in diabetic children and adolescents. Relationships to metabolic control, HLA-DR antigens, retinopathy, and EEG.

To investigate incipient diabetic neuropathy, peroneal motor nerve conduction velocity (PMNCV) was measured in 61 diabetic children and adolescents whose type 1 diabetes became clinically apparent before the age of 14 years. PMNCV in diabetic patients (48.3 +/- 5.6 m/s) was significantly lower than in controls (56.5 +/- 5.5 m/s), 23 diabetics (36%) having a value more than 2 SD below the mean for normals. There was a highly significant negative correlation between PMNCV and HbA1 levels concomitant with PMNCV measurement or mean annual HbA1 concentrations preceding PMNCV. The relationship between PMNCV and the clinical score of diabetic control since the onset of the disease was also significant. Age, duration of diabetes and HLR-DR antigens were unrelated to PMNCV. EEG abnormalities and retinopathy, whose pathogenesis is different, were not necessarily associated with subclinical neuropathy. Being easy and sensitive, PMNCV determination provides the paediatric diabetologist and the patient himself with an important motivation to improve diabetic control.

Adolescent↗
PubMed1985

Transient acute disc swelling associated with improved metabolic control in an adolescent with type-I diabetes: role of dexamethazone therapy.

Acute disc swelling in type-I diabetic patients is a distinct syndrome that may be distinguished clinically, particularly from papilloedema due to increased intracranial pressure. This paper reports the first detailed case of this rare condition in which disc swelling seems to be associated with rapid improvement of metabolic control. We suggest that the pathogenesis of disc swelling is related to a local breakdown of the blood retinal barrier at the level of the optic nerve, resulting in an intense leakage. Compression of the optic nerves secondary to this vasculopathy appeared to be reversed by administration of dexamethazone. It is suggested that in diabetic patients with long-standing poor metabolic control, rapid conversion to good metabolic control could have this result. However further information is necessary to substantiate this relationship.

Adolescent↗
PubMed1983

Clinicopathological study of the visual pathways, eyes, and cerebral hemispheres in 32 cases of disseminated sclerosis.

The pathological study of the cerebral hemispheres and visual pathways in 32 cases of disseminated sclerosis, including 15 cases in which the retinal structures were investigated, lead us to point out: 1) the high frequency of histological lesions of the optic nerves, tracts and radiations; 2) the lack of correlation between the extent of demyelination of the optic nerves and the impairment of visual acuity that is mainly related to axonal lesions; 3) the relative high frequency of pathological sheathing of retinal veins; and 4) the high proportion of shadow plaques in the cerebral hemispheres in cases with clear-cut relapses and remissions.

Adult↗
PubMed1982

[Glycosylated hemoglobin and clinical evaluation of the degree of diabetes control. Relation to blood sugar, blood cholesterol, blood triglycerides, and the duration of diabetes and retinopathy. Study of 85 diabetic children and adolescents].

The measurement of HbA1 gives an "objective" estimate of the degree of metabolic control of diabetes during the erythrocyte lifespan. 333 assays in 85 young diabetics aged three to twenty-three years showed a mean HbA1 of 10.9 +/- 2.6% (controls: 7.4 +/- 1.4%). HbA1 levels parallel the clinical evaluation of the degree of control. HbA1 concentrations are correlated with the duration of diabetes (r = 0.26; p less than 0.001), triglyceridemia (r = 0.22; p less than 0.001), cholesterolemia (r = 0.26; p less than 0.001) and glycemia (r = 0.50; p less than 0.001). The HbA1 glycemia correlation grows stronger as glycemia increases. This probably reflects the existence of a labile form of HbA1. HbA1 concentrations measured repeatedly over one year were not significantly different in diabetics with and without retinopathy, probably because the study period was too short. Measurement of HbA1 is also of value in diagnosing non-compliance.

Adolescent↗
PubMed1982

Exogenous insulin needs. Relationship with duration of diabetes, C-peptidemia, insulin antibodies, and retinopathy.

The study included 75 young diabetics, having a mean age of 13.7 (+/- 3.4) years, and whose diabetes duration was 5.0 (+/- 3.1) years. All of the subjects were insulin dependent, and none had developed insulin resistance. Injections of either conventional or purified insulin were used. The subjects' diets were "spontaneously balanced", and their physical exercise was similar to non-diabetic school-age children. The 75 diabetics were arbitrarily divided into two groups, A and B, according to their average insulin dose/kg, either less than 1 U/kg or greater than 1 U/kg. Groups A and B were comparable according to their age, age of diabetic onset, degree of diabetic control, frequency of retinal complications, proportion of different insulin types, and concentration of beef or pork insulin antibodies. Insulin antibodies were therefore not responsible for any modification in insulin needs. Insulin needs per kg were very significantly correlated to residual secretion of endogenous insulin (r = -0.34; p less than 0.001). They were equally dependent on the duration of diabetes probably because of the progressive beta cell exhaustion. Insulin needs were also weakly negatively correlated to weight, therefore the heaviest diabetics injected an insulin/kg dose relatively less than the lighter diabetics.

Adolescent↗
PubMed1982

[Residual insulin secretion in juvenile diabetes. Relationships with duration of diabetes, metabolic control and retinopathy (author's transl)].

This study concerned 74 diabetic children and adolescents, ages ranging from 3 to 21 years. Duration of the disease ranged from 1 month to 15 years. Blood samples were taken during a 12 month period of observation. 292 immunoreactive C-peptide (CPR) evaluations showed a residual endogeneous secretion of insulin in 57% of cases. CPR and duration of diabetes were negatively correlated (r = -0.35; p less than 0.01); however, even 5 years after onset of the disease, a residual beta-cell activity could be observed. CPR was not related with blood glucose, triglyceride, cholesterol or glycosylated hemoglobin levels. On the other hand, CPR was statistically higher in patients whose diabetes had been well-controlled from the onset of the disease, according to clinical criteria, and in those who did not present with retinopathy: however they were also the patients with the shortest duration of disease.

Adolescent↗
PubMed1981

[Islet-cell antibodies and organ-specific antibodies in diabetic children and adolescents. Relationship with age, age at onset, duration of diabetes, residual insulin secretion and retinopathy (author's transl)].

The prevalence of islet-cell antibodies and of 10 organ-specific auto-antibodies was determined in 71 diabetic children and adolescents whose mean duration of diabetes was 4 1/2 years. Forty-four p. cent of the patients had autoantibodies; 15% had islet-cell antibodies and 31% had organ specific antibodies. The prevalence of antinuclear, gastric parietal cell and striated muscle antibodies was significantly higher in diabetics than in controls. There was no relationship between prevalence of antibodies and age of the diabetics nor age at the onset of the disease. The frequency of circulating islet-cell antibodies tended to decrease with the duration of diabetes while organ-specific antibodies remained stable. The study failed to demonstrate any correlation between measurable C-peptide and the presence of autoantibodies. Diabetic retinopathy, diagnosed by fluorescein angiography, was not related to the presence of autoantibodies.

Adolescent↗