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Biomedical subjects

E Eschwege

Publications and source records attributed to E Eschwege.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Hospital care of insulin-treated diabetes in African immigrants, in France].

Eighty insulin treated diabetics from North or West Africa were interviewed and compared to 80 French controls matched for sex, age and duration of insulin-therapy. Modalities and access to medical care in a specialized clinic were studied. African people were predominantly blue collar workers (49%) and French people employees (70%). The percentage of unemployed people was similar. Africans performed blood glucose self testing less frequently (35.5% vs 60.5%). Only 40% (vs 75%) participated in specific educational activities because 40% of the migrants did not read French. Despite insulin treatment being similar, metabolic control was worse among migrants (HbA1: 10.5 +/- 2.4 vs 9.3% +/- 1.9; p less than 0.01). In migrants, there was an increased prevalence of degenerative complications which did not reach statistical significance. Three parameters may explain these differences: less strict follow-up, poorer knowledge, lower socioeconomic status.

Adult↗
PubMed1986

Drug sales data and prevalence of diabetes in France.

The importance of diabetes in France was estimated on the basis of drug sales data from 1976 to 1982. In 1982, 1.1% of the French population was taking oral hypoglycaemic agents daily, and 0.2%, insulin. These results are compared with the prevalence of diabetes (1.9%) estimated in a 1976 French epidemiologic study carried out on a random sample of practitioners, and other European estimates. The particularly high consumption of oral antidiabetic agents in France is then addressed, in relation to diagnosis and prescription habits.

Biguanides↗
PubMed1985

Coronary heart disease mortality in relation with diabetes, blood glucose and plasma insulin levels. The Paris Prospective Study, ten years later.

The Paris Prospective Study is a long-term investigation of cardiovascular diseases in a population of 7164 working men, aged 43-54 years. The first annual follow-up session (1968-73) included a 0-2 hr 75 g OGTT with measurement of plasma insulin and glucose levels beside the major coronary heart disease (CHD) risk factors: arterial pressure, cigarette smoking, weight, cholesterol, triglycerides. After a mean 11.2 years follow-up, 651 deaths, among them 126 due to CHD, were recorded. The annual CHD mortality rates were respectively 1.4, 2.7 and 3.2 per 1000 for the 6055 normoglycaemic, 690 impaired glucose tolerance, and 293 new and known diabetic subjects (1980 WHO classification) (p less than 0.01). The annual risk was analyzed by the multivariate Cox model. It showed that the fasting plasma insulin was positively associated with risk independent of the other factors (p less than 0.05), whereas glucose tolerance, including overt diabetes, was not significantly associated. We conclude that high insulin levels may constitute a more sensitive predictor of CHD than the degree of glucose intolerance, it could be useful to avoid excessive insulin plasma concentration, and even to lower its level.

Adult↗
PubMed1985

[Diabetes, hyperglycemia, hyperinsulinemia and risk of cardiovascular mortality. Findings of the Paris Prospective Survey, 10 years later].

The Paris Prospective Study is a long-term investigation of coronary heart disease (CHD) conducted on 7038 working men, aged 43-54 years and followed 11.2 years in mean. The first examination included a 0-2 h 75 g OGTT with measurement of plasma insulin and glucose levels, beside the major CHD risk factors. 651 deaths (CHD = 126) were recorded. The annual CHD mortality rates were respectively 1.4, 2.7 and 3.5 per 1000 for the 6055 normoglycaemic, 690 impaired glucose tolerance and 293 new and known diabetic subjects (1980 WHO classification) (p less than 0.001). It showed that the fasting plasma insulin was positively associated with risk independent of the other factors (p less than 0.05), whereas glucose tolerance, including overt diabetes, was not significantly associated. Thus, high insulin levels may constitute a more sensitive predictor of CHD than the degree of glucose intolerance and it could be useful to avoid excessive insulin plasma concentration, and even to lower its levels.

Adult↗
PubMed1983

[Prevalence of smoking among diabetics and influence of tobacco on diabetic retinopathy].

Among 647 patent diabetics regularly followed who attended the out-patient clinic of a hospital Diabetology Department between December 1st, 1979 and June 30th, 1980, 35% were habitual smokers, 20% ex-smokers and 45% non-smokers. Insulin-treated diabetics did not smoke more than non insulin-treated diabetics. Only one-half of the smokers declared that they had been advised by a doctor to stop smoking. This study failed to demonstrate any effect of tobacco on the prevalence or severity of diabetic retinopathy.

