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Biomedical subjects

G Panzram

Publications and source records attributed to G Panzram.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Chlorpropamide-alcohol flush test in non-insulin-dependent diabetes mellitus in young age (MODY type)].

The chlorpropamide alcohol flush test (CPAF) has been described as a dominantly inherited feature in NIDDM, particularly of young people (MODY-type). Validity and usefulness of the CPAF were analyzed in 40 MODY-patients recruiting from a population study (criteria acc. to Tattersall and Fajans, 1975), 59 first degree relatives (24 diabetics, 35 non-diabetics), 40 NIDDM of maturity onset, 40 IDDM, and 40 healthy controls. The CPAF (single challenge test, placebo control, subjective evaluation by questionnaire acc. to Köbberling, 1980) proved to be positive in only 8 MODY-patients and 5 of diabetic first-degree relatives. In comparison to NIDDM of maturity onset (40/8), IDDM (40/6) and healthy controls (40/2) the frequency of positive CPAF showed no significant differences. Between flushers and non-flushers within the MODY-group no relationship to vascular findings, metabolic and genetic data (including HLA-typing) could be found. It is concluded that the CPAF is a real but rather nonspecific phenomenon unsuitable as a genetic marker.

Adolescent↗
PubMed1981

[Studies on prognosis of diabetes mellitus].

On the epidemiologically defined number of all diabetics who were detected in the district of Erfurt in 1966 the prognosis with medium time limit was investigated retrospectively. The 2,500 patients (1,650 females, 910 males) correspond above all to type 2 of diabetes. According to the observation time of 10 years altogether died 1,054 patients (44.3%), 63.4% of cardiovascular causes of death (autopsy rate 20.9%). In all age groups with a sufficient number of subjects the mortality of the males was above the mortality of the females; according to that their median survival time was shorter. In comparison to the total population of the district of Erfurt the diabetics examined showed an aged-depending excess mortality between 1.1 and 1.9. By means of several methods an over-mortality could be proved already for the first year after the manifestation. The worse prognosis of the diabetics type 2 is interpreted as a consequence of an increased cardiovascular comorbidity, the causes of which have to be found in the complex action of atherogenic risk factors in the time before the manifestation of diabetes.

Adult↗
PubMed1981

[Disorders in the regulation of blood pressure and heart rate as as expression of the autonomic neuropathy in diabetes mellitus].

In 30 diabetics with a peripheral neuropathy in comparison to a control group corresponding to age analyses of the circulation with continuous registration of the mean arterial pressure, of the heart and respiration rate were performed. For the objectivation of decreased waves of heart rate and blood pressure of 2nd and 3rd degree a spectral-analytic examination was additionally performed. The judgment of autonomous disturbances of regulation was made in every patient with the help of 10 functional parameters. No references to an autonomous neuropathy were found only in 2 patients, 1 to 4 pathological test results could be proved in 19 diabetics, and 5 to 9 pathological test results in 9 diabetics. A decreased respiratory arrhythmia in the stroke respiration and the absence of heart rate waves of 3rd degree in younger patients proved as particularly evident for the diagnosis of autonomous neuropathy. The present results of the examination refer to the fact that the inclusion of the complex examination methods using dynamic and rhythmologic functional parameters for the ascertainment of the diagnosis and for the graduation of the autonomous diabetic neuropathy is necessary.

Adult↗
PubMed1981

Prognosis of diabetes mellitus in a geographically defined population.

The centralised registration and care of all diabetics in a geographically defined population has provided an epidemiological basis for a longitudinal investigation of the prognosis of this disease. Records of all newly diagnosed diabetics who had been registered in the Erfurt district (population 1.25 million) in 1966 were studied in relation to the time period 1966-1976. Of the known 2,560 diabetics (910 men, 1,650 women; 93.7% greater than 40 years of age), 1,054 had died during the 10-year follow-up period. Cardiovascular causes accounted for the majority of deaths (63%). In almost all age classes proportionally more men than women had died at follow-up; there was a significant difference in the 60-69 year group (men 61.6%, women 46.2%). In comparison with the general population, excess mortality ranged from 2.1 to 1.0, decreasing with age at onset without significant differences between men and women. Excess mortality was present in most age classes and was evident within the first year after diagnosis. Current life-table analysis confirmed the shortened life expectancy of the diabetics. The lower life expectancy of noninsulin-dependent diabetics may not be due to hyperglycaemia alone but probably also involves a variety of atherongenic risk factors.

