Search PubMed⌕ Search

Biomedical subjects

J Ostman

Publications and source records attributed to J Ostman.

211 records · Page 12Linked to original sources
PubMedDate not supplied

Insulin dissociation from its receptors on human fat cells. Evaluation of the negative cooperativity model.

Insulin dissociation from its receptors on isolated human fat cells was investigated using mono-125I-[Tyr A 14]-insulin. Fat cells were equilibrated with 0.05 pmol/ml of the radioligand and then transferred to a radioactive free buffer. The rate of dilution-induced dissociation of bound labelled insulin was enhanced in the presence of native insulin (1.7 nmol/ml), both at 24 degrees C and 37 degrees C and in both omental and subcutaneous adipocytes. The dissociation of radioactive insulin was more rapid when fat cells were equilibrated with 0.15 than with 0.05 pmol/ml of radioactive insulin, both in the presence or absence of an excess of native insulin. Thus, the presence of site-site interactions of the negative cooperativity type among insulin receptors of human fat cells is demonstrated.

Adipose Tissue↗
PubMedDate not supplied

Residual C-peptide excretion is associated with a better long-term glycemic control and slower progress of retinopathy in type I (insulin-dependent) diabetes mellitus.

We evaluated the progression of microangiopathic lesions in 22 type I diabetic patients with residual C-peptide excretion and in 22 type I diabetic patients matched for age at onset and disease duration without residual C-peptide excretion. We also wished to elucidate whether certain HLA-DR phenotypes were associated with preserved insulin secretory activity and/or microvascular lesions. The two groups of patients were investigated in 1984 and 1985. In the previous report, we observed less frequent signs of early microangiopathic lesions in association with a lower HbA1c in the group with a detectable urinary C-peptide excretion. The HbA1c level has been measured regularly (7-12 times) since the initial investigation; the mean value was lower in the patient group with residual C-peptide excretion than in the non-C-peptide group (p = 0.01). Nine of the patients in the group without urinary C-peptide excretion had increased severity of retinopathy, but only two in the group with urinary C-peptide excretion (p = 0.04) had progression of retinopathy. Incipient and/or manifest albuminuria was observed in six of the nonexcretor group and one of the C-peptide excretors. Four of the patients were receiving antihypertensive treatment and three others had a diastolic blood pressure greater than or equal to 90 mmHg in the non-C-peptide excretor group as compared with one with a pressure greater than or equal to 90 mmHg in the C-peptide excretor group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

von Willebrand factor antigen in plasma and urine in patients with type I (insulin-dependent) diabetes mellitus with and without nephropathy.

von Willebrand factor (vWF) antigens were quantitatively and qualitatively analyzed in plasma and urine in 41 patients with type I (insulin-dependent) diabetes. The patients were divided into three groups according to their albumin excretion: group N (n = 24) without any excretion (less than 20 micrograms/min), group M (n = 8) with microalbuminuria (20-200 micrograms/min), and group P (n = 9) with persistent albuminuria (greater than 200 micrograms/min). Healthy subjects served as controls (n = 28). The plasma concentration of vWF was higher (p less than 0.05) in the patients with diabetes mellitus than in the controls. Differences between the groups of patients were not statistically significant. The typical multimeric structure described for vWF in normal plasma was observed in all patients. In urine, significantly higher excretion of vWF fragments was observed in the three diabetic study groups as compared with the controls. In group P the patients' urinary vWF/creatinine levels tended to be higher than in groups N and M. Qualitative analysis of urinary vWF fragments demonstrated a similar distribution pattern of fragments, with three distinctive peaks, in the patients of groups N and M and in the controls. The distribution pattern of vWF fragments in group P, however, differed clearly from that in the controls and showed a great variation within the group. The urinary fragments tended to be of a higher molecular weight and several less distinct fragments with the whole spectrum of molecular weight were observed. Because in these patients with proteinuria no qualitative changes appeared in plasma, it is suggested that abnormal degradation of vWF occurred in the kidneys.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Gender equity in health care: the case of Swedish diabetes care.

To explore the issue of gender equity in diabetes care in Sweden and to develop strategies for monitoring gender equity in health care, population-based studies and statistics published since 1990 were reviewed that contained gender-specific data on health care utilization, glycemic control, patient satisfaction, health-related quality of life, and mortality from diabetes. The review shows that diabetic women in Sweden report more frequent outpatient contacts, less patient satisfaction, and a lower health-related quality of life than diabetic men. No gender differences were found in the level of glycemic control. Young and middle-aged men with diabetes have a high excess all-cause mortality as compared with nondiabetic men. A trend toward stronger social gradient in mortality among women than men with diabetes was observed in a large nationwide study.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Lack of pharmacokinetic interaction between glibenclamide and trimethoprim-sulphamethoxazole.

