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Biomedical subjects

G Slama

Publications and source records attributed to G Slama.

At least 163 records · Page 9Linked to original sources
PubMed1985

Sucrose or honey at breakfast have no additional acute hyperglycaemic effect over an isoglucidic amount of bread in type 2 diabetic patients.

Exclusion of simple sugars from the diabetic diet is not always followed by patients and may not even be as crucial as was hitherto thought. We tested three types of mixed breakfasts (400 kcal, 50 g HCO) including an isoglucidic amount either of white bread (30 g), honey (20 g) or sucrose (15 g), at the critical morning period i.e. for breakfast, in a group of 21 Type 2 (non-insulin-dependent) diabetic patients (6 well- and 15 badly controlled). Mean plasma glucose and insulin levels were comparable on the three occasions: respectively with bread, sucrose and honey, peak glucose values were 18 mmol/l, 17.7 mmol/l and 17.5 mmol/l in the uncontrolled group versus 13.9 mmol/l, 12.8 mmol/l and 12.7 mmol/l in the well-controlled group. Peak insulin values were 33.6 mU/1,34.0 mU/l and 36.3 mU/l (p greater than 0.05) in uncontrolled patients against 57.5 mU/l, 54.8 mU/l and 52.5 mU/l in well-controlled subjects (p greater than 0.05). The mean increment in peak plasma glucose values for the three breakfasts was as follows: 6.9 mmol/l, 6.3 mmol/l and 6.2 mmol/l for the uncontrolled group against 7.2 mmol/l, 5.9 mmol/l and 6.2 mmol/l in well-controlled subjects; the mean increment in peak plasma insulin levels was 21.8 mU/l,22.0 mU/l and 24.2 mU/l in the controlled group versus 38.2 mU/l, 32.0 mU/l and 34.7 mU/l in the well-controlled subjects, all values being non-significantly different (p greater than 0.05). We conclude that, in acute conditions, simple sugars have no additional hyperglycaemic effect over an isoglucidic amount of bread in well-and in badly controlled Type 2 diabetic patients, even at breakfast.

Adult↗
PubMed1985

Influence of concentration on the kinetics of SC-infused insulin. Comparison between square-wave SC infusion and bolus SC injection.

The influence of various concentrations of a constantly SC-infused insulin solution on plasma free insulin (PFI) levels wa studied in eight type 1 diabetic subjects. Soluble insulin at three different concentrations (10, 40, and 100 U/mL) was pumped at two different rates: 1.5 U/h between meals and 15 U/h for 30 minutes just before meals. For each randomly allocated concentration, PFI levels were studied twice in the same day during two six hour postmeal periods. In addition, at the end of the U40 infusion, a comparable amount of insulin was injected as a bolus. The total amount (56 U/d) and distribution of insulin delivered were similar in all patients and with each concentration. The mean maximum PFI levels were 39 +/- 7.2, 28.4 +/- 3.4, 36.2 +/- 6.4, and 29.2 +/- 7.6 mus U/mL, respectively, during the U10, U40, and U100 infusions and the U40 bolus injection; these values were observed, respectively, 60, 120, 90, and 90 minutes after a step up increase of insulin infusion and after the SC bolus injection. PFI levels returned to basal values between three and five hours after the step decrease. There was no significant difference in the kinetics of PFI levels variation, whatever the concentration in the range of 10 to 100 U/mL. For U40 these kinetics did not differ from that observed after a bolus SC injection of soluble insulin.

Absorption↗
PubMed1985

Insulin receptor changes in type 2 diabetes after short term insulin treatment.

We have studied erythrocyte insulin receptor changes before and after 8 days of continuous subcutaneous insulin infusion by a pump in 11 uncontrolled obese non-insulin-dependent diabetics (type 2), diet and drug resistant for at least three months previously. All the patients were hospitalized. On day 1 of the study, their oral hypoglycemic agents were stopped and hypocaloric diet (1000 Kcal/day) was maintained (strictly reinforced). This period of reinforced treatment was not accompanied by correction of hyperglycemia. On day 9 patients were placed for 12 hours on artificial pancreas in order to bring their fasting blood glucose levels down to normal values. Then they were submitted to a continuous subcutaneous insulin infusion (CSII) for the following 8 days. There was a significant decrease in mean fasting plasma glucose (P less than 0.001) and a rise in insulin (P less than 0.05) levels after insulin treatment. Mean specific insulin binding was also significantly increased (P less than 0.01). The increase in binding (with insulin therapy) correlated with the fall in fasting hyperglycemia (r = 0.786, P less than 0.01). In addition, the increase in binding correlated negatively with changes in fasting plasma insulin levels (r = -0.867, P less than 0.01), under treatment, on one hand and with the dose of exogenous insulin administered (r = -0.681, P less than 0.05) on the other hand. There was no correlation between binding and fasting plasma insulin levels (before and after insulin therapy), or between diabetes duration and any of the previous parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Sucrose taken during mixed meal has no additional hyperglycaemic action over isocaloric amounts of starch in well-controlled diabetics.

