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Biomedical subjects

J Mirouze

Publications and source records attributed to J Mirouze.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Long-term remission in fresh acute diabetes mellitus].

Among 28 patients with acute diabetes mellitus of recent onset, long-term remission (25-48 months) was obtained in 14 and medium-term remission (10-24 months) in the other 14. At the onset of the disease these two groups were very similar: remissions were longer in the older patients and shorter in the leaner ones. In patients seen at an early stage, there is no hormonal or immunological data to differentiate between those who will be in remission and those who will not. In our series, insulin secretion was the same in all patients at the onset of diabetes and at the end of the remission period. Further explorations suggested some degree of resistance to insulin, but this was easily overcome by the initial intravenous insulin treatment and by the conventional subcutaneous insulin treatment after the remission had ceased. Our data show the weakness of arguments which separate insulin-dependent from non insulin-dependent patients in acute diabetes mellitus of recent onset.

Acute Disease↗
PubMed1987

[Pumps for insulin infusion in the ambulatory treatment of diabetes mellitus].

Insulin infusions given by portable pumps constitute a recent therapeutic advance in those difficult cases of diabetes mellitus which cannot be stabilized by repeated conventional injections. The different varieties of pumps, catheters and insulins used are described. The intravenous and intraperitoneal routes of administration have given results superior to those of the subcutaneous route. Short-term results are evaluated by change in blood glucose levels, medium-term results by glycosylated haemoglobin levels and various metabolic and hormonal abnormalities, and long-term results mostly by the influence of treatment on degenerative complications of diabetes. The metabolic and infectious incidents and accidents of the method as well as its psychological advantages and drawbacks are discussed.

Administration, Cutaneous↗
PubMed1987

Calcium absorption in corticoid treated subjects effects of a single oral dose of calcitriol.

We compared the fractional absorption of calcium (FACa, 6 h, % TD) and the radiocalcium transit (% TD per min) in seven glucocorticoid-treated patients (10-25 mg prednisolone per day) and in seven normal subjects, in the basal state and 12 h after an oral dose of synthetic 1,25-(OH)2D (3 micrograms). In the basal state, the radiocalcium transit was significantly decreased (P less than 0.02) at 15 min in patients treated with prednisolone, but FACa at 6 h was not significantly decreased (51 +/- 5 vs. 60 +/- 5% TD). 12 h after an oral dose of 1,25-(OH)2D which resulted in supraphysiologic plasma levels, FACa increased significantly (P less than 0.02) in both groups but the peak absorption rate of Ca remained lower in the corticoid-treated patients than in controls (P less than 0.02). The results suggest that glucocorticoids decrease the 1,25-(OH)2D-dependent transport of calcium across the proximal small intestine.

Aged↗
PubMed1986

Beneficial effect of glycaemic improvement in non-ischaemic forms of diabetic retinopathy: a 3-year follow-up.

Recent studies have suggested that optimal glucose control fails to arrest or even worsens background retinopathy possibly by aggravating retinal ischaemia. Fourteen insulin-dependent diabetic patients, aged 34 +/- 11 years (mean +/- SD) treated by long-term intraperitoneal insulin infusion using portable pumps, were followed for 3 years. Preproliferative or proliferative lesions on ophthalmoscopy and large non-perfused areas on fluorescein angiography were exclusion criteria. Six patients were found to have minimal and 8 mild background retinopathy. The patients were retrospectively assigned to two comparable groups except for their glycaemic equilibrium under insulin infusion: average control (n = 6) and excellent control (n = 8), although glycaemic control was significantly improved in all cases when compared to previous conventional therapy. Fluorescein changes were scored blindly and independently by 3 ophthalmologists according to modifications of fluorescein diffusion and capillary abnormalities. The two types of retinal lesions improved gradually in 10 patients and deteriorated in only 1 patient, although not progressing to proliferative retinopathy. Structural improvements were significantly more frequent in the excellently controlled group. We conclude that non-ischaemic lesions may still be arrested and even improved by tight metabolic control.

Adult↗
PubMed1986

Trial of mild immunosuppression by methisoprinol in acute onset diabetes mellitus: effects on rate and duration of remission.

There is a lot of data that suggests the immune system plays a role in the pathogenesis of Type 1 DM. Methisoprinol, an immunomodulatory drug, has been reported as being efficient in preventing DM induced by a low dose of streptozotocin in mice. The efficiency of this drug in Type 1 DM was assessed by the rate and duration of remission obtained in recent acute onset DM by strict blood glucose control. We used 2 different therapeutic procedures successively: one was short in an anti-viral aim (50 mg/kg body wt. daily during 10 days) and the other longer given as immunomodulatory treatment (50 mg/kg body wt. daily during 2 weeks and 30 mg/kg body wt. daily during 4 weeks more) with reinduction (30 mg/kg body wt. daily during 4 weeks) every 5 months. No side effect was observed during the treatment. In both studies there was no improvement in the rate and duration of remission when compared to controls; residual beta-cell function was not increased after treatment by methisoprinol. Mild immunotherapy did not appear helpful in Type 1 DM.

Adolescent↗
PubMed1986

[Comparison of biosynthetic human insulin and purified pork insulin. Studies in insulin-resistant obese patients using the insulin suppression test].

An insulin suppression test performed in random order with either biosynthetic human insulin or purified pork insulin was used to compare biological activity of these two insulins in obese patients suffering from varying degrees of glucose intolerance. Blood glucose curve, steady-state blood glucose levels, insulin sensitivity indices and steady-state plasma insulin levels were identical during the two sets of tests. Furthermore endogenous insulin and glucagon secretion were similarly suppressed. The insulin suppression test is a simple and rapid procedure to compare the biological activity of fast-acting insulins. Our results confirm the insulin-resistance in obesity and clearly show that biosynthetic human and porcine insulins have similar biological potency.

Adult↗
PubMed1986

[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↗
PubMed1985

[Glycoregulation disorders in giant-cell arteritis].

Eight patients with giant cell arteritis (6 with Horton's disease and 2 with polymyalgia rheumatica) were investigated for abnormalities in glycoregulation, previously reported in Horton's disease, using oral glucose tolerance tests with measurement of insulinaemia and C-peptide response to glucagon to evaluate pancreatic function. The results were compared with those obtained in an age and weight matched population of patients with inflammatory syndromes of other origins. All patients with giant cell arteritis had abnormal glucose tolerance tests, with diabetes mellitus in 6 and impaired glucose tolerance in 2. Insulinaemias at all stages of the test, insulin response areas and basal C-peptide values were elevated; C-peptide response to glucagon was normal. Similar results were observed in patients with other inflammatory syndromes. It is concluded that glycoregulation disorders are not incidental in giant cell arteritis, that the normal pancreatic function seems to exclude immune pancreatic vasculitis, and that the abnormal glycoregulation is probably due to insulin-resistance. Since these abnormalities cannot be explained by the patients' advanced age alone, the part played by the inflammatory syndrome, which was common to both groups, is discussed. Its responsibility for inducing insulin-resistance may account for the fact that corticosteroids, which are rapidly effective against giant cell arteritis, normalise oral glucose tolerance tests.

Aged↗