Eight patients aged 57-86 years with non-insulin-dependent diabetes mellitus (NIDDM) taking long-term glibenclamide treatment (5-15 mg/day) were given oral trimethoprim-sulphamethoxazole due to an acute bacterial infection. After 4-6 days of combined treatment, the total plasma glibenclamide concentrations were determined every second hour for 12 h, and the area under the curve (AUC) was computed. A second plasma glibenclamide profile was obtained 2-4 weeks after withdrawal of trimethoprim-sulphamethoxazole. The levels of plasma glibenclamide did not differ between the two occasions, nor did the simultaneously determined levels of blood glucose and plasma insulin. It is concluded that there is no consistent pharmacokinetic interaction between glibenclamide and trimethoprim-sulphamethoxazole in NIDDM patients.

Acute Disease↗
PubMedDate not supplied

Health attitudes, self-monitoring of blood glucose, metabolic control and residual insulin secretion in type 1 diabetic patients.

The aim of the present cross-sectional study was to determine in patients who have had insulin-dependent diabetes mellitus for a long time, the relationship between residual insulin secretion and self-monitoring of blood glucose, psychological factors, and blood glucose control (HbA1c). In 97 patients with a disease duration of 9-16 years a sample from a 24-h urine collection was analysed for C-peptide excretion. In 35 of these patients an excretion greater than or equal to 0.2 nmol/24 h was detected. They were matched for age at onset and disease duration with patients without any detectable C-peptide excretion. Twenty-nine matched pairs were obtained and 22 of them have been further investigated. HbA1c was lower in the C-peptide excretors than in the non-excretors (6.9 +/- 0.3 vs 7.9 +/- 0.3%) (p less than 0.025). The patients were interviewed by means of a questionnaire dealing with their 'health beliefs'. It was shown that in the group with residual insulin secretion there was a significantly lower perceived risk of developing kidney disease (p less than 0.025) than in the group without residual insulin secretion, but in all other items measured there was no difference between the two groups. Furthermore, in the group with residual insulin secretion we found a correlation (p less than 0.01) of low HbA1c with high frequency of self-monitoring of blood glucose and high perceived vulnerability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Difficulties in classifying diabetes at presentation in the young adult.

All newly diagnosed diabetic patients in Sweden aged 15-34 years have been registered since 1983. In this study the clinical characteristics initially and after 2.5-3 years were evaluated by a questionnaire to the patient's physician and by non-fasting C-peptide. The study comprised patients registered 1983-84, and for 281 patients (37%), complete information was obtained. At diagnosis 75% were classified as Type 1, 19% as Type 2, and 6% as secondary diabetes or as uncertain by their physician. Twenty patients (7.1%) were reported to have ketoacidosis. Seventy-five percent were treated with insulin, 7% with oral hypoglycaemic agents (OHG), and 18% with diet alone. At follow-up 71% were classified as Type 1, 21% as Type 2, and 8% as secondary or uncertain while treatment was 82% insulin, 8% OHG, and 9% diet. During the follow-up period 42% of the initially non-insulin-treated patients were put on insulin whereas only a few stopped insulin treatment. Patients treated with diet or OHG at follow-up were older, had higher percent desirable weight, and lower blood glucose at diagnosis than patients treated with insulin. All except one patient had measurable random C-peptide at follow-up and mean values were for patients treated with insulin 0.55, OHG 1.41 and diet alone 1.29 nmol l-1. Random blood glucose results were similar. In conclusion the majority of newly diagnosed patients in the age group 15-34 years have the characteristics of Type 1 diabetes and Type 2 diabetes is rare before 25-30 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Treatment after transient ischemic attacks: a comparison between anticoagulant drug and inhibition of platelet aggregation.

Treatment with an anticoagulant (AC) or acetylsalicylic acid (ASA), chosen at random, was given to 241 patients with symptoms of carotid transient attacks of ischemia, some of whom recovered completely within 24 hours (TIA) while the others had slight residual symptoms (TIA-IR). Cerebral infarction was recorded in 4 patients in each of these treatment groups during a mean follow-up period of 20 months. The incidences of TIA and TIA-IR were also similar in the two groups. Severe hemorrhage occurred more often in the AC group, whereas other side reactions, including gastrointestinal disorders, were more common in the ASA group. Recurrent cerebral ischemic events were significantly more common among the patients that had had greater than or equal to 2 TIAs in the 14 days immediately preceding randomization, and in those with a history of CVS symptoms more than 14 days before randomization, or those with a carotid bruits. In the group experiencing greater than or equal to 2 TIAs in the 14 days prior to randomization the incidence of recurrent cerebral ischemic events was the same for