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H Lestradet

Publications and source records attributed to H Lestradet.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Genetic and environmental factors in insulin-dependent diabetes].

Insulin-dependent diabetes results from the interaction of genetic, immunological and environmental factors. In view of the association between insulin-dependent diabetes and HLA system, it has been postulated that the diabetogenic gene(s) is (or are) located in the region of the DR locus in that system. The hypothesis of viral factors is supported by epidemiological arguments and experimental models but has only been exceptionally confirmed in man. The fact that anti-islet antibodies are frequently detected at the onset of insulin-dependent diabetes or even before the first symptoms develop suggests that an auto-immune mechanism might be involved in the destruction of beta-cells. Although the mode of inheritance of genes supposed to predispose to insulin-dependent diabetes as well as the mechanisms behind the pancreatic lesion are still poorly understood, determining "markers" of the disease should eventually make it possible to detect subjects at risk of diabetes and to prevent its development.

Antibody Formation↗
PubMed1983

HLA-DR2 in two sibships with insulin-dependent diabetes mellitus.

We report two families selected from 124 genotyped Caucasian insulin-dependent diabetes mellitus (IDDM) families because of unusual features. In both families, all offspring are affected and four out of six bear the allele HLA-DR2 which is an uncommon phenotype among diabetic patients. Onset before the age of 1 year in all the patients of one family, association with optic atrophy in the other, and the existence of pairs of affected sibs of different HLA types in both, are infrequent findings and support the evidence of heterogeneity in IDDM.

Age Factors↗
PubMed1983

Age--related heterogeneity of insulin-dependent diabetes mellitus.

One hundred and thirty-three insulin-dependent diabetic (IDD) patients were genotyped for HLA-A, B, C, DR and 123 of them for Bf. The study shows a relationship between these genes and the age of onset of diabetes and emphasizes the possible heterogeneity of the disease. When patients under the age of 0 years at the onset of the disease were compared with those aged 11 to 29 years, a significant excess of HLA-B18 (41% versus 15%, p less than 0.001) and BfF1 (40% versus 21%, P less than 0.05) was observed. The haplotype B18, BfF1 was also more frequent in the first group of patients (haplotype frequency 18% versus 6%, p less than 0.02). The frequency of the whole haplotype Cw5, B18, BfF1, DR3 and of its segment BfF1, DR3, and the strength of the gametic associations between these alleles were much higher in IDD patients than in non-diabetic controls, irrespective of the age of onset of their diabetes. The association between early age of onset of IDD and the B18, BfF1 haplotype independently of DR3 (no association between age and DR3) suggests that a factor influencing the onset of the disease in young children could be under the control of (1) gene (s) in linkage disequilibrium with B18 and/or BfF1.

Adolescent↗
PubMed1982

[Treatment of severe diabetic ketoacidosis in children. A comparative study of two methods (author's transl)].

Fifteen children with severe diabetic ketoacidosis (pH less than 7,10) were treated according to two protocols. Protocol I used in 7 patients, consisted in a low dose insulin therapy by intravenous and intramuscular injections. Protocol II consisted in a low dose continuous intravenous insulin therapy, with insulin added to the rehydration solution at constant concentration (22 U/l). Rehydration and potassium supplementation were similar in both methods. The fall of glucose concentration, rise in venous pH, fall of diuresis, glycosuria, ketonuria were similar in the two groups. With protocol I three hypoglycemias (greater than 4 mM) and three hypokalemias (greater than 3 mEq/l) did occur. With protocol II no hypoglycemia and only one moderate hypokalemia was observed. Thus, continuous infusion of insulin added to the rehydration solution, including isotonic bicarbonate, isotonic saline, glucose and electrolytes is as effective as discontinuous insulin infusion, but with a lower incidence of complications. In addition, this method has the advantage of being easy and applicable everywhere.

Adolescent↗
PubMed1982

HLA haplotype study of 53 juvenile insulin-dependent diabetic (I.D.D.) families.

R4 heterozygotes was observed. By contrast, the observed frequency of patients homozygous for DR3 or DR4 was not increased, but even slightly decreased. The data support a model of inheritance comprising at least two closely linked specifically "diabetic" loci (most of the time marked by B18, BfF1, DR3 and B15, BfS, DR4) and a non-specifically "diabetic" haplotype favouring auto-immunisation (most of the time marked by B8, BfS, DR3). This model is discussed in the light of the presented data and of those of the literature.

Adolescent↗
PubMed1982

Circadian metabolic rhythms in obese children.

Obese children display constant hyperinsulinism and, frequently, hyperphagia. In animals, lesions of the hypothalamic system affect simultaneously the circadian rhythm of insulin secretion and of food intake. In this study, circadian metabolic rhythm was examined in obese and non-obese children, by two different protocols. (1) Oral glucose tolerance tests (OGTT) were carried out at 9 a.m. and 3 p.m. on 2 consecutive days. (2) Circadian variations of plasma glucose and insulin were determined. After OGTT, in the control children there was a significant drop in the insulin/glucose ratio in the afternoon, whereas in the obese group this ratio remained high, with no significant change during the day. Differences were also observed in free fatty acid, growth hormone, and cortisol responses. The control children showed a circadian rhythm for blood glucose levels which was not present in obesity. These preliminary data suggest impairment of metabolic rhythms in obese children; they should stimulate further studies on the hypothalamic system in obesity.

Adolescent↗
PubMed1981

[Familial diabetes insipidus of central origin (author's transl)].

In a 10-year-old girl admitted to hospital for polyuria and polydipsia, the central nervous system origin of the symptoms was demonstrated by low antidiuretic hormone levels (inferior to 1 pg/ml) and reduction of diuresis after administration of 1-deamino-8D-arginine-vasopressin (DDAVP). A study of the girl's family history showed that the disease was hereditary and autosomal dominant. Intranasal instillations of DDAVP twice daily constitute the best known treatment of the condition.

Child↗
PubMed1981

Long-term study of mortality and vascular complications in juvenile-onset (type I) diabetes.

A cohort of 372 insulin-dependent diabetic children, diagnosed between October 1949 and December 1960, were followed-up until December 1976 by the same team of physicians. At the time of diagnosis all patients were under 16 yr of age and were given standardized treatment which did not change from 1949 to 1976. The therapy consisted of daily insulin adjustment based on clinical assessment, the degree of physical activity, and the results of semi-quantitative urine tests for sugar and ketone bodies. These tests were systematically performed before breakfast, lunch, and dinner. Diet was normal, unmeasured, rich in carbohydrates (approximately 60%), and quantitatively unrestricted unless the patient was overweight. Rates for mortality and for the principal complications among this cohort were computed by the actuarial method. During the 26 yr of study, 26 deaths occurred, 16 of which were directly connected with diabetes. After 16 yr of follow-up, rates of proteinuria and hypertension were 4% and 2.1% respectively. The incidence of retinopathy reached 27%, including 1.5% proliferative retinopathy. After 26 yr, the rates rose to 14% for proteinuria, 16% for hypertension, and 85% for retinopathy, including 18% in the proliferative phase.

Adolescent↗