Diabetes Mellitus↗
PubMed1983

[The A.I.C.L.A. controlled cooperative trial. Secondary prevention of cerebral ischemic accidents due to atherosclerosis by aspirin and dipyridamole. 3: Results].

As decided in the protocol, the AICLA study ended when all the 604 patients had completed a follow up of three years. Adhesion to the protocol and drug compliance were excellent. Side effects, particularly peptic ulcers and bleedings of various origins were more frequent in the 2 treatment groups containing aspirin. The number of fatal and non fatal cerebral infarction was 31 in the P group, 17 in the ASA group, and 18 in the ASA + D group. Taking into account the duration of follow up for each patient, these figures correspond to cummulate rates of 18 p. 100 in the P group and 10.5 p. 100 in the 2 others. Analysis with the Mantel Method showed: 1 - a difference at the 6 p. 100 level between the 3 groups and between P an AD; 2 - A difference at the 5 p. 100 level between P and A; 3 - No difference between A and AD; 4 - A difference at the 2 p. 100 level between the P group and the two treated groups taken together. Among other diseases occurring during the trial, the only significant difference concerned myocardial infarction, less frequent in the 2 treated groups (p less than 0.05). Subgroup analysis failed to show a significant sex difference in the efficacy of aspirin. It is concluded that, in patients such as those defined in the protocol, Aspirin (1 g) has a significant beneficial effect in the secondary prevention of atherothrombotic cerebral infarction.

Aspirin↗
PubMed1983

[Influence of arterial hypertension on diabetic retinopathy].

The influence of arterial hypertension on the prevalence of diabetic retinopathy was evaluated by a cross-sectional study in 882 diabetic patients of whom 337 were insulin-treated and 505 were non insulin-treated. Arterial hypertension was defined by blood pressure values higher than 160-90 mmHg. Retinopathy was considered to be present when at least 2 microaneurysms were observed at the posterior pole. When duration of the diabetes was taken into account the prevalence of retinopathy in hypertensive subjects (69%) was not significantly higher than in normotensive subjects (47%) among the insulin-treated patients. However among non insulin-treated patients retinopathy was significantly more frequent in hypertensive (39%), than in normotensive subjects (25%; p less than 0.05).

Adult↗
PubMed1983

[Cross-sectional study of growth between 3 and 20 years of age in the population of Tunisia].

In the course of a study designed to estimate the prevalence of diabetes in the Gouvernorat of Tunis, 1449 households chosen at random were examined at home between October 1976 and June 1977. The following parameters : weight, height, tricipital and subscapular skinfold thickness were determined for each subject 3 years old or more. From the data observed on 1 889 males and 1 940 females aged from 3 to 20 years, estimates by age and sex are proposed as references for growth among the tunisian population in urban area. Then an approach of the secular trend is derived from the distributions of height according to the year of birth in the adult population.

Adolescent↗
PubMed1983

[Diabetes in private practice. Data of the INSERM national survey on private practice (1974-1975)].

Data from a national survey of private medicine in France were used to estimate the frequency of diabetes in primary care and to analyse both patient characteristics and therapeutic management. An approach was made to 2012 physicians who were requested to complete a questionnaire for each patient they saw during the course of a single day; 1103 responded and completed more than 20000 questionnaires. An additional investigation looked into the nature of the non responders. Diabetics represent 2,2% of patients in private medicine. Each year about 5,5 million consultations in private practice in France are for diabetes alone or for diabetes in association with other illnesses. 89% of diabetic patients are over 45 years of age and more than 48% older than 65. In most cases (80%), diabetes is associated with other medical problems, half of them being consequences of diabetes (cardio-vascular diseases, ocular and renal diseases). In 85% of cases, diabetics receive their basic care from a general practitioner. Therapeutic management is based mainly on drugs; diet or advice about life style are mentioned in barely one third of cases. Using linkage with social security data, it was possible to make a crude estimate of the number of diabetics in France. It was estimated at about 1 million for 52,6 million inhabitants.

Adult↗
PubMed1982

Maternal smoking and birth weight in relation to dietary habits.

A study on dietary and smoking behavior during pregnancy was performed between January, 1976, and September, 1979, at the St. Antoine Maternity Hospital in Paris. In addition to the routine clinical examinations at the third, sixth, eight, and ninth months of pregnancy, the women were systematically questioned about their dietary and tobacco habits. No dietary advice was given by the dietitians at any time, nor was there special counseling against smoking. Among 534 women who were followed up, 200 (37%) were smokers before pregnancy. At the sixth month, half of them had stopped smoking and the others had reduced their consumption. The analysis showed that the mean caloric intake and the gain in weight were the highest in the women who continued to smoke and the lowest in nonsmokers. Intermediate results were found in smokers who stopped. Birth weight was, on the average, 70 gm lower among smokers throughout pregnancy, compared with the other two groups, but this difference was not significant. These findings are consistent with the hypothesis that the negative effects of smoking on the fetus could be compensated for, to a great extent, by extra food.

