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Biomedical subjects

G Hermansson

Publications and source records attributed to G Hermansson.

29 records · Page 2Linked to original sources
PubMed1986

Home blood glucose monitoring in diabetic children and adolescents. A 3-year feasibility study.

In order to elucidate the question whether blood glucose monitoring should replace glucosuria testing in childhood diabetes 160 diabetic children and adolescents were invited to participate in a feasibility study on home blood glucose testing. Seventeen girls and 15 boys with an age of 4-21 years and duration of diabetes for 0.3-18.7 years accepted, thus a selection of motivated patients. They performed 20-22 diurnal blood glucose profiles, each consisting of 7 blood samples, during a 3 month period. Thereafter, all patients were encouraged to continue blood glucose self-control and the actual performance of the 32 patients was evaluated 3 years later. Daily glucosuria tests were also made and HbA1 was analysed. Patients' attitudes were evaluated through 2 questionnaires. The study shows that blood glucose monitoring is feasible in the actual age groups. Most patients were positive towards blood tests, particularly because it gave an immediate answer to an actual problem, but its introduction did not change the metabolic control. However, pain restricted its daily use and only 6.4% of the patients preferred blood testing to urinalysis for long term use. Furthermore, the correlation between home glucosuria and HbA1 was as good as between home blood glucose and HbA1. It is concluded, that blood glucose self-monitoring is a valuable tool in the management of childhood diabetes, but that it should be regarded as a complement to and not a substitute for daily home urinalysis.

Adolescent↗
PubMed1985

Urinary tract infection in children with type I diabetes.

The prevalence and incidence of bacteriuria in 304 girls and 337 boys with type I diabetes was studied by screening for bacteriuria at their regular outpatient controls. In 90 girls and 108 boys a urine specimen was sampled every third month during a year. The prevalence of bacteriuria was 3/304 in girls and 0/337 in boys. During the one year follow-up one of the 90 girls had pyelonephritis and two cystitis while none of the boys had bacteriuria. It is concluded that the rate of urinary tract infection in young diabetic persons does not differ from that present in healthy young people.

Adolescent↗
PubMed1985

Strategy for self-monitoring of diabetic control.

Treatment of diabetes must aim at normal metabolism. Sporadic measurements of any known parameter is not a sufficient guarantee but continous regular self-monitoring is necessary. At least in insulin dependent diabetes it seems reasonable that we should monitor the free insulin levels, but that still belongs to the future. As blood glucose gives us a good reflection of the hormonal and metabolic balance, this is a relevant parameter to follow. Glycosylated proteins, mainly hemoglobin, give only retrospective information of moderate value for the practical management of the disease. Furthermore, one should be aware of the different weak points of glycosylated hemoglobin which does not tell the only, total truth about glucose balance. Self-monitoring of blood glucose is a very valuable tool, especially when used in a systematic way. To get information covering the whole day every day tests for glucosuria have still a place, especially among children and young adults with rather short duration of diabetes. With a sensible approach it is possible to get good compliance among most patients. A combination of blood and urine glucose selfcontrol creates opportunities for a good metabolism in diabetes.

Adolescent↗
PubMed1984

Sulfur amino acid metabolism in juvenile-onset nonketotic and ketotic diabetic patients.

Sulfur amino acid metabolism was studied in non-fasting nonketotic and ketotic juvenile-onset diabetic children and the results were compared to age-matched healthy children on an ordinary diet. An increased excretion of total sulfur and inorganic sulfate was found in diabetic children, probably a result of a decreased protein-serum synthesis and/or increased endogenous protein catabolism, although as a result of hyperglycemia a decreased tubular reabsorption may also have contributed. All diabetics showed a normal excretion of methionine. For cyst(e)ine and taurine an increased excretion was seen in ketotic diabetics, probably also a consequence of an increased endogenous protein degradation. As a sign of the latter, an increased output of 3-methylhistidine was also observed, a confirmation of earlier reports. The increased output of mercaptolactate and mercaptoacetate found in ketotic patients, was probably also a result of enhanced endogenous protein degradation. An increased urinary excretion of N-acetylcysteine was seen in diabetic children, which may reflect an enhanced availability to acetyl coenzyme A.

Adolescent↗
PubMed1983

Increase in stable glycosylated haemoglobin after induction of poor glycaemic control.

