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Biomedical subjects

J Mirouze

Publications and source records attributed to J Mirouze.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Effect of Miglitol (Bay m1099), a new alpha-glucosidase inhibitor, on glucose, insulin, C-peptide and GIP responses to an oral sucrose load in patients with post-prandial hypoglycaemic symptoms.

Sixteen patients suffering from symptoms suggestive of idiopathic reactive hypoglycaemia and reproducible during an oral glucose tolerance test when plasma glucose was less than or equal to 2.8 mM, were included in an acute, double-blind and cross-over study to test the efficacy of Miglitol (Bay m1099), a new alpha-glucosidase inhibitor versus placebo. Patients were randomized to ingest 100 mg Miglitol or placebo together with a sucrose solution (45 g/m2 body surface), one week apart. During four hours, plasma glucose levels were continuously monitored and plasma insulin and gastric inhibitory polypeptide (GIP) levels were measured at 30-minute intervals; serum C-peptide concentration was determined at 0, 30, 60 minutes and then every hour. The post-load rise in plasma glucose was significantly blunted by Miglitol, as shown by the reduced plasma glucose peak, the diminished early (0-120 min) area under the glycaemic curve and the decreased rate of plasma glucose rise. Thereafter, plasma glucose nadir was significantly raised and rate of plasma glucose fall was slowed by Miglitol with a concomitant improvement in the hypoglycaemic index. Insulin secretion was dampened as indicated by parallel reduction of plasma insulin and serum C-peptide peaks; morever, early area under the insulin curve and total (0-240 min) area under the C-peptide curve were significantly reduced. Decrease of plasma GIP peak and total area under the GIP curve were also significant. During sucrose tolerance test with Miglitol, hypoglycaemic symptoms were significantly alleviated but intestinal side-effects were common. Blunting the insulin response to glucose directly by delaying glucose absorption and indirectly through reducing GIP secretion, may be a valuable therapeutic approach in reactive hypoglycemia; nevertheless, long-term study with Miglitol are needed, due to the poor intestinal tolerance of this drug in the present acute study.

1-Deoxynojirimycin↗
PubMedDate not supplied

[Pulsatile administration of gonadotropin releasing hormone in the female. Diagnostic and therapeutic indications].

Prolonged pulsatile exogenous GnRH allows differentiation between hypothalamic and pituitary causes of hypogonadotrophic hypogonadism and is able to induce ovulation and pregnancy in most of women with hypothalamic amenorrhea (HA). When compared with human menopausal gonadotropin, GnRH appears to be a more efficient therapy of HA but yields inferior results in chronic anovulatory patients with persistent LH secretion. Pulsatile GnRH following a GnRH-analog suppression represents a new promising treatment of infertile women with polycystic ovarian syndrome. However such a combined therapy is time-consuming and only permits to attempt 3 to 4 stimulated cycles during a year. Therefore the successful preliminary reports need to be confirmed by a further randomized study.

Adolescent↗
PubMedDate not supplied

[Remission of diabetes during conventional insulin therapy or therapy controlled by use of an artificial pancreas].

12 recent acute-onset ketotic juvenile diabetics were optimally treated during 5 +/- days by means of an external artificial pancreas. Remission of diabetes occurred in 9 patients (75%). In a comparative group of 28 patients treated by conventional subcutaneous insulin, only 3 (11%) steady remissions were obtained. In a third group of 6 patients treated by insulin infusion without feed-back control, only 1 remission (17%) was obtained. The difference between these two groups and the first group (patients treated by the artificial pancreas) is significant (p less than 0.01). Urinary C-peptide/blood glucose ratio showed a steady improvement of insulin secretion during the remission period. At this time, actuarial analysis shows that the number of patients still in remission decreases during the first 10 months but seems to stabilize after this period. Duration of our remissions is equal to the duration of the "spontaneous" remissions taken from the literature. New treatment able to sustain the residual insulinsecretion during the remission phase (with presently can be induced frequently with our technique) are still to be found.

Adolescent↗
PubMedDate not supplied

Probability of remission in individual in early adult insulin dependent diabetic patients. Results from the Cyclosporine Diabetes French Study Group.

