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Biomedical subjects

H Mehnert

Publications and source records attributed to H Mehnert.

At least 91 records · Page 5Linked to original sources
PubMed1988

Role of angiotensin-converting enzyme inhibitors in early antihypertensive treatment in non-insulin dependent diabetes mellitus.

The effect of captopril monotherapy on blood pressure and metabolism was investigated in a placebo-controlled study in 30 non-insulin dependent (Type II) diabetic subjects during a 3-week observation period (run-in/drug; placebo/wash-out) on a metabolic ward. Captopril significantly reduced both systolic and diastolic blood pressure (154/90 +/- 5/2 vs. 144/86 +/- 4/3 mmHg) without major side effects. Mean run-in postprandial blood glucose concentrations were also reduced upon ACE-inhibition (9 a.m.: 12.7 +/- 0.4 vs. 11.1 +/- 0.4 mmol/l; 1 p.m.: 11.0 +/- 0.3 vs. 8.9 +/- 0.3 mmol/l; P less than 0.05), while blood kinin concentrations (40.0 +/- 2.5 pmol/l) were approximately doubled (108.8 +/- 23.5 pmol/l; P less than 0.05). Body mass index, fasting plasma insulin, serum electrolyte pattern, uric acid, white blood count, lipid profile as well as hepatic and renal function parameters remained unaltered throughout the observation period. The data are in line with recent experimental studies showing a beneficial metabolic effect of captopril in Type II diabetes. ACE inhibitors might therefore become first-line drugs in early antihypertensive intervention in Type II diabetic patients.

Aged↗
PubMed1988

[Changes in ultrasonic findings in the liver in relation to parenteral nutrition with long chain triglyceride and medium chain triglyceride/long chain triglyceride lipid solutions].

Fatty infiltration of the liver with cholestasis is one of the complications of total parenteral nutrition (TPN). The casualty has not yet been determined. It seems probable, however, that these alterations could be prevented when a mixture of medium- and long-chain triglycerides (MCT/LCT) is used as fat component of TPN instead of the application of long-chain emulsions (LCT) alone. To determine whether this could be demonstrated also morphologically in man, 14 patients needing TPN (25 kcal/kg BW x d, CH 45%, F 35%, P 20%) were examined with ultrasound in order to compare liver-size and grey-scale value before and after 7 days of TPN. Seven of the patients were randomly given as their fat-intake an MCT/LCT-emulsion, the other 7 LCT exclusively. There were no changes in liver size and grey-scale value in the MCT/LCT-group, whereas both parameters showed a significant rise in the patients with LCT (size: 10.4 +/- 1.4 to 11.5 +/- 1.4 cm; grey-scale value: 9.3 +/- 1.0 to 11.6 +/- 0.7). These data suggest that TPN, administered with a mixture of MCT/LCT emulsions as fat component, could reduce the risk of hepatic dysfunction such as cholestasis and fatty infiltration of the liver.

Fat Emulsions, Intravenous↗
PubMed1988

[Inhibition of muscle amino acid release by infusion of a triglyceride emulsion].

Amino acid balances of 12 healthy volunteers were investigated with the forearm technique under the influence of an intravenous infusion of a long-chain triglyceride emulsion (LCT). Arterial concentrations of the amino acids declined due to a decrease of basal muscular release of most of the amino acids. Decreased phenylalanine and tyrosine output suggest that muscular proteolysis might be inhibited. With constant insulin and substantially unchanged blood glucose concentrations, this is apparently due to the increased concentration of free fatty acids.

Amino Acids↗
PubMed1987

Cell-mediated autoimmunity at the onset of insulin-dependent diabetes mellitus (IDDM).

Peripheral blood lymphocytes have been investigated in 20 newly diagnosed type-I diabetics and 10 healthy subjects using monoclonal antibodies. Mononuclear cells were marked with anti-T-lymphocytes (Leu2, 3, 4, 12) and anti-Ia-antibodies (K14, L243) using indirect immunofluorescence. The percentage of circulating K14- and L243-positive cells was significantly higher in all diabetics than in normal controls. An increase in the number of K14-bearing cells was found in newly diagnosed patients with duration of less than 7 days (n = 10) compared with diabetics of longer duration (1 to 8 months; n = 10). Using dual-color immunofluorescence with fluorescein-conjugated anti-T-lymphocytes and rhodamin-conjugated anti-Ia-antibodies it was not possible to identify Ia-antigen bearing cells (Ia cells) as helper or suppressor lymphocytes. In addition, there was no significant difference in the number of Ia cells in diabetics with and without islet cell antibodies. It is concluded that there is evidence of activation of cellular immune response in type I diabetes, particularly in the early days of manifestation. However, previous assumptions that Ia cells represent T-cell activation have to be questioned.

