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Biomedical subjects

J Ludvigsson

Publications and source records attributed to J Ludvigsson.

At least 181 records · Page 10Linked to original sources
PubMed1979

Sensory nerve conduction velocity and vibratory sensibility in juvenile diabetics. Relationship to endogenous insulin.

Sensory nerve conduction velocity (NCV) and the vibratory sense (biothesiometry) were determined in 67 children and adolescents with insulin dependent diabetes. Age at onset of diabetes varied between 1-14 years (mean +/- S.D. 6.5 +/- 3.6) and the duration of diabetes between 4-17 years (7.7 +/- 3.4). Within +/- 3 months of the nerve function tests blood was drawn for determination of C-peptide and insulin antibodies (IgG and IRI). A low NCV (less than 50 m/s) in the sural nerve and/or an abnormal vibratory sense (greater than or equal to 1.0 microns) were found in 34 patients (50.7%). Measurable fasting serum C-peptide 0.04-0.60 pmol/ml (0.17 +/- 0.15) was found in 16 patients (23.9%). All but one patients had insulin antibodies with IgG 0.130-11.029 mU/ml (2.957 +/- 2.509) and total IRI 10-9120 muU/ml (1204 +/- 1723). In multiple regression analysis we did not find any correlation between nerve function and sex, age, or age at onset of diabetes, and there was only a weak relationship between NCV and duration. However, there was a positive correlation between NCV and C-peptide (p less than 0.001). Vibration sense was also better among patients with C-peptide (p less than 0.05). The results support the view that insulin deficiency contributes to peripheral diabetic neuropathy.

Adolescent↗
PubMed1979

The effect of large doses of vitamin C on leukocyte function and some laboratory parameters.

Consumption of large doses of vitamin C has been ascribed several beneficial effects e.g. on serum cholesterol, haemoglobin synthesis, leucocyte function. Other authors have warned against large doses which could cause renal stones, disturbed vitamin C metabolism, a diabetogenic effect. To test certain statements 24 healthy women received either placebo, 1000 mg or 4000 mg ascorbic acid daily in a double blind study. Blood was drawn at regular intervals. Those women who received large doses of vitamin C increased their serum levels of vitamin C, during the medication, but otherwise we found no differences neither in leucocyte levels of vitamin C, leucocyte function nor other laboratory parameters between women who received placebo or large doses of ascorbic acid.

Adolescent↗
PubMed1978

beta-cell function in children with diabetes.

Although it is generally believed that insulin secretion is minimal or absent in juvenile-onset diabetes, we have found appreciable levels of C-peptide at the time of onset in 12 patients, 4 to 16 years old (9.3 +/- 4.2). Ten of them had ketonuria but none severe ketoacidosis. All entered a remission period. Most of the patients had near normal C-peptide levels during the remission, and their beta cells had the capacity to respond to a breakfast stimulation with increased insulin secretion. C-peptide and proinsulin were also determined in 98 juvenile diabetics with age at onset of 1 to 16 years (6.8 +/- 3.9) and a duration of diabetes between two and 17 years (6.7 +/- 3.4). Many were found to have persisting beta-cell function, which seems to be of importance for ensuring stability in metabolic control. Although little is known about factors that may slow or reverse the process leading to beta-cell failure, our results suggest that early detection and intensive treatment of diabetes before severe metabolic disturbances have occurred may help preserve beta-cell function.

Adolescent↗
PubMed1977

HLA-types, C-peptide and insulin antibodies in juvenile diabetes.

HLA-types were determined in 102 juvenile diabetics. HLA-B8 was found in 39 patients (RR 2.64; p less than 0.01) and HLA-BW15 in 32 patients (RR 1.33; n.s.). HLA-B7 was found in 14 patients (RR 0.40; p less than 0;05). There were no correlations between HLA-B8 or BW15 and family history of diabetes, occurrence of infection before onset of diabetes, ketonuria at onset or the age at onset of diabetes. Serum C-peptide, insulin binding capacity of IgG and total serum insulin, IRI, were determined in 94 patients who had had diabetes for more than two years and who were beyond the remission period. Measurable amounts of C-peptide were found in 33 patients (34.7%). There was no evidence of a relationship between any particular HLA-antigen and the B-cell function except for an increased incidence of do a decreased incidence of detectable C-peptide in patients with the combination HLA-B8, W15. Only four patients (4.3%) were lacking insulin antibodies; HLA-BW15 positive patients had higher levels of insulin antibodies than other groups, while HLA-B7 positive patients had lower levels; The results suggest that HLA-B7 and HLA-B18 might be associated with a different and perhaps milder form of juvenile diabetes.