Adult↗
PubMed1982

The risk of diabetic control: a comparison of hospital versus general practice supervision.

Two groups of insulin-treated outpatients (one followed up at the Hotel-Dieu Hospital and the second mainly supervised by general practitioners) were chosen at random in 1978. The two populations were comparable in age, age at diagnosis, sex, level of education, overall activity and socio-professional and economic status. Outpatients followed up in the diabetic unit had better blood glucose control, with about the same number of hypoglycaemic reactions as patients followed up in general practice. This better control was associated with more social activity and less visits to the physician, despite the fact that patients attending the hospital spent more money on their diet and had more daily insulin injections. All these differences remain significant after adjustment for the duration of diabetes. It may be inferred that attempts to improve control in insulin-treated patients are associated with a more active life and with no increase in the frequency of hypoglycaemic reactions.

Blood Glucose↗
PubMed1982

[Controlled cooperative trial. Secondary prevention of atherosclerosis-related cerebral ischemic accidents by aspirin dipyridamole. 2: Description of subjects at the beginning of the trial].

This paper is the second devoted to the controlled trial "A.I.C.L.A." comparing aspirin, aspirin + dipyridamole and placebo in the secondary prevention of athero-thrombotic cerebral ischaemic events. It presents the description and distribution of baseline characteristics at entry. Six hundred and four patients (men: 70 p. 100, mean age : 63) were entered. Risk factors were distributed as follows: arterial hypertension: 63 p. 100, Diabetes: 24 p. 100, High blood lipids: 26 p. 100, high uric acid: 20 p. 100, hematocrit greater than 46 p. 100: 34 p. 100, cigarette smoking: 64 p. 100, angina pectoris and myocardial infarction: 15 p. 100, peripheral vascular disease: 7 p. 100, 37 p. 100 of patients had a stroke prior to entry. The ischemic event at entry occurred not more than one year prior to randomization and less than 3 months in 77 p. 100. It was much more often a completed stroke (84 p. 100) than a transient ischaemic attack (16 p. 100) and was referrable either to the carotid (46 p. 100) or the vertebrobasilar circulation (50 p. 100). On the whole patients are older and strokes more severe than in other similar studies. Randomization produced remarkably comparable treatment groups since almost no significant difference was observed between the 3 groups.

Aged↗
PubMed1982

[Haemoglobin AIc in patients on venesection therapy for haemochromatosis (author's transl)].

Haemoglobin AIc values measured in diabetic patients with idiopathic haemochromatosis tended to be lower than in diabetics without haemochromatosis. The observed difference was analysed with respect to different parameters related to diabetes or haemochromatosis and their treatment (sex, age, duration of diabetes, insulin-dependency, frequency and volume of blood withdrawn) which could possibly explain these low values. Among the twenty-eight subjects with haemochromatosis, thirty-two non-diabetics, twenty-six insulin-dependent diabetics, and twenty-four non-insulin-treated diabetics, we observed that the more frequently venesection therapy was performed, the lower the levels of haemoglobin HbAIc, HbAIa+b tended to be. Thus, the decreased HbAIc rates observed in haemochromatosis patients may be ascribed to the venesection therapy, which induces an increased turnover of red cells, and consequently a decrease of the time available for their glycosylation.

Adult↗
PubMed1981

Alcohol consumption in a healthy population. Relationship to gamma-glutamyl transferase activity and mean corpuscular volume.

We analyzed the multivariate relationship between alcohol consumption and gamma-glutamyl-transferase (GGT), mean corpuscular volume (MCV), and tobacco consumption. A group of 995 healthy outpatients (604 men and 391 women, 18 to 76 years old) were systematically examined. Daily alcohol consumption was established after an interview regarding complete dietary habits. Significant correlations have been found between daily alcohol intake and corresponding GGT and MCV values, .35 and .34, respectively, in men and .24 and .21 in women. Multiple regression analyses confirm the superiority of GGt over MCV as a laboratory marker of alcohol intake and show the advantage of using them together. A rough estimation of alcohol consumption is proposed as a first step in mass screening of heavy drinkers.

Adolescent↗