Adolescent↗
PubMed1980

[Intensified therapy of newly detected maturity onset diabetes].

In a prospective study 150 newly detected maturity onset-diabetics were randomized in 2 biostatistically comparable groups and underwent a treatment of different intensity. While the patients of the control group were treated according to the routine method used up to now in the dispensary for diabetics, in the intervention group an intensifying of the therapy took place, taking particular into consideration the body weight as well as the carbohydrate and fat metabolism. The decrease of body weight achieved by dietary intensive care proved to be the decisive factor for the tendency towards normalisation of glucose tolerance, hyperlipoproteinaemia and IRI-secretion, which could be registered in the intervention group after 2 years of observation. Following the preceding strong phase of diet, by Biguanides and Clofibrate a further significant improvement of the carbohydrate and fat metabolism could not be achieved. The decisive reserve in the treatment of obese maturity onset-diabetes could be seen in a permanent and continuous reduction of body weight. The results of this treatment depend highly on an intensive education as well as on frequent control of the patients' metabolism and their cooperation.

Biguanides↗
PubMed1978

[Prognosis of diabetes mellitus after an early diagnosis by means of glucosuria screening. Results of a 10 year course control].

The 10-year course of diabetes in 250 patients detected by glucosuria screening in 1963 was evaluated in an inter-individual pair comparison with patients from the same territory admitted during the same calendar year. Pairs were grouped according to age, sex, and weight. Judged by mortality, survival time, causes of death, and vascular complications, the medium-term prognosis was not improved by screening, although in the screening group a strict diet could be maintained to a greater extent. Problems of evaluation and effectiveness of mass examination in chronic diseases are discussed. Glucosuria and hyperglycemia do not suffice as screening criteria for the early recognition of the complex risk of arteriosclerosis in maturity onset diabetes. Multi-screening in groups with especially high diabetes risk is expected to yield higher effectiveness than the mass screening hitherto performed.

Diabetes Mellitus↗
PubMed1977

[The course of asymptomatic diabetes under varying preventive therapy--concluding report of a 5-year prospective study].

During a prospective study the course of asymptomatic diabetes in different preventive treatment (diet, additionally tolbutamide, carbutamide or buformin) was observed concerning the frequency of manifestation and the behaviour of the oral glucose tolerance. Among the 100 protodiabetics after 5 years 38 clinical manifestations could be established, which finally nearly equally were distributed to all 4 groups of treatment. Only under the influence of buformin an effect preventing manifestation limited to 2 years appeared. Patients with persisting full or partial remissions continuously and more decreased in weight than cases of manifestation. Furthermore, the course was determined by the initially existing degree of hyperglycaemia as well as by the improvement of the glucose tolerance achieved in the first year. On account of the results of the examinations and the existing literature a preventive use of oral antidiabetics cannot be recommended.

Buformin↗
PubMed1977

[Studies on mortality in diabetics in a circumscribed region: age and death, length of diabetes and causes of death].

Studies were carried out in regard to the age at death, duration of diabetes mellitus at the time of death and cause of death in an unselected evaluation of the findings in all 1694 diabetics who died in Erfurt and environs over an 11-year period. The The mean age of the patients at the time of death was 70.6 years, with virtually no difference between the sexes. Only six patients died prior to the age of 40. In accordance with the age structure of diabetics in a circumscribed area, the average survival time was 6.5 years. The interval between the first manifestation of the disease and death was 0 to 4 years in 45% of the patients; only every fifth patient survided for 10 or more years. These results are interpreted as being a reflexion of the frequent incidence of preceding or simultaneously-occuring atherosclerosis in these diabetics. Cardiovascular incidents affecting, above all, the coronary and cerebral vessels, account for about 60% of the deaths. Differences between these results and other statistical analyses can be explained on the basis of the unselective nature of the case material in the present study which was, moreover, collected in a defined region over a definite period of time.

Adult↗
PubMed1976

[Comparative analysis of electrocardiographic findings in diabetics and metabolically healthy persons].

