Fasting growth hormone in treated diabetic children.
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Biomedical subjects
Publications and source records attributed to G W Chance.
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The results of the first 10 years of a prospective study of the effect of corn-oil and standard diets given to diabetic children since diagnosis suggest that the corn-oil diets currently available in Britain are not acceptable to most diabetic children and adolescents. Attempts to administer such diets may result in hyperpre-beta-lipoproteinaemia. In most diabetic children normal serum lipid levels can be maintained with adequate diabetic control and a standard diabetic diet.
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A method is described to determine the fatty acid composition of small samples of subcutaneous adipose tissue, and of fasting plasma free fatty acids (FFA) and triglycerides. These analyses were carried out on samples from five normal children, six diabetic children consuming a standard diabetic diet, 17 diabetic children prescribed a diet rich in corn oil since diagnosis 4-7 years ago, and 2 brothers with familial hypercholesterolemia on a corn oil diet for 3 yr. The results obtained showed that: (1) The composition of adipose tissue triglycerides in the diabetic children on a standard diet was similar to that in the normal children. (2) The 17 diabetic children were consuming different quantities of corn oil. (3) There was a highly significant correlation between the percentage of linoleic acid present in adipose tissue and in the fasting plasma FFA fraction. It is therefore concluded that future assessments of the adherence of these diabetic children to their corn oil diet will be possible by examination of the fasting plasma FFA fraction, obviating the need for repeated adipose tissue biopsies. (4) The sum of the concentration of saturated and monounsaturated fatty acids of the same chain length in adipose tissue was similar to that in the fasting plasma FFA fraction, even though the proportions of individual acids were different in the two fractions.
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The placenta from 30 women with diabetes mellitus were examined and weighed at delivery. Nineteen of these were from women with overt and eleven from women with gestational diabetes. Eleven placentae from normal pregnancies served as controls. There was no difference between the mean +/- s.d. placental weight for the diabetic group and the control group (609 +/- 148 versus 591 +/- 93 g, NS). The mean placental weight ratios for the diabetic group and the control group were also similar (0.98 +/- 0.23 versus 0.89 +/- 0.15, NS). Moreover, there was no difference between the weights and weight ratios of placentae from women with overt (622 +/- 173 g, 1.02 +/- 0.27) and those with gestational diabetes (586 +/- 90 g, versus 0.90 +/- 0.13). Placental weights correlated with birthweights (r = 0.70, P less than 0.01) and with skinfold thickness measurements fo the infants (r = 0.40, P less than 0.05), but neither with gestational ages (r = 0.15, NS) nor with maternal glycosylated haemoglobin levels in the third trimester (r = 0.24, NS). Among the women with overt diabetes, placental weights were greater in those in White's class B and C than those in class D and R (689 +/- 143 versus 530 +/- 177 g; P less than 0.05). In general, placentae from well controlled diabetic patients were not heavier than those from normal pregnant women, although there was an increase in placental weight in White's class B and C, as compared with those in class D and R.
Although the impact of environmental contaminants on human health has been widely studied, few reports in the Canadian literature have focussed on the specific vulnerability of children. Because of their rapid growth, physiologic and metabolic immaturity, the fetus and child are often at increased risk from toxic substances in their environments. Furthermore, greater air, food and fluid intakes relative to body weight compared with the adult, increase the child's potential for excessive exposures. The crawling stage of infancy, the play patterns and short stature of toddlers also serve to increase their exposure to dust and heavy and volatile substances which accumulate near the floor. This article provides an overview of some of the developmental physiologic, anatomic and behavioural features of the fetus, infant and child which increase their vulnerability to environmental contaminants in comparison with adults. Specific examples are given.