The hyperglycaemic effect of 20 g sucrose taken at the end of a regular mixed meal by diabetic patients was measured in six adult type 1 diabetics, C-peptide negative, controlled by the artificial pancreas, and twelve adult type 2 diabetics, with fasting plasma glucose levels below 7.2 mmol/l (130 mg/100 ml) and post-prandial plasma glucose levels below 10.0 mmol/l (180 mg/100 ml), treated by diet alone or with glibenclamide and/or metformin. All the patients were given on consecutive days, in random order, two mixed meals of grilled meat, green beans, and cheese, as well as a cake made either of rice, skimmed milk, and saccharine (meal A) or rice, skimmed milk, and 20 g sucrose (meal B). The meals contained equal amounts of calories and of carbohydrate. There was no difference between the meals in plasma glucose curves and plasma insulin or insulin infusion rate variations whether in peak values, peaking times, or areas under the curves, in either group of patients. Sparing use of sucrose taken during mixed meals might help well-controlled diabetic patients to comply with their daily dietary prescription while maintaining good blood glucose control.

Adult↗
PubMed1984

[Analysis of compliance with blood-glucose self monitoring at home in 113 diabetic patients treated with insulin].

Four months following hospitalisation. 160 insulin-treated patients were sent at their homes a questionary on home blood glucose monitoring. In hospital they had received no teaching specifically orientated towards this problem. From the usable replies (132) it was estimated that 11 +/- 8 (mean +/- SEM) sticks a week were used, most by diabetics in whom insulin therapy had been instituted less than a year before (p less than 0.01), more sticks were used by those who were thirty to forty years old, those who received three injections a day and those had distinct lesions of microangiopathy although the differences did not reach conventional levels of statistical significance. Neither sex nor the use of a finger- pricker system made a significant difference. The widespread use of home glucose monitoring shows the fortunate convergence of the physicians ' wishes (to obtain the best control of blood glucose level) and the patients needs (to obtain information, understanding, security and comfort).

Adult↗
PubMed1983

Progressive centripetal degeneration of axons in small fibre diabetic polyneuropathy.

A clinicopathological study is presented of 5 patients with a pseudosyringomyelic dissociation of sensory loss and severe autonomic disturbances related to diabetic polyneuropathy. Sensory loss which followed a pattern that suggested a length-related degeneration of fibres was associated with spontaneous pains in 3 patients. Plantar ulcers and neurogenic arthropathies were also present in 3 patients. The pathological changes in sural nerve biopsies included a severe loss of unmyelinated and small myelinated axons which appeared to be involved earlier than larger myelinated fibres. Distal degeneration of single fibres with subsequent axonal sprouting from the proximal axon was demonstrated in all patients. This severe axonal neuropathy was associated with primary and secondary segmental demyelination. Our observations are consistent with a progressive centripetal degeneration of axons in predominantly sensory diabetic polyneuropathy.

Adult↗
PubMed1982

Metformin reduces post-prandial insulin needs in type I (insulin-dependent) diabetic patients: assessment by the artificial pancreas.

It has been suggested that biguanides should be used in Type 1 (insulin-dependent) diabetic patients in order to diminish insulin requirements and reduce the chances of insulin reactions. The efficacy of these compounds in such patients has been controversial. We have studied the effect of metformin (850 mg) given at 08.00 h in diminishing insulin needs after a 60 g carbohydrate mixed meal taken at 12.00 h, using an artificial pancreas and a sequential analysis of the results. The morning test dose of metformin or placebo was preceded by 48 h treatment with metformin (850 mg twice daily) or placebo. After the eighth patient a 26% saving of insulin need was demonstrated in the metformin-treated group (p less than 0.01). Metformin is thus effective in reducing post-prandial insulin needs in Type 1 diabetic patients, although its use in such circumstances requires consideration of several other issues.

Adult↗
PubMed1982

Reduction of post-prandial insulin needs by pectin as assessed by the artificial pancreas in insulin-dependent diabetics.

The efficacy of a moderate amount (7 grams) of apple pectin in diminishing post-prandial insulin needs in insulin dependent diabetics (IDD) has been tested using an artificial pancreas in a sequential analysis. With this method, only four patients who served as their own control, showed significant reductions in insulin requirement of 3 Iu with pectin after a 60 g carbohydrate mixed meal. The use of pectin cut by 35 per cent the post prandial insulin demand. The patients judged the treatment as acceptable. More prolonged use in IDD is advisable.

Adult↗
PubMed1981

[Is glycosylated haemoglobin subject to rapid variations? Changes in insulin-dependent diabetic patients under a 24-hour artificial pancreas treatment (author's transl)].

According to recent studies, glycosylated haemoglobin (HbA1) is subject to rapid variations. In order to verify this point, nine insulin-dependent diabetic patients underwent a 24-hour normalization of glycaemia with an artificial pancreas. There was a non-significant decrease of HbA1 from 9.26 +/- 1.03 p. cent to 8.69 +/- 0.84 p. cent (mean +/- s.d.). An explanation to the apparent discrepancies between the different studies is proposed. The variations observed could largely be due to the inclusion or non inclusion in the assay methods of a subfraction of glycosylated haemoglobin: a Schiff's base likely to undergo glysosylation in a rapidly reversible manner.

Diabetes Mellitus↗