Adolescent↗
PubMed1987

[Clinical testing of a new blood glucose measuring system. A cooperative study at 8 centers].

The glucometer II system is a small measurement device with built-in batch-specific pressbutton calibration. The corresponding test strip "Glucostix" uses a two-color system. The blood glucose test strip can be evaluated both visually and by instrument. The precision determined in series was between 2.0% and 6.7% using control sera. The day-to-day precision was between 1.5% and 7.9%. Comparison of the methods on the basis of 781 and 109 capillary blood samples respectively revealed a good agreement between the hexokinase method or the glucose oxidase method (Beckman analyser) and the glucometer II values. The precision of measurement by the system was comparable in the two test strip batches employed. Visual reading of the test strips revealed a good agreement with the laboratory method in the hypoglycemic and normoglycemic range; at higher concentrations of blood glucose, a trend to underestimation of the measurement values was shown. The easy handling and small size of the instrument facilitates measurement of blood glucose by the patient under everyday conditions.

Blood Glucose↗
PubMed1987

Sustained normoglycemia and remission phase in newly diagnosed type I diabetic subjects. Comparison between continuous subcutaneous insulin infusion and conventional therapy during a one year follow-up.

After onset of type I diabetes 7 diabetics were randomized to subcutaneous insulin pump treatment (CSII) (age 12 to 29 years, mean: 21 years) and 7 diabetics to conventional insulin treatment (CI) (age 14 to 28 years, mean: 21 years). HbA1, glycosylated serum proteins and mean blood glucose (MBG) as parameters of metabolic control were determined monthly. After 2 months both groups showed HbA1 values in the normal range. Mean MBG values were (mean +/- SD) 116 +/- 7 mg/dl for CSII and 118 +/- 14 mg/dl for CI. Residual insulin secretion was determined monthly by fasting C-peptide. After 14 days, 5, 7, 8 months fasting C-peptide values were significantly (P less than 0.05) higher in CI. After one year fasting C-peptide was comparable in both groups (CSII and CI mean: 0.06 nmol/l). The administered insulin dose was comparable in both groups with a 55% reduction of insulin dose after 5 months in CSII (0.35 +/- 0.15 U/kg/24 h) and in CI after 7 months (0.31 +/- 0.28 U/kg/24 h). After 12 months of insulin therapy about 60% of the initial insulin dose was injected in both groups. 1 patient on CSII (12 years) and 2 patients on CI (15, 28 years) showed a complete remission (for 3-9 months) with no exogenous insulin and normal HbA1 values. 50% of the patients had episodes where they did need less than 0.2 U/kg/24 h insulin to maintain optimal diabetic control (3 CSII, 4 CI). During the first year of insulin treatment in type I diabetes with CSII as well as with CI a comparable near normalisation of diabetic control could be achieved.

Adolescent↗
PubMed1987

[Carbohydrate intolerance as a danger in infusion therapy].

The following types of carbohydrate intolerance are discussed as a risk in infusion therapy: Hereditary fructose intolerance, fructose-1,6-biphosphatase deficiency, impairment of glucose utilization during the post-aggression syndrome and/or in latent or overt diabetes mellitus. Asking about symptoms of fructose intolerance has to be part of every routine anamnesis. Application of any kind of carbohydrate requires differential therapeutic considerations. Undiscovered fructose intolerance is more likely the younger the patient is, whereas the frequency of glucose intolerance increases with age. In unconscious patients without anamnesis, fructose or sorbitol should not be applied. Never should an attempt be made to compensate falling blood glucose levels under infusion therapy by application of fructose or sorbitol. As carbohydrate addition to routine fluid and electrolyte substitution xylitol in the specified low dosage is without risk in a diabetes-like metabolic condition as well as in fructose intolerance.

