Search PubMed⌕ Search

Biomedical subjects

J Ludvigsson

Publications and source records attributed to J Ludvigsson.

At least 163 records · Page 9Linked to original sources
PubMed1982

Rapid and slow rate of decrease in HbA1a + b and HbA1c during improved glycaemic control.

The change in glycosylated haemoglobins was studied with a column chromatographic method when glycaemic control was rapidly improved in nine diabetic patients. The patients were followed for 3 weeks or more. There was a decrease in HbA1a+b and HbA1c within the first few days of improved control and this decrease was faster than later on. The initial decrease of HbA1a+b was faster than that of HbA1c. In individual patients the initial decrease in glycosylated haemoglobins correlated with the initial rate of decrease in blood glucose. It is concluded that HbA1a+b and HbA1c decrease biphasically during improved glycaemic control. The rapid initial decrease may be due to labile HbA1 and it is large enough to influence the value of HbA1 as an indicator of long-term glycaemic control in some patients.

Adolescent↗
PubMed1981

A prospective analysis of antibodies reacting with pancreatic islet cells in insulin-dependent diabetic children.

Islet cell cytoplasmic and cell surface antibodies along with other autogenic tissue antibodies were determined prospectively from the day of diagnosis of insulin-dependent diabetes in a group of children and adolescents. Prior to the initiation of insulin therapy 30 out of 33 were antibody-positive, 67% having islet cytoplasmic antibodies and 67% islet cell surface antibodies. Among 74 age- and sex-matched non-diabetic individuals 1% had islet cell cytoplasmic antibodies and 3% had islet cell surface antibodies. A prospective analysis in 17 patients showed a diminishing prevalence of islet cell antibodies with increasing duration of diabetes. Islet cell cytoplasmic or cell surface antibodies were found independently of each other or in combination and with various patterns of persistence. The results indicate a strong association of islet cell antibodies with the onset of insulin-dependent diabetes in childhood and adolescence.

Adolescent↗
PubMed1980

Pancreatic B-cell function and abnormal urinary peptides in a boy with lipoatrophic diabetes and stenosis of the aqueduct of Sylvius.

A boy with the classical clinical manifestations of acquired lipoatrophic diabetes has been studied for 5 years from the onset of diabetes at age 13. At the age of 15 a ventriculo-cisternal shunt operation was performed because of stenosis of the aqueduct of Sylvius, followed by a dramatic improvement in his diabetic state with a decrease of the 24 hr insulin requirement from 130 to 32 units. After 12 months there was a relapse with increased insulin requirement up to the preoperative level. Pimozide treatment was given for 7 months with no effect on the metabolic derangements. Extremely high basal levels of serum C-peptide and pro-insulin were found throughout the period of observation. A further increase occurred after i.v. arginine infusion tests, indicating hyperfunctioning B-cells. Repeated screenings of peptides in the urine by sephadex chromatography revealed pathological patterns similar to those observed in patients with other hypothalamic disorders, but different from that found in the urine of patients with congenital generalized lipodystrophy. Injection into mice of peptides extracted from the preoperative urine produced an acute hyperglycemia. The mechanisms behind this hypothalamic syndrome are unknown, but it is postulated that the abnormal urinary polypeptides originate from disorganized hypothalamic centres and that these peptides may be responsible for the disturbed carbohydrate and lipid metabolism.

Adolescent↗
PubMed1980

Physical exercise in relation to degree of metabolic control in juvenile diabetics.

Physical exercise is considered to be one of the basic principles in the management of diabetes, but the evidence to support the long-term benefit of exercise in insulin dependent diabetes is limited. The aim of this study was to analyse the influence of physical activity on the degree of metabolic control, and different groups of diabetics were studied, the largest including 143 children and adolescents with an age at onset between 1-16 years (mean +/- S.D. 7.3 +/- 3.9) and duration of diabetes 1-17 years (7.8 +/- 4.6). In the first part of the study there was a highly significant correlation (r = 0.54, p less than 0.001) between degree of physical activity based on a weekly history and index of metabolic control (proportion of daily urine tests without glucosuria), when other factors of importance for metabolic control were kept constant. With a statistical technique it was possible to show that the observed correlation had its direction from physical exercise to degree of metabolic control. The positive correlation between degree of exercise and metabolic control could be confirmed in a follow-up during two other years. However, it was also evident that in many single patients the correlation between degree of physical exercise and metabolic control was rather negative. Several explanations are possible. The importance of adequate insulin treatment for a positive effect of exercise is stressed.

Blood Glucose↗
PubMed1980

B-cell response to exercise in diabetic and non-diabetic children.

20 non-diabetic and 11 insulin dependent diabetic (IDD) children underwent short time (20 min) bicycle ergometer exercise followed by a 10 min rest period. Glucose, IRI, C-peptide and proinsulin were determined prior to and at the end of the exercise, and again after 10 min rest. While no significant change in mean glucose was observed during exercise in the non-diabetics, significant decreases were observed in IRI, C-peptide and proinsulin. After 10 min rest glucose as well as the three B-cell secretory products increased significantly. The change in glucose was significantly (p less than 0.001) correlated to the change in IRI. In the resting period IRI rose more than C-peptide in some subjects. IRI even rose without simultaneous rise in C-peptide indicating a release of tissue bound IRI. The group of IDD children did not show any significant changes in glucose and total IRI, while the endogenous insulin, as measured by C-peptide, did show a fall during exercise. The same was found for proinsulin. The lack of increased endogenous secretion during the rest period was most likely due to suppression of B-cell due to hyperinsulinism and lack of increased glucose concentrations during the rest period.

Adolescent↗
PubMed1980

Attitudes towards physical exercise in juvenile diabetics.