The electrocardiograms of 447 diabetics and of the same number of non-diabetic test persons who were coordinated as biostatic twins, taking into consideration age, sex, and weight, were evaluated according to the Minnesota-code and compared. The cardiac endangering of the diabetics was most clearly expressed in the larger frequency of infarctions and the chronic-ischaemic heart disease which can be proved in all age groups. Diabetic males with short duration of diabetes showed the highest frequency of infarctions. The frequency of coronaropathy which is not increased in most age groups in the long-term diabetics compared with the control persons characterizes them as a positive selection of diabetics with an apparantly primarily low atherogenic potency. Hypertonus and/or adiposity were concomitant with a nearly doubled frequency of the ischaemic heart disease. The breadth of the P-wave as a possible reference to angiopathic changes in the region of the atrium was significantly larger in the diabetics in all age groups than in the control group.

Adult↗
PubMed1976

[The influence of insulin, glucose and other monosaccharides on the platelet functions (author's transl)].

In vitro investigations were carried out on the action of insulin, glucose, xylose, galactose, fructose and sorbitol on the platelet aggregation test according to Breddin, on the ADP- and collagen-inducced aggregation and the release of platelet factor 4 as well as on the retraction. When incubating platelet-rich plasma with insulin and glucose simultaneously, a marked inhibition of the ADP- or collagen-induced platelet aggregation and release reaction results. Insulin as well as glucose impaired the platelet function only at high concentrations, this inhibition however did not reach that of a combination of both. Fructose, xylose and sorbitol exerted no significant inhibitory effects. In contrast to the prevented aggregation, the retraction was enhanced. As the causal mechanism for the inhibition of the platelet function the Crabtree effect is discussed.

Blood Platelets↗
PubMed1976

[Long-term diabetes--a special form of diabetes].

Two hundred and eight long-term diabetics from the diabetic population of one district were examined thoroughly by physicians of the several special branches and compared with a control group consisting of biostatic twins with a healthy metabolism. Case control was performed for 5 years. The frequent absence of pathological findings in the coronary, peripheric and cerebral regions as well as a significantly high percentage of standard weight and underweight were found to be characteristic signs in that patients who survived their diabetes for several tens of years. Five years after the first registration, 68 long-term diabetics and 23 subjects of the control group had been died. However, the excess mortality does not surpass the mortality of subjects diseased for a short period. Besides the age and the duration of the manifestation, the survival rate was found to be dependent on the degree of the micro- and macroangiopathies, hypertension and over-weight. On the other hand, the duration of the diabetes and the metabolic condition did not exert any perceptible influence.

Age Factors↗
PubMed1975

[Electrocardiographic findings in a selection-free number of cases of long-term diabetic patients].

When the conventional ECG after resting was used for establishing frequency and degree of severity of the ischaemic heart disease the stronger cardiac endangering of the longterm diabetic could be ascertained only from residues of an infarction (pathologic Q- and QS-types). With regard to all electrocardiographic criteria of the ischaemic heart disease according to the WHO-definition concerning the coronary risk a dependence on age, over-weight and increase of blood pressure was found without essential differences between the two groups. According to data in literature ischaemic reactions in diabetics are significantly more frequently to be expected only by inclusion of the electrocardiogram after work. Among the group of diabetics the frequency of the ischaemic heart disease increased with the duration of the disease. In contrast to retinopathy there was no dependence on the quality of the metabolic condition.

Adult↗
PubMed1975

[Studies of nephropathies in 168 diabetic patients with over 20-year onset of the disease].

Within a clinical epidemiological investigation 168 diabetics were examined multidisciplinarily who survived the beginning of their disease by at least 20 years. The qualitative proof of protein in the urine was regarded as criterion for the presence of a diabetic nephropathy. 29% of the long-term diabetics showed a proteinuria. In a control group of probands with healthy metabolism, however, only 2.5% proteinurias were found. Statistically ascertained correlations were the results in cases of proteinuria and retinopathy (microangio-pathy). Particularly close were the relations of proteinuria to arteriolosclerosis (macroangiopathy). There were no relations between the proof of a proteinuria and the quality of the control of the carbohydrate metabolism which was pursued during decades.

Adult↗