Adolescent↗
PubMed1977

Atopic allergy and serum IgE in randomly selected eight-year-old children.

The incidence of atopic allergy and serum IgE levels as well as specific IgE antibodies was studied in a randomly selected sample of 164 8-year-old children who were followed-up for 2 years. The total incidence of atopic disease was 18.9 per cent. Serum IgE levels were above + 2 s.d. for the age before the onset of atopic disease in seven of 11 children who developed an atopic disease during the observation period. The direct paper disc sandwich radioimmunoassay, PRIST, equalled the Phadebas IgE test for discriminating between atopy and non-atopy, but PRIST is preferred because of its simplicity. Actual or future atopic disease disease is most probable when the serum IgE is above the + 2 s.d. limit for age. Serum IgE levels below the geometrical mean for age are rarely found in atopic disease. An IgE determination with PRIST will give more discriminative information than the family history and is recommended for routine purposes when there is a history of possible atopic allergy in a child.

Child↗
PubMed1977

C-peptide in juvenile diabetics beyond the postinitial remission period. Relation to clinical manifestations at onset of diabetes, remission and diabetic control.

A group of 58 diabetics, age 6-17 years and with a duration of diabetes of 3-14 years was studied in order to show whether the nature of the clinical manifestations and the treatment at the onset of the disease are related to the subsequent C-peptide production and also whether remaining C-peptide production is related to better diabetic control. The relations between a number of clinical and laboratory variables were analysed including the degree of ketosis and the insulin dose given at onset of diabetes, the incidence of postinitial remission period, the fasting C-peptide level after the remission period, the level of insulin antibodies and the actual diabetic control expressed as the degree of glucosuria in the patients' urine tests at home. Multiple regression analysis was the main method used. Postinitial remission was positively correlated to initial insulin dose and negatively correlated to duration of ketonuria at onset. C-peptide, which was found in 24.1% of the patients was positively correlated to age at onset and initial insulin dose, but negatively correlated to ketonuria at onset. Diabetic control was positively correlated to insulin dose at onset and to C-peptide level, but negatively correlated to insulin antibodies. It could further be shown that patients who had received a more vigorous treatment immediately at onset had both a higher incidence of postinitial remission and a better diabetic control. The results suggest that an early diagnosis followed by rapid normalization of the metabolism at the onset of juvenile diabetes increase the possibility of preservation of some of the endogenous insulin production, which seems to facilitate diabetic control.

Adolescent↗
PubMed1977

Socio-psychological factors and metabolic control in juvenile diabetes.

The influence of exogenous and environmental factors on metabolic control was studied in 58 insulin treated juvenile diabetics, 6-17 years of age. Duration of diabetes varied between 3-14 years and age at onset of diabetes between 1-13 years. The social situation as well as knowledge about and attitudes towards diabetes among the patients and their parents were estimated by interviews, questionnaires and special tests. The quality of the diet, exercise and insulin treatment was assessed. An index of diabetic control was calculated on the basis of the patients daily urinalysis made at home. Multiple regression analysis and a special statistical "instrumental" variable technique were used in an effort to analyse the correlations between all variables. The social situation of the diabetic children was comparable with that of other Swedish children, but many parents felt the economic burden of the diabetic treatment as a problem. Knowledge tests showed that 25% of the parents and 62% of the patients above 12 years had unsatisfactory knowledge about diabetes. However, 93% of the patients seemed to have predominantly positive attitudes towards the treatment. Severe psychological problems had occurred in 7 cases. Food habits were appropriate among 21% of the patients and 26% had very regular exercise customs. Physical exercise seemed to be the most important of the exogenous factors for the diabetic control (p less than 0.001). Among teenagers knowledge was positively correlated to positive attitudes which in turn were positively correlated to physical exercise. Instrumental variable technique gave further indications of a positive influence of knowledge on control, and the correlation between diabetic control on one hand and knowledge combined with positive attitudes on the other was significantly positive. The results emphasize the importance of assisting young diabetic patients and their families in their socio-psychological adaptation to the strains of diabetic therapy.

Adolescent↗
PubMed1977

C-peptide in juvenile diabetes.