Eight insulin-treated diabetic patients in good glycaemic control were studied as out-patients with frequent determinations of stable glycosylated haemoglobin (HbA1c) before, during and after 1 week of induced poor glycaemic control. Stable HbA1c was determined by cation exchange chromatography after elimination of the labile fraction by incubation in saline (0.15 mol/l). The increase in mean blood glucose was significant on the first day of reduced insulin therapy and greatest after 1 week (6.9 +/- 3.9 mmol/l above basal values). Stable HbA1c increased significantly on day 7 of the reduced insulin treatment. The increase represented, on average, 0.009% of total haemoglobin per mmol/l increase in mean blood glucose per 24 h during the period of induced hyperglycaemia. After restoring insulin therapy, a significant decrease in blood glucose was achieved on day 1 and after 2 days, the blood glucose level was similar to before the study. There was no significant decrease in stable HbA1c within the first 2 weeks of improved glycaemia.

Adult↗
PubMed1982

Plasma and urine carnitine in children with diabetes mellitus.

L-Carnitine is essential for the transport of long chain fatty acids into mitochondria and, hence, in ketoacid production. Total, free and acylcarnitine in plasma and urine have been determined in 52 children and adolescents with insulin-dependent juvenile diabetes and compared with 72 controls. The subjects were divided into three age groups 8-10, 11-15 and 16-20 years. The plasma, total and free carnitine were significantly lower in diabetic patients than in controls in all age groups. Acylcarnitine was significantly higher in the diabetic patients than in the controls in the two younger age groups. No sex-related differences in plasma carnitine and its derivatives were found in the two younger groups. A statistically significant correlation coefficient was noted between glycosylated hemoglobin and the plasma acyl/free carnitine ratio, 2 p less than 0.05. The daily urinary excretion and renal clearance of carnitine and its derivatives showed few significant differences between the diabetic and the control subjects.

Adolescent↗
PubMed1982

Rapid and slow rate of decrease in HbA1a + b and HbA1c during improved glycaemic control.

The change in glycosylated haemoglobins was studied with a column chromatographic method when glycaemic control was rapidly improved in nine diabetic patients. The patients were followed for 3 weeks or more. There was a decrease in HbA1a+b and HbA1c within the first few days of improved control and this decrease was faster than later on. The initial decrease of HbA1a+b was faster than that of HbA1c. In individual patients the initial decrease in glycosylated haemoglobins correlated with the initial rate of decrease in blood glucose. It is concluded that HbA1a+b and HbA1c decrease biphasically during improved glycaemic control. The rapid initial decrease may be due to labile HbA1 and it is large enough to influence the value of HbA1 as an indicator of long-term glycaemic control in some patients.

Adolescent↗
PubMedDate not supplied

Gastroplasty for obesity: long-term weight loss improved by vagotomy.

Sixty-nine (13M, 56F), severely obese patients (body mass index 47 kg/m2) have had vertical banded gastroplasty (GP) with 5-cm polypropylene mesh (n = 39) or fascia (n = 30) bands since 1981. Of these 69 patients, 30 also had truncal vagotomy (TVG) without drainage. Total office follow-up rate is 94%. During follow-up of 1 year or more (mean 60 months), 25 patients with vagotomy plus gastroplasty lost 33 +/- 3 kg, corresponding to 51% of excess weight, compared to 21 +/- 3 kg (34% excess weight) in the 34 patients having gastroplasty alone (p < 0.01). In patients followed > or = 5 years (mean 83 months) 10 patients with TVG lost 40 +/- 5 kg (61% of excess) compared to 17 +/- 4 kg (28% of excess) in 22 patients with GP alone (p < 0.001). Frequency and severity of complications were similar in both groups, but there were seven reoperations after GP and three after TVG (p < 0.05). Studies of gastric emptying of a solid meal in 14 of the patients with GP and 14 with TVG demonstrated greater weight loss in those with prolonged emptying and gastroesophageal pooling, though the emptying rates of patients with GP and those with TVG showed no statistically significant difference. Our earlier studies, which showed reduced liquid consumption after vagotomy, imply that this mechanism (rather than delayed emptying) explains why vagotomy potentiates weight loss after gastroplasty.

Adult↗