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Biomedical subjects

E Chantelau

Publications and source records attributed to E Chantelau.

At least 91 records · Page 5Linked to original sources
PubMed1986

Effects of the glycaemic index of dietary carbohydrates on prandial glycaemia and insulin therapy in type I diabetes mellitus.

Four carbohydrate diets with different glycaemic index were fed to 10 type I diabetic patients on continuous subcutaneous insulin infusion (CSII). Every diet consisted of 4 meals with identical carbohydrate content, being consumed during one day each at 8.00, 12.00, 16.00 and 18.00 h. CSII was conducted according to the patients' experiences, aiming at plasma glucose values between 70 and 160 mg/dl. From 8.00 to 20.00 h, plasma glucose was measured every 2 h. Plasma glucose profiles were near-normal with all of the diets; differences between the diets were statistically insignificant. The premeal insulin dosages, as delivered by the patients, varied significantly in relation to the time of the day, and to the premeal plasma glucose concentration. The patients varied their prandial insulin doses also in relation to the 4 diets, indicating that the glycaemic index was helpful for the prediction of their prandial insulin requirements. It is concluded that near-normoglycaemia can be achieved in type I diabetic subjects on CSII irrespective of the glycaemic index of their diet, if the prandial insulin requirements are met adequately.

Adult↗
PubMed1985

[Liberalized diabetic diet for type I diabetics under intensive insulin injection therapy. Follow-up observations for over 2 years].

The dietary habits and metabolic status of 14 selected ambulant type-1 diabetics, who were previously treated with conventional insulin therapy, were investigated over a period of 2 years under intensified insulin injection therapy. In this, multiple doses of regular insulin in combination with intermediate-acting insulin were injected daily and the regular metabolic controls as well as adjustment of the insulin dosage were undertaken by the patients themselves. Whereas conventional insulin therapy made exclusive use of intermediate-acting insulin, 41% of the daily dose in the intensified insulin injection therapy was regular insulin. The total daily insulin dose of 51 +/- 12 U/d was therefore not significantly different from that in the conventional insulin therapy (49 +/- 10 U/d). During the intensified insulin injection therapy the usual diabetic diet was relaxed in several aspects: neither the daily intake of fat, protein and calories, nor substitution in the diet using exchange lists was specified. Despite this liberalization HbA1c values decreased significantly from 9.3 +/- 1.2% to 7.8 +/- 0.7% (P less than 0.05) and blood lipids remained in the normal range. The results of this retrospective investigation lead to the conclusion that despite some measure of diet liberalization, selected, trained, type-1 diabetics of normal body weight and without primary dyslipoproteinaemia can attain good metabolic control under intensified insulin injection therapy.

Activities of Daily Living↗
PubMed1985

Absorption of subcutaneously administered regular human and porcine insulin in different concentrations.

The influence of the insulin concentration on its absorption from the subcutaneous tissues was studied by direct measurement of the appearance of insulin in the circulation after its subcutaneous administration. 10 units of regular insulin of semisynthetic human and porcine origin in strength of 15 units/ml, 40 units/ml, and 100/units/ml were administered as bolus to 9 healthy male volunteers, using switched-off, manually handled insulin pumps. Insulinaemia rose significantly higher (p less than 0.05) and insulin levels peaked earlier after the delivery of the 15 units/ml insulin solutions compared to the 100 units/ml insulin solutions. These findings might be of interest for type-I diabetic patients using insulin pumps that are to be loaded with regular insulin in varying concentrations.

Absorption↗
PubMed1982

[Continuous subcutaneous insulin infusion brings about normal blood sugar in type I diabetes mellitus despite relaxing of diet instructions].

