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Biomedical subjects

J D Baum

Publications and source records attributed to J D Baum.

At least 109 records · Page 6Linked to original sources
PubMed1980

Twenty-four-hour metabolic profiles in diabetic children receiving insulin injections once or twice daily.

Twenty-four-hour metabolic profiles were performed twice in each of 15 diabetic children, once when they were receiving single daily injections of insulin (Monotard plus Actrapid) and once on a twice-daily regimen (Semitard plus Actrapid). Before the study control was optimised at home on each regimen. There were no differences in overall 24-hour diabetic control on the two regimens as measured by mean blood glucose concentration, area under the blood glucose curve, M value, and 24-hour urinary glucose excretion. Hyperglycaemia after breakfast occurred on both regimens. Significant differences were noted before breakfast, when blood glucose and ketone concentrations were lower and plasma free insulin higher on the single-injection regimen, and after supper and during the night, when blood glucose values were lower on the two-injection regimen and associated with a rise in plasma free insulin after the evening injection. Once-daily injections provided insufficient circulating insulin after the evening meal, while twice-daily injections did not last through the night. Plasma C peptide, indicating residual endogenous insulin secretion, was just detectable in two children but easily detectable in four children, whose 24-hour diabetic control was significantly better than that in the remaining 11 children.Conclusions about the superiority of one insulin regimen over another must be based on specific differences in diabetic control. Both regimens studied achieved adequate control, and though neither provided physiological control specific modifications to the regimens could help to produce more normal profiles.

Adolescent↗
PubMed1980

Timing of pre-breakfast insulin injection and postprandial metabolic control in diabetic children.

A peak period of hyperglycaemia in insulin-dependent diabetics occurs after breakfast. A randomised crossover study was performed on nine diabetic children at home to study the effect of varying the time of their morning mixed injection of Monotard and Actrapid insulin on this hyperglycaemic peak. Performing the study at home minimised the children's stress.After diabetic control had been improved children injected their insulin 30 minutes (early injection) or five minutes (late injection) before breakfast on two consecutive Saturday mornings. Blood samples were taken at 30-minute intervals over 3(1/2) hours and analysed for concentrations of glucose, insulin, C-peptide, pyruvate, lactate, alanine, and ketones. Diet, insulin dose, and exercise were kept the same on both test days.The mean blood glucose concentration at breakfast (0 minutes) was 11 mmol/l after the early injection and 10 mmol/l after the late injection. Subsequent concentrations were consistently lower with the early injection regimen than the late regimen. The greatest difference between values in the two groups was 3.7 mmol/l at 150 minutes. Mean plasma insulin concentrations were lower in the children on the early regimen than in those on the late regimen at 30 minutes before breakfast but higher at 0 minutes and thereafter. There were no significant differences in mean concentration of intermediary metabolites between the two injection regimens. These were mainly within the normal range for healthy young adults except for the ketone concentrations, which were raised with both injection regimens until 180 minutes after breakfast.These results suggest that the timing of the morning injection of insulin is important in the control of postprandial hyperglycaemia in diabetic children.

Adolescent↗
PubMed1980

Preterm milk.

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Breast Feeding↗
PubMed1980

A human milk formula.

In view of the possible deficits in the energy value and protein content of human milk when used for feeding low birth weight preterm neonates, a method has been devised suitable for use in a human milk bank for making milk formulae from human milk products. Human milk formula (HMF) is produced by adding, to whole human milk, human cream, obtained by separation by centrifugation, together with salt-free and lactose-free human milk protein, extracted by simple dialysis and freeze-drying. This human milk formula is, therefore, enriched in energy, human milk fat, protein and salts (which may be added), to approach the current concept of an ideal milk formula(e) for preterm infants. In addition, the increased concentration of antimicrobial proteins achieved in HMF may offset any losses in these proteins caused by pasteurisation.

Dietary Fats↗
PubMed1980

Effect of a traditional and of a new nipple shield on sucking patterns and milk flow.

