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I Augustin-Pascalis

Publications and source records attributed to I Augustin-Pascalis.

5 recordsLinked to original sources

Analysis of HLA haplotypes in families with type 1 diabetes mellitus in La Réunion island.

To analyse HLA and insulin-dependent diabetes mellitus (IDDM) association in the ethnically mixed population of La Réunion island, we carried out a family study on 70 diabetic subjects. HLA-DQA1, -DQB1 and -DRB1 typing was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), completed by PCR-sequence-specific oligonucleotide (SSO) and PCR-sequence-specific priming (SSP). Haplotype-relative risks (HRR) were determined with the non-transmitted parental haplotypes as controls, and relative risks (RR) were calculated with a classical case-control study. The most significant risks were found for the cis and trans combinations between DQA1*03 or *0501 (Arg52+) and DQB1*02 or *0302 (Asp57-) alleles, suggesting a direct role for the HLA-DQ heterodimer in IDDM susceptibility. Interestingly, due to the mixed origin of the population, the trans-encoded DQ molecules in the (DR3)-DQA1*0501-DQB1*02/(DR4)-DQA1*03-DQB1*0302 subjects were also found cis-encoded in patients with the (DR7 or 9)-DQA1*03-DQB1*02 haplotype and in a patient with the rare (DR11)-DQA1*0501-DQB1*0302 haplotype. A relative predispositional effect (RPE) analysis gave significant haplotype-IDDM+ associations in the following order: (DR3)-DQA1*0501-DQB1*02 > (DR4)-DQA1*03-DQB1*0302 > (DR9)-DQA1*03- DQB*02 > (DR7)-DQA1*03-DQB1*02 > (DR2)-DQA1*01-DQB1*0502. No protective effect remained significant once the susceptible haplotypes were removed. A stratification study showed a stronger influence of the DQ genes than DRB1 alleles within the DR7 haplotypes. On the other hand, IDDM subjects with only one susceptible haplotype had inherited this haplotype more often from their father than from their mother. This paternal effect could be related to the greater risk of IDDM in offspring of diabetic fathers than the risk in offspring of diabetic mothers.

Adult↗

Secondary failure of oral antidiabetic and dietetic therapy in non-insulin-dependent diabetes mellitus. Remission through short sessions of continuous intravenous insulin infusion.

The infusion of periodic intravenous insulin for the equilibrium of the diabetic state is proposed for cases of non-insulin-dependent diabetes mellitus (NIDDM) that have become resistant to oral treatment. In order to re-establish the efficacy of oral antidiabetic treatment, 37 patients with NIDDM presenting secondary failure to diet and oral antidiabetic therapy were subjected to sessions of continuous intravenous insulin infusion, resulting in transitory normal blood sugars. With a diminution of symptoms, an increase in the efficacy of oral treatment was noted in 18 cases (48.6%), allowing the continuation of treatment without disturbance of the equilibrium over periods of 6 and 12 months. This improvement is not concurrent with the rise in glucagon-stimulated insulin secretion as evidenced by C-peptiduria and basal C-peptidemia. An improvement in insulin sensitivity (not investigated in this study) might explain this beneficial effect. Periodic intravenous infusions of insulin, based on the diabetic equilibrium, are proposed for the treatment of NIDDM patients that have become resistant to oral therapy.

Blood Glucose↗

[Secondary failure of oral antidiabetics. Value of intravenous insulin infusions].

A temporary strict blood glucose control was achieved by means of intravenous insulin infusion in 37 non insulin-dependent diabetic patients with secondary drug failure to reinduce the efficacy of oral hypoglycemic agents. This procedure was successful in 18 patients (48.6%) resulting in better glycemic response to oral hypoglycemic agents. Results remained identical 6 and 12 months later. This improvement does not seem related to an increase in insulin secretion as urinary C-peptide and basal and glucagon-stimulated plasma C-peptide were identical before and after insulin infusion. We suggest that a decrease in insulin resistance, not tested in this study, may explain the beneficial effect or normoglycemia in our patients.

Administration, Oral↗

[Thyroiditis].

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Acute Disease↗