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Biomedical subjects

G Consoli

Publications and source records attributed to G Consoli.

47 records · Page 3Linked to original sources

Impaired insulin secretion in human diabetes mellitus. Effect of pharmacological activation of gamma-aminobutyric acid system.

To evaluate whether the gamma-aminobutyric acid (GABA)ergic system plays a role in the defective insulin secretion in human diabetes mellitus, 15 non-insulin-dependent diabetics with fasting hyperglycemia above 140 mg/dl were submitted to two consecutive i.v. glucose tolerance tests (IVGTT) (0.33 g/kg b.w.), in basal conditions and after pharmacologic activation of the GABA system with baclofen and sodium valproate. Baclofen, a synthetic analogue, was given to 8 diabetics in two divided doses of 10 mg each 8h and 1h before the post-treatment test; sodium valproate, a drug that increases endogenous GABA activity, was given orally (800 mg) 60 min before the performance of the post-treatment IVGTT. Neither treatment brought about significant changes in insulin, C-peptide, glucagon or growth hormone responses to i.v. glucose nor did they significantly change glucose disappearance rates. These results seem to indicate that GABA does not play a major role in the pathogenesis of defective insulin secretion in non-insulin-dependent diabetes mellitus.

Aged↗

Sodium salicylate restores the impaired insulin response to glucose and improves glucose tolerance in heroin addicts.

Plasma glucose, insulin, C-peptide, glucagon and growth hormone responses to intravenous glucose were evaluated in 10 heroin addicts in the basal state and during an infusion of sodium salicylate, an inhibitor of endogenous prostaglandin synthesis. Ten normal subjects, matched for age, sex and weight served as controls. In the basal state, the heroin addicts had markedly reduced insulin responses to intravenous glucose and low glucose disappearance rates (p less than 0.01 vs controls). The infusion of sodium salicylate caused a striking increase of the acute insulin response to intravenous glucose (from 14.5 +/- 4 microU/ml to 88 +/- 11 microU/ml, p less than 0.001) and restored to normal the reduced glucose tolerance (KG from 1.10 +/- 0.1% min-1 to 2.04 +/- 0.19% min-1). Hypoglycemic values were found in all addicts at the end of the test during salicylate infusion. Indomethacin pretreatment in five additional addicts also caused normalization of the impaired insulin responses to the intravenous glucose challenge and restored to normal the reduced glucose disappearance rate. Plasma glucagon and growth hormone levels were normally suppressed by glucose in addicts in basal conditions; sodium salicylate infusion completely overturned these hormonal responses which became positive in the first 15 min following the glucose challenge. These results demonstrate that the two prostaglandin synthesis inhibitors can restore the impaired B-cell response to glucose in heroin addicts to normal, indicating that this response is not lost but is inhibited by heroin itself or by other substances, perhaps by the endogenous prostaglandins.

Adolescent↗

The combined insulin and sulfonylurea therapy in diabetes of elderly people.

The usefulness and safety of the combined insulin-sulfonylurea (gliclazide) therapy were investigated in 70 elderly diabetic patients poorly controlled by insulin alone. More than half (45 diabetics, 64% of total) ameliorated significantly their metabolic control after six months of the combined treatment: not only the glycemic profile and glycated hemoglobin Alc were significantly decreased, but the daily insulin dose was reduced by approx. 35% (p < 0.01). These positive results in terms of improved glycemic control as well as reduction of daily insulin needs were still present after a mean period of follow-up of 5 years. The good percentage of positive results, the small incidence of hypoglycemic episodes and the consistent reduction of peripheral hyperinsulinism make this intervention (insulin-gliclazide) a safe strategy that can be adopted in a population of elderly diabetics, poorly controlled on insulin alone.

Journal Article↗

Analysis of diabetic family connection in subjects with insulin-dependent diabetes mellitus (IDDM).

The family connection of diabetes was examined from the clinical records of 3,372 subjects who were seen, as an out patient population, within the frame of a Regional Health Program in Taranto, South Italy. The family connection of diabetes resulted from a questionnaire in which the subjects had to give informations about their disease, if present, and degrees of relationship that were directly verified by us with the examination (clinic and laboratory) of relatives said to have diabetes. From the analysis of records, it emerged that 112 patients were affected by insulin-dependent-diabetes mellitus (IDDM): 54 of them were related with at least one subject suffering from noninsulin-dependent diabetes mellitus (NIDDM), 13 with at least one subject affected by IDDM and the remaining 45 did not show any family connection. The corresponding figures found in a group of healthy control subjects, matched to IDDM patients for age, sex and BMI, were 19, 2 and 84, respectively (p less than 0.001). 34 IDDM patients were related with a first degree of relationship (parents, sons, sibs) to diabetic subjects (IDDM or NIDDM), but only 4 controls showed such a degree (p less than 0.001). These results seem to indicate that patients with IDDM have an increased family history of NIDDM.

Adolescent↗

Multicenter study of the safety/efficacy of misoprostol in the prevention and treatment of NSAID-induced gastroduodenal lesions.

Gastrointestinal symptoms and lesions are often associated with the clinical use of non-steroidal antiinflammatory drugs (NSAIDs). An open-label, single arm multicenter Italian study evaluated if misoprostol, a prostaglandin E1 analogue with gastroduodenal mucosal protective activity, was effective in the prevention and treatment of NSAID-induced gastroduodenal lesions. Patients affected by rheumatoid arthritis (RA) or osteoarthritis (OA), in treatment with NSAIDs and suffering from gastric symptoms or gastroduodenal lesions related to NSAID use, were admitted to the study. Gastrointestinal and arthritic symptoms were assessed before and after 4 weeks co-administration of an NSAID (the most frequent was diclofenac, used in 35% of the RA and in 22% of the OA patients, followed by piroxicam and tenoxicam respectively) + misoprostol (200 mcg two times daily in 58% of the cases, 200 mcg three times daily in 39%, 200 mcg four times daily in 3%). On admission and after 4 weeks of therapy a gastrointestinal endoscopy was performed to evaluate the condition of the gastroduodenal mucosa. Final results showed that: (i) NSAID-related gastric lesions were more frequent than duodenal lesions; (ii) when patients were given misoprostol and NSAIDs, 96% of them did not develop gastric lesions and 97% did not develop duodenal lesions; (iii) even when NSAID therapy was continued, gastric or duodenal lesions induced by NSAIDs healed or in any case did not worsen in 92% and 91% respectively of the cases; (iv) during the period of coadministration of NSAIDs+misoprostol, NSAID-related UGI symptoms disappeared or improved in 77% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents, Non-Steroidal↗

Communicating hydrocephalus in a patient with mixed cryoglobulinemia and chronic hepatitis C.

This report describes a case of communicating hydrocephalus (CH), associated with mixed cryoglobulinemia (MC), which complicated chronic hepatitis C. The possible role of MC vasculitis and plasma hyperviscosity in the pathogenesis of CH is also discussed. Furthermore, we suggest screening MC patients for CH and to search for cryoglobulins in CH patients whose etiology is unknown.

Chronic Disease↗