In 6 normal weight juvenile diabetic patients treated with continuous subcutaneous insulin infusion (CSII) we have investigated whether the restrictive management of the diabetes diet could be relaxed. On 2-3 days of a 4 week period the patients ate a) a conventional diabetes diet consisting of 3 main meals and in-between snacks of a prescribed carbohydrate content or b) a liberal diabetes diet in which the patients could choose the number of meals and carbohydrate contents. With both diets, mean blood glucose levels during the day were in normal range (96 +/- 3 and 101 +/- mg/dl, mean +/- SEM). On the liberal diet meal frequency and carbohydrate intake per day were significantly lower, the carbohydrate content per meal significantly larger when compared with the conventional diabetes diet. There was not difference in insulin requirements per day (basal rate plus premeal dosage). All the patients preferred the liberal diet. CSII allowed juvenile diabetic patients a more liberal management of their diabetes diet without negative effects on blood glucose control. Hence CSII improved the quality of life in these patients.

Adult↗
PubMed1982

Human and porcine regular insulins are equally effective in subcutaneous replacement therapy. Results of a double-blind crossover study in type I diabetic patients with continuous subcutaneous insulin infusion.

Semisynthetic human Actrapid insulin (HAI, Novo, Copenhagen) was tested against porcine Actrapid insulin (PAI, Novo, Copenhagen) in 12 type I diabetic patients treated with continuous subcutaneous insulin infusion (CSII). In a double-blind crossover trial each patient received both types of insulin over a 3-wk period, respectively. No significant differences between HAI and PAI were observed in the following parameters: mean blood glucose levels (MBG) of 3-6 measurements per day (129 +/- 5 versus 125 +/- 4 mg/dl, means +/- SEM), mean maximal excursions of blood glucose during the day (107 +/- 6.6 versus 107 +/- 6.9 mg/dl), total daily insulin requirements (sum of basal and premeal insulin doses, 45.7 +/- 1.4 versus 42.7 +/- 1.4 U/day), and a mean of weekly determined hemoglobin A1c values (7.77 +/- 0.13 versus 7.83 +/- 0.14% of total hemoglobin); the frequency of mild hypoglycemic episodes was similar with the two insulins. Thus, under the controlled conditions of CSII, semisynthetic human and porcine regular insulin preparations are of identical efficacy in type I diabetic patients at near normoglycemia.

Absorption↗
PubMed1981

Cardiovascular risk factors and HDL-cholesterol levels in obesity.

In 1332 patients with different degrees of obesity (344 men, mean age 36 +/- 13 years, Broca Index 1.46 +/- 0.23; 988 women, mean age 37 +/- 13 years, Broca Index 1.67 +/- 0.30), cardiovascular risk factors (RF), serum HDL-cholesterol, and insulin levels were investigated. The most frequent RF was diastolic hypertension (68 per cent), followed by systolic hypertension (56 per cent), glucose intolerance (55 per cent), hypertriglyceridemia (31 per cent), hyperuricemia (19 per cent) and hypercholesterolemia (18 per cent). Only 9.4 per cent of the patients were without RF, and these patients were younger and less obese than patients with RF. Compared with controls, HDL-cholesterol levels were decreased in obese patients, however, the negative linear correlation between relative body weight and HDL-cholesterol levels was only significant in women, not in men. HDL-cholesterol levels were higher in women than in men. Serum insulin levels were correlated positively with relative body weight and negatively with age. Partial correlation analysis revealed a stronger influence of age than body weight on blood pressure, serum levels of total cholesterol, LDL-cholesterol, triglycerides and blood glucose levels. Uric acid levels correlated positively, and HDL-cholesterol levels negatively with relative body weight alone and not with age. On the basis of prevalence of RF, low serum HDL-cholesterol and high insulin levels, obese patients must be considered at high risk with respect to the development of cardiovascular disease.

Adult↗
PubMed1980

[Blood-sugar self control. A means for the diabetic of controlling his metabolic management. Quality control of a battery-run pocket size reflectometer (glucose-meter)].

Home blood glucose monitoring by diabetic patients has recently been advocated as an effective means to improve metabolic control. The Glucocheck apparatus, a pocket-size battery-driven reflectance-meter (in Germany commercially available under the name Glucose-meter), has been evaluated for accuracy and practicability. In 450 blood glucose measurements, the variance between the values obtained using the Glucocheck apparatus and routine clinical laboratory procedures was +/- 11.7%. Especially in the low range of blood glucose concentrations, the Glucocheck method was very reliable. The quantitative precision of the Glucocheck method depends, however, quite considerably on the ability of the patient to use the apparatus correctly. In order to profit from Glucocheck in clinical practice, particular efforts to educate the patients in its use are necessary.