Contrary to our recommendations many juvenile diabetics are inactive and rather negative to physical exercise. We have tried to estimate the attitudes towards and motivation for regular physical exercise among juvenile diabetics by interviewing, giving questionnaires to and using a special attitude test. Different groups have been studied, the largest including 138 diabetics aged 1-21 years with age at onset between 1-16 years (7.3 +/- 4.0) and duration of diabetes 1-17 years (5.7 +/- 3.6). The results are somewhat divergent comparing different patient groups and when using different methods. Generally teenagers seem to be somewhat more negative. According to direct questions in questionnaires or interviews most patients seem to know that physical exercise is important and very few dislike this part of the treatment. However, the special attitude test reveals more mixed feelings. Many patients mean that is easy to be theoretically positive, but quite another thing to really exercise regularly. Too often physical exercise becomes a medicine instead of a natural pleasant habit. It is important that the hospital staff inform the patients without nagging, and then support and stimulate the patients, and give them adequate responsibility.

Adolescent↗
PubMed1980

Vitreous fluorophotometry in juvenile diabetes.

A group of 26 juvenile diabetics, 8-22 years old with a mean duration of diabetes of 7.8 +/- 5.7 years were examined by vitreous fluorophotometry. Eleven non-diabetic healthy individuals, 12-27 years old, served as controls. Vitreous fluorescein concentrations one hour after injection of fluorescein were higher in the diabetics than in the controls indicating an abnormal blood-retinal barrier. In diabetes beyond the partial remission period a pronounced leakage of fluorescein into the vitreous body occurred, while diabetics still in partial remission showed no such abnormal leakage. There were no significant correlations between a defect blood-retinal barrier and duration or age at onset of diabetes. Some diabetic patients showed an abnormal leakage with a duration of diabetes less than 2 years, while some other patients with a duration of more than 16 years did not have an abnormal blood-retinal barrier. The diabetics with defect blood-retinal barrier had a lower glucosuria index during the last year, indicating a more inadequate metabolic control than those patients who had a normal barrier. There was no relation between the actual blood-glucose value during the examination and abnormal leakage. In some diabetics, all beyond partial remission significantly elevated fluorescein concentrations were also found in the anterior parts of the vitreous body, indicating a break-down of the blood-aqueous barrier as well. In conclusion, vitreous fluorophotometry provides information about early, functional and possibly reversible retinal changes in juvenile diabetes. The observation that the blood-retinal barrier remained intact during the remission period supports the hypothesis that normoglycemic metabolic control is of importance for the preservation of a normal blood-retinal barrier function.

Adolescent↗
PubMed1980

Compliance and the health relief model--its relevance to the treatment of juvenile diabetes mellitus.

The significance of the concept of compliance is shown. There is made a distinction between compliance, identification and internalization. Factors of importance to compliant behaviour, beside personality variables, are mentioned. For example group goals, the need to be popular, the maintenance of existing relationships and the need for correct behaviour. The Health Belief Model (HBM) as defined, especially by Becker and associates, is discussed. Compliant behaviour (in a group of mothers to diseased children) is said to be dependent to: - General Health - Related Motivation - The Value of Reducing the Threat - The Probability of Reducing the Threat HBM is related to juvenile diabetes mellitus, as an example of a chronic, serious and difficult-to-treat disease, and found to be useful also in this case.

Adolescent↗
PubMed1980

Attitudes towards self-control with urinalysis in juvenile diabetes.

Urinary glucose excretion reflects the blood glucose levels and is therefore recommended and used as a relevant and practical method for self-control in juvenile diabetes. The purpose of this study was to estimate the attitudes of of diabetic children and their parents towards such daily urinalysis. In 1975 69 juvenile diabetics 6-18 years old and their parents were studied and three years later another 69 patients were added. Still a year later 31 of the children were studied again. Standardized interviews, questionnaires and a special attitude test were used. The results indicate that a great majority of the patients and the parents accept the self-testing method and regard it as a valuable tool in the management of the disease. Almost nobody experienced the urine tests as a psychological problem. As urinalysis has become established as a self-evident part of the treatment, the attitudes have become even more positive among a growing number of patients. Parallel to this feeling of usefulness the patients are honest and the urine tests thus give reliable information.

Adolescent↗
PubMed1979

Social adaptation in juvenile diabetes.

A sample of 36 juvenile diabetics, age 19--28 years, and with a duration of diabetes of 14--17 years were interviewed with regard to their social adaptation. Five patients could not be traced and six patients did not want to participate. Educational and professional careers were normal. However, none had received individual diabetes-oriented vocational guidance. A majority of patients was unsatisfied with the information given at the diabetic clinics, and a negative attitude towards society and its institutions was common. Patients often felt that as children they had been neglected by the diabetic team, while their parents received all information. It is concluded that diabetic children and adolescents require continuous socio-psychological support, that psychologists and/or social workers should be permanent members of the diabetic teams, and that paediatricians should follow diabetic patients until they are fully grown up.

Adolescent↗
PubMed1979

Self-control with urinalysis in juvenile diabetes.

Urinary glucose excretion reflects the blood glucose levels and is therefore recommended and used as a relevant and practical method for self-control in juvenile diabetes. The purpose of this study was to estimate the attitudes of diabetic children and their parents towards such daily urinalysis. In 1975 69 juvenile diabetics 6--18 years old and their parents were studied and three years later another 69 patients were added. Standardized interviews and questionnaires were used. Only 3 out of 138 patients refused to test their urine regularly and to write down their results in the diary. The results indicate that a great majority of the patients and the parents easily accept the self-testing method and regard it as a valuable tool in the management of the disease. Almost nobody experienced the urine tests as a psychological problem.

Adolescent↗