C-peptide can be used as a measure of endogenous insulin secretion in insulin treated diabetics with insulin antibodies. At the onset of juvenile diabetes insulin production is thought to be absent or minimal, but we have found rather high levels of C-peptide, even in ketoacidotic patients. The ketoacidosis does not mean an irreversible beta cell failure. In the postinitial remission period with stable metabolism many patients have normal or almost normal C-peptide levels and their beta cells have the capacity to respond to natural stimulation with an increased insulin secretion. For some unknown reason the metabolism becomes more labile coinciding with decreasing C-peptide values. However, even several years beyond the postinitial remission period many juvenile diabetics have some persistent beta cell function, and it has been shown that even trace remnants of beta cell function are of importance for stabilization of the metabolism. There is no reason to believe that the beta cell failure should be predetermined e.g. by genetic factors. However, little is known how to influence the progression and stop the increasing beta cell failure. Some of our results suggest that an early detection and an intensive treatment of diabetes before severe metabolic disturbances and pronounced insulin deficiency have appeared, may increase the possibility of preserving some beta cell function.

Adolescent↗
PubMed1977

Diabetics in school. Knowledge and attitudes of school staff in relation to juvenile diabetics.

The purpose of this study was to assess whether the schools satisfy the special requirements of diabetic pupils. Both school staff and parents were of the opinion that diabetic pupils need special consideration at school. However, the results reveal an inadequate knowledge of the basic facts about diabetes and its treatment--a situation which could have dangerous consequences for the child and complicate its schooling in a number of ways. The treatment of juvenile diabetes may also become difficult to manage. Most school staff seemed to lack any source of information about diabetes. The contact between parents and school was not always sufficient and information from the hospital was seldom adequate. At present the school cannot be expected to participate in the treatment of diabetes in the way that could be desired. Improved information of school staff on the subject is recommended, as well as early and repeated contacts between hospital and school. These conclusions are drawn from an investigation in which 308 school staff members and the parents of 61 diabetic pupils answered questiomaires.

Attitude to Health↗
PubMed1977

C-peptide in diabetic children after stimulation with clucagon compared with fasting C-peptide levels in non-diabetic children.

Fasting serum C-peptide and total immunoreactive insulin (IRI) were determined in 38 non-diabetic children and adolescents 6-22 years old. C-peptide varied between 0.22-0.73 pmol/ml (mean +/- SD, 0.45 +/- 0.11). There was a tendency to higher values during puberty. No difference was found between subjects with or without a family history for diabetes. IRI varied between 0-31 millimcron/m1 (mean +/- SD, 11.3 +/- 6.5). The C-peptide response to glucagon was studied in 10 insulin dependent juvenile diabetics 11-19 years old, who had had measurable amounts of fasting C-peptide on some occasions during the previous years. Duration of diabetes varied between 4-12 years. A slight but significant rise in C-peptide level occurred in 3 patients. Their metabolic control estimated on the basis of daily urinalysis was "excellent" or "good". The results support the hypothesis that even trace remnants of the beta cell function may be of importance for the metabolic control in juvenile diabetes.

Adolescent↗
PubMed1977

Vitamin C as a preventive medicine against common colds in children.

During 7 weeks in the spring of 1973 a double-blind pilot study on 172 children in the age group 8-9 was carried out to test the possible effect of 1000 mg vitamin C daily as a prophylactic agent against common colds. During the autumn of 1973, a main study was carried out on 642 children of the same age. The investigations had the same pattern and lasted for 3 months. Both studies have been processed on the same principles. The results were somewhat divergent but, like previously published studies on children, seemed to indicate that the duration and severity of the cold were reduced while, on the other hand, the incidence remained unaltered or indeed increased. The total number of days of upper respiratory tract infection was smaller for the vitamin C group only in the pilot study (not in the main study). No proven biochemical effects were obtained. Preventive treatment of healthy children with vitamin C in large doses this had no definitely proved effect against colds.

Adolescent↗
PubMed1976

C-peptide in children with juvenile diabetes. A preliminary report.

Serum C-peptide, insulin-binding IgG and total insulin (IRI) were determined in 96 juvenile diabetics aged 4-21 years, with onset of diabetes at the age of 1-16 years and with 2-17 years' duration of diabetes. Thirty-four patients (35.4%) had detectable levels of C-peptide (greater than or equal to 0.04 pmol/ml). Compared to non-diabetic adults, 19 had values below the normal range, 12 showed values within the normal range (0.18-0.63 pmol/ml) and 3 rated above normal. There was a negative correlation between the fasting C-peptide concentration and the degree of ketonuria at the onset of diabetes and a positive correlation between C-peptide levels and the incidence of post-initial remission periods. Patients without detectable C-peptide had significantly higher levels of insulin antibodies than those who had detectable levels of C-peptide. The possibility of a relationship between the intensity of the initial treatment of diabetes and the preservation of the B-cell function is discussed, as well as the possibility of insulin antibodies being a cause of B-cell exhaustion.

Adolescent↗