Adult↗
PubMedDate not supplied

Association of blindness to intensification of glycemic control in insulin-dependent diabetes mellitus.

Intensive glycemic control (IGC) in previously hyperglycemic insulin-dependent diabetes mellitus (IDDM) patients is associated with a decreased long-term risk of progression of diabetic retinopathy (DR); up to 12 months after institution of IGC, however, the risk of progression of DR transiently increases. In an observational study, a cohort of 122 patients with IDDM was followed prospectively for changes in glycosylated hemoglobin (HbA1, normal < 8%) and in DR 0-12 months after institution of IGC. In six of these patients (women, mean age 24 years, duration of diabetes 14.3 years, with incipient nephropathy and retinopathy) a total of seven eyes went blind after 6-12 months of IGC, despite laser coagulation treatment. From the whole sample, a control groups of eight patients (six women) was set up, matched for age, duration of IDDM, degree of retinopathy, visual acuity, blood pressure, and microalbuminuria, with preserved vision after 12 months of IGC. In the case patients, the mean (95% confidence interval) initial HbA1 was 14.9% (13.8%-16.1%), versus 13.4% (12.4%-14.4%) in the control patients (p < 0.05). The mean HbA1 decrements after 4 months of IGC, were 3.0% (1.9%-4.1%) in the cases, and 2.1% (1.2%-3.0%) in the controls (NS); and after 12 months, the respective decrements were 4.9% (2.4%-7.4%) in the cases versus 2.0% (0.5%-3.5%) in the controls (p = 0.04). In conclusion, IGC with a decrement of > 2% per year is associated with a high risk of progression of antecedent diabetic retinopathy to blindness in IDDM patients with an extremely high initial HbA1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

An audit of cushioned diabetic footwear: relation to patient compliance.

The recurrence rate of neuropathic foot ulcers is reported in 51 diabetic patients regularly attending a diabetic foot clinic. All of the patients were provided with protective footwear reducing peak plantar pressure at the forefoot area by 50% (versus normal shoes), and were followed up for up to 4 years. Compliance with this footwear was recorded by assessing the daily time of wearing protective or normal shoes, and compliance with foot care was recorded from the entries in the patients charts. The results of this observational study demonstrate that wearing protective shoes for > 60% of the daytime significantly (p = 0.0002) reduced the ulcer relapse rate by > 50% in comparison with shorter wearing times for these shoes. In addition, patients without ulcer relapses had foot care significantly more frequently than patients with relapse (p < 0.05). It is concluded that cushioned protective footwear in association with frequent foot care is essential in the prevention of neuropathic diabetic foot ulcer recurrence.

Aged↗
PubMedDate not supplied

Foot dimensions of elderly people with and without diabetes mellitus - a data basis for shoe design.

BACKGROUND: Injuries from footwear are common in elderly people, particularly in those with diabetes mellitus and polyneuropathy. A common cause is a mismatch between foot and shoe. OBJECTIVE: To assess the length and the breadth of the feet by an automatic measuring device in 568 patients with diabetic polyneuropathy and in 100 nondiabetic control subjects of the same mean age of 64 years. RESULTS: While the foot length in all cases matched well with the size of the normal footwear available on the market, more than two thirds of the feet were considerably broader than the normal footwear available. The foot breadth correlated variably with the foot length. Tables of foot dimensions for men and women are provided over the complete range of shoe sizes. CONCLUSIONS: This anthropometric data set on feet, which is the first conducted in elderly people, proves that most feet of elderly people with or without diabetic neuropathy do not fit ordinary casual footwear. Therefore, the construction of shoes according to the anthropometric data of elderly people is required in order to prevent foot injuries in this particular population.

Aged↗