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Biomedical subjects

E Chantelau

Publications and source records attributed to E Chantelau.

At least 37 records · Page 2Linked to original sources
PubMed2000

Possible activation of auto-immune thyroiditis from continuous subcutaneous infusion of genapol-containing insulin.

A case of a type 1 diabetic woman with auto-immune thyroiditis is reported, in whom repeated exposure to insulin containing Genapol(R) (polyethylen-polypropylenglycol) over 3 years reproducibly parallels with an increase of serum TSH (thyroid-stimulating hormone) above the normal limit. Previously, adverse effects of Genapol(R) insulin have been related to its intraperitoneal application, and thought to be restricted to anti-insulin-immunity; activating effects on thyroid auto-immunity have been repeatedly disputed. We suggest that Genapol(R) insulin should be replaced by other insulin preparations with a better safety record.

Autoantibodies↗
PubMed1999

Effects on parameters of glucose homeostasis in healthy humans from ingestion of leguminous versus maize starches.

BACKGROUND: Due to their lower glycaemic index, leguminous seeds affect human carbohydrate metabolism lesser than do cereals. Problems, however, could arise from side effects, e.g., increasing flatulence. AIM OF THE STUDY AND METHODS: In 26 healthy subjects, metabolic and symptomatic responses following acute ingestion of equivalent amounts of pure pea starch (NASTAR (Cosucra BV, Rosendaal/The Netherlands), crude yellow pea flour (CPC Deutschland, Germany), and modified and unmodified cornstarches (SNOWFLAKE and SIRONA, Cerestar/Germany) were assessed, i.e., plasma glucose, serum insulin, C-peptide, hydrogen exhalation, and flatulence. RESULTS: Pure pea starch elicited less hyperglycaemia (minus 47 %), hyperinsulinaemia (minus 54 %), and C-peptide secretion (minus 37 %) as compared to cornstarch (p<0.05), while the responses to modified versus unmodified corn starch were similar (8 subjects, n.s.). Pure pea and corn starches were equally well tolerated, while flatulence and breath hydrogen concentration were increased only after the intake of crude pea flour. Maldigestion of pea flour was calculated to be around 10 % (reference lactulose). CONCLUSIONS: The well-known metabolic advantages of pea starch over cornstarch were confirmed. Tolerability of pure pea starch was excellent, but not of crude pea flour. Provided it has the same technical characteristics, pure pea starch as a "prebiotic" could replace cornstarch in industrial food production.

Adult↗
PubMed1999

[The "diabetic foot" syndrome. An overview].

Amputation has been used most frequently to treat the diabetic foot syndrome, occlusive microangiopathy being suspected as the underlying cause. This paradigm is obsolete: most diabetic foot lesions are due to traumatic painless (neuropathic) infections. Evidence is presented for alternative treatment strategies to effectively reduce exorbitant amputation rates in diabetic patients.

Amputation, Surgical↗
PubMed1998

Evidence that upregulation of serum IGF-1 concentration can trigger acceleration of diabetic retinopathy.

BACKGROUND: Acute reduction of chronic hyperglycaemia can accelerate early diabetic retinopathy. In adolescent patients with Mauriac's syndrome, this phenomenon is related to an upregulation of subnormal serum IGF-1 levels. AIM: To obtain longitudinal data on serum IGF-1 and retinopathy status in poorly controlled adult insulin dependent (type 1) diabetic patients without Mauriac's syndrome, in whom hyperglycaemia is reduced by intensive insulin therapy. METHODS: Four patients with chronic severe insulin deficiency and early micro-angiopathy were studied prospectively. Changes in plasma glucose, HbA1c, serum IGF-1 levels, proteinuria, retinopathy, and clinical status were followed up closely. RESULTS: Reducing hyperglycaemia from > 16 mmol/l (equivalent to HbA1c > 11%) to < 10 mmol/l (HbA1c < 8%) within 5 months increased serum IGF-1 levels by 70-220%. While proteinuria and symptomatic neuropathy regressed, retinopathy progressed from the mild to the severe non-proliferative stage with maculopathy (n = 4), and to the proliferative stage (n = 1). Laser coagulation was commenced upon the appearance of sight threatening macular oedema (n = 4). CONCLUSION: Upregulation of serum IGF-1 preceding retinal deterioration in these patients suggests a cause-effect relation, consistent with earlier experimental and clinical data.

Adult↗
PubMed1997

Effect of patient-selected intensive insulin therapy on quality of life.

The purpose of the study was to assess quality of life in patients with IDDM in relation to the type of insulin therapy. Two patient cohorts were studied. In cohort A, 77 patients deliberately intensified their traditional insulin injection therapy from up to two daily injections with syringe to multiple daily injections with insulin-pen; in cohort B, 55 patients changed from intensive therapy with pen to insulin pump-treatment (CSII). The therapeutic regimens were changed during a 5-day in-patient treatment and teaching course. The DCCT questionnaire was applied before and up to 6 months after changing of therapy. Treatment satisfaction increased after intensification of insulin therapy in both groups, mainly due to greater flexibility with leisure-time activities, and with the diet. Pump-users reported reduced problems with hypoglycemia (P < 0.02). HbA1c indicating acceptable metabolic control already before the study, remained unchanged. Therapy-associated inconvenience, mainly in association with lifestyle, improved in IDDM patients deliberately intensifying their insulin therapy by pens or pumps (CSII). Pump-treatment, rather than pen-therapy, conferred particular protection from hypoglycaemia.

Adult↗
PubMed1997

Elevation of serum IGF-1 rather than sex steroids precedes proliferative diabetic retinopathy in Mauriac's syndrome.

We report the case of a 21-year-old man with Mauriac's syndrome, in whom diabetic retinopathy progressed to the proliferative state despite slightly improved glycemic control and completely suppressed sex steroids (by a GnRH agonist). However, a gradual increase in serum IGF-1 from 162 to 482 ng/ml over 9 months clearly preceded retinal deterioration, which responded to panretinal laser coagulation. We conclude that substantial elevation of serum IGF-1 may be another risk factor for the progression of mild diabetic retinopathy to the proliferative state.

Adult↗
PubMed1996

Antibiotic treatment for uncomplicated neuropathic forefoot ulcers in diabetes: a controlled trial.

To investigate the effect of oral antibiotics in purely neuropathic ulcers (Wagner grade 1-2, no osteomyelitis), a double blind placebo-controlled study was performed. Forty-four patients were enrolled and subjected to standard treatment with absolute pressure relief (half shoes), daily wound cleansing (topical disinfectant), sterile dressings (specialized nurse). Patients were randomized to an antibiotic (amoxicillin plus clavulanic acid), or placebo. The study was stopped when the antibiotic proved unsuitable according to swab result, or on clinical grounds (no improvement within 6 days of recruitment). Main outcome measure was the ulcer closing rate during 20 days, as assessed by standardized photographs. All ulcers except one were infected. Of the placebo group (n = 22), 2 patients had to be withdrawn within 6 days, versus 3 patients of the antibiotic-group (n = 22). In the placebo group, 10 ulcers were healed versus 6 ulcers in the antibiotic group (NS). Mean (95% CI) reduction in ulcer radius was 0.41 (0.21-0.61) mm day-1 in the placebo group versus 0.27 (0.15-0.39) mm day-1 in the antibiotic group (NS). In conclusion, there is no benefit from antibiotic treatment with amoxicillin plus clavulanic acid as a supplement to standard therapy in uncomplicated neuropathic foot ulcers, provided pressure relief is complete, and wound care is performed strictly supervised. However, a Type-II statistical error cannot be excluded in this small study.

Administration, Oral↗