Blood Glucose↗
PubMed1987

Daily insulin dose as a predictor of macrovascular disease in insulin treated non-insulin-dependent diabetics.

In the longitudinal Schwabing study, unselected insulin-treated diabetic patients were followed for major vascular complication (MVC) (stroke, myocardial infarction, gangrene) and asymptomatic, early detectable peripheral vascular disease (PVD). In the group of insulin-treated NIDDM multiple logistic regression analysis revealed the number of daily injected insulin units as a significant predictor for MVC and PVD (t = 1.98; p less than 0.04; x +/- S.D.: PVD yes 57.6 +/- 21.4 U/d; PVD no 44.3 +/- 17.7; age-adjusted univariate p less than 0.001). Daily insulin dose correlated highly significantly with serum triglycerides (r = 0.40, p less than 0.001) as well as with blood glucose (r = 0.33, p less than 0.001). These data suggest that insulin resistance is characteristic for atherosclerotic disease in NIDDM and the hyperinsulinemia-hypertriglyceridemia-syndrome might be a powerful cardiovascular risk factor in diabetes mellitus.

Adolescent↗
PubMed1987

[Captopril in hypertensive patients with type II diabetes mellitus].

Since the angiotensin converting enzyme (ACE) is identical with kininase II, the reduction of its activity by an ACE-inhibitor such as captopril will not only decrease the concentration of angiotensin II but also elevate the levels of kinins. Although the slight increase of the latter will not contribute to the antihypertensive action of ACE-inhibitors, we are sure today that it exhibits local metabolic effects in cardiac and skeletal muscle tissue. These endogenous kinins have been shown to improve the utilisation of glucose in the human forearm, the whole organism and the isolated perfused rat heart and seem to exhibit their effects via prostaglandins. A cross-over plot of the glycolytic intermediates at the height of phosphofructokinase induced by bradykinin in rat heart and the activation of the purified enzyme from rabbit heart by PGE2 point to an enhanced glycolytic rate as their mode of action. From these findings similar effects under ACE-inhibitors can be assumed. This was investigated in ten non-insulin-dependent diabetics, whose glucose disposal rate was measured by the glucose clamp technique. After 25 mg of captopril their peripheral insulin resistance was significantly improved, which was found to be due to an accelerated rate of glucose uptake into their forearm muscle tissue. To evaluate the clinical relevance of these data, 15 mildly hypertensive, overweight type II-diabetic patients (mean age: 53 years; seven women) were hospitalized. After a seven-day wash-out period, the patients were given 25 mg of captopril twice daily for seven days. During the treatment, systemic kinin concentrations significantly increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

[Detection of substrate metabolism in skeletal muscles in the human].

The technical procedure of puncture and catheterization of arteria brachialis and a deep forearm vein in man and practical mode of blood sampling are described. For measurement of local blood flow depending on specific study design, venous occlusion plethysmography, i.m. or i.a. injection of 133Xenon can be used. The theoretical and practical problems of these methods are discussed in detail.

Catheters, Indwelling↗
PubMed1986

[Effect of fructose and sorbitol on insulin-induced hypoglycemia].

Twelve metabolically normal subjects were given 0.325 g/kg fructose or glucose dissolved in water 30 minutes after intravenous infusion of insulin, 0.05 U/kg. Blood glucose concentration was then measured for up to 60 minutes or until the onset of hypoglycaemia (study I). In study II two bread units (BU) were given to six subjects in the form of dark bread, as well as 12 g of butter and water. In two other groups, of six subjects each, 1 BU was substituted either by fructose or sorbitol. Seven subjects who had been given insulin but only water to drink afterwards served as the control group. In study I, both glucose and fructose achieved a clear slowing in the blood-sugar drop compared with the control group. But with glucose there was initially a slight rerise and the final hypoglycaemic level was somewhat delayed. This minor difference between glucose and fructose was not demonstrable in study II with the addition of fat and carbohydrate substitution. Each carbohydrate combination similarly influenced the course of blood sugar concentration. The results indicate that diabetics should continue to be given glucose rather than fructose or sorbitol if hypoglycaemia occurs. On the other hand, both fructose and sorbitol, although acutely less effective in raising blood glucose concentration, do counteract as carbohydrates the development of insulin-induced hypoglycaemia.

Adult↗