The effect of a traditional (Mexican Hat) and of a new (Thin Latex) nipple shield on the sucking patterns and milk intake of 5-8-day-old babies was examined. Milk intake was determined accurately by test weighing using a Sartorius electronic balance with animal weighing keyboard, and sucking patterns by filming the mouth of the baby. The Mexican Hat reduced milk transfer by 58% (P is less than 0.01), and increased sucking rate (P is less than 0.05) and time spent resting (P is less than 0.01). The Thin Latex nipple shield reduced milk intake by a smaller amount (22%), and had no significant effect on sucking patterns.

Breast Feeding↗
PubMed1980

The nipple-shield sampling system: a device for measuring the dietary intake of breast-fed infants.

We have devised a method for the determination of the composition of the milk infants obtain from the breast during suckling itself, suckled breast milk (SBM). The method involves the use of a nipple-shield sampling system, together with data on the pattern of milk flow from mother to infant derived from a cross-sectional analysis of test weighings during feeding. In this study, marked changes were demonstrated in milk fat the sixth day postpartum. From this information the total intake of fat and energy during the feed was calculated. These preliminary findings suggest that published information on the dietary intake of breast-fed infants may need some revision.

Breast Feeding↗
PubMed1980

24-hour metabolic profiles in diabetic children.

15 metabolic profiles were performed on 10 diabetic children who were on once-daily injections of insulin. Blood and urine glucose concentrations were high throughout much of the day and night, and were associated with abnormal levels of blood ketones, lactate, and pyruvate. The plasma free-insulin profiles gave a characteristic pattern for each type of insulin. The investigation gives valuable information for the clinical management of such children.

Adolescent↗
PubMed1980

Emotional, behavioural, and educational disorders in diabetic children.

This study assesses the emotional and educational status of a group of diabetic children and considers the interaction of these measurements with diabetic control. Information was collected on 76 diabetic children (43 boys and 33 girls) by means of interviews at their clinic and two questionnaires, including the Rutter B2 behavioural scale, which were completed by their schools. This information was compared with estimates of diabetic control. The mean age of these children was 10.9 years and their mean duration of diabetes 3.5 years. Information was also obtained, by means of a questionnaire completed by teachers, on a group of nondiabetic children. Psychiatric disorder was not more common in the diabetic children than in the controls, but diabetic children were more backward at reading. 20 diabetic children were at least two years behind and 6 were between one and two years behind with reading. The figures for the nondiabetic children were 10 and 1 respectively. There was a correlation between poor diabetic control and the presence of psychiatric disorder, and backwardness in reading. In 39% of diabetic children there were adverse psychosocial factors in the family background. Poor diabetic control correlated with the presence of adverse psychosocial factors. In any serious attempt at achieving diabetic control in children, attention to insulin and diet must not be divorced from attention to the domestic, scholastic, and emotional problems of the child.

Adolescent↗
PubMed1979

Pattern of milk flow in breast-fed infants.

122 six-day-old infants were test-weighed during breast feeding. Cross-sectional data collection avoided repeated interruptions of individual feeds. Milk flow conformed to a definite pattern: a mean of 50% of the feed from each breast was taken in the first two minutes of sucking and a mean of 80-90% was taken by four minutes. The second half of a ten-minute feed from either breast was almost non-nutritive. Preliminary studies suggest that the pattern is the same after one month of lactation.

Breast Feeding↗
PubMed1979

Hospital admission rates of diabetic children.

In 1973 a children's diabetic clinic was established in Oxford. An analysis has been made of the effects this has had on the pattern of emergency admissions classified as severe hyperglycaemia (A), moderate hyperglycaemia (B) and hypoglycaemia (C). A comparison of the admission rate per "diabetic year" over the four years before and the three years after the children's clinic was established showed a significant decrease in admission rate for all hyperglycaemic admissions (p less than 0.05). This decrease was shown to be mainly due to a reduction in admissions with severe hyperglycaemia (A) (p less than 0.01), there being no significant change in admission rate for moderate hyperglycaemia (B). There was no significant change in admission rate for hypoglycaemia (C).

Age Factors↗