The aim of this study was to determine which candidates were suitable for immunotherapy among adult insulin dependent diabetic patients of recent onset. A statistical analysis was performed using the results of a multicentre randomized trial of cyclosporine versus placebo after nine months of treatment. When the baseline characteristics of the patients in remission were compared with those not in remission, there was no difference observed either in initial residual beta-cell function (glucagon stimulated C-peptide level), or in immunological markers (T4 and T8 lymphocytes counts, Interleukin 2). The parameters showing the most difference were, in addition to treatment group, the duration of diabetes symptoms and body mass index at inclusion, and the HLA-DR phenotype. This was confirmed using a logistic regression analysis, in which these variables were found to be significantly related to remission. The probability of remission in each individual patient was then calculated using these variables in the mathematical function provided by the logistic model. Ninety eight out of 110 patients were correctly classified using this method. In addition, it must be noted that only subjects adequately treated by cyclosporine were still in complete remission after a one year follow-up. Conversely, it appeared that immunosuppression in subjects having a predicted probability of remission lower than 0.35 using the mathematical function, and being non-DR3, non-DR4 has to be avoided. These results will be useful in optimizing the recruitment of patients in on-going or future trials of immunotherapy in early diabetes.

Adolescent↗
PubMedDate not supplied

Effect of acarbose on glucose and insulin response to sucrose load in reactive hypoglycemia.

The aim of the present study was to evaluate the acute effect of acarbose, an alpha-glycosidase inhibitor, on glycemic and insulin response to an oral sucrose load in sixteen patients suffering from idiopathic reactive hypoglycemia. In each subject, two oral sucrose tolerance tests (45 g/m2 body surface) were performed with either placebo or acarbose in a double-blind random order. Compared with placebo, acarbose dramatically flattened the blood glucose curve with values significantly lower from 30 to 90 min and higher from 150 to 240 min. Moreover the magnitude of both glucose peak and nadir, and rate of blood glucose rise and fall were significantly reduced by acarbose as was the hypoglycemic index. Plasma insulin levels from 30 to 120 min, insulin peak and area under the insulin curve were significantly lower after ingestion of acarbose. Thus, in reducing the early rise in blood glucose and insulin after sucrose ingestion, acarbose prevents the occurrence of reactive hypoglycemia; the present study confirms that this drug may be of value in the treatment of reactive hypoglycemia.

Acarbose↗
PubMedDate not supplied

Effect of long term acarbose (Bay g 5421) therapy on metabolic control of non insulin dependent (type II) diabetes mellitus.

The ability of Acarbose to improve the metabolic control of type II diabetics has been studied in a double blind study. 28 patients, poorly controlled despite maximal oral treatment and diet received 4 months of Acarbose (n = 15) or Placebo (n = 13). After 4 months of Acarbose post prandial blood glucose levels were significantly reduced at 10 and 14 hours compared to baseline values (p less than 0.05). Nevertheless, the metabolic control of Acarbose and Placebo groups was not statistically different at the end of the study. The beneficial effect of Acarbose appears to be slight but this may be due to 1) the relatively low dosage of acarbose used, 2) the importance of carbohydrate restriction, or, more probably, 3) the selection of the patients as most of them might have been classified as insulin requiring diabetics.

Acarbose↗
PubMedDate not supplied

[Dietary and drug treatments of calcium nephrolithiasis (author's transl)].

Dietary and drug treatments of calcium nephrolithiasis depend mainly on the mineral composition of renal stones: calcium oxalate, phosphate or mixed stones. The association with an hypercalciuria is an important factor which must be taken into account because oxalates and phosphates precipitate as calcium crystals in case of urinnary oversaturation. Despite many therapies have been proposed, their efficiency seems to be rather small when they are used alone. Usually, it is necessary to act on several factors with a combination of therapeutic methods. Absorptive hypercalciuria are improved with both low calcium diets and inhibitors of calcium absorption. In renal hypercalciuria, the treatment is based on the administration of thiazide diuretics which enhance calcium renal tubular reabsorption. The other therapeutic methods depend on the nature of renal stones: urinary acidification for calcium phosphate; administration of succinimide, oral phosphate or organic phosphonates for calcium oxalate stones; association with purine biosynthesis inhibitors in case of the presence of urates in renal calculi.

Benzothiadiazines↗
PubMedDate not supplied

[Dietary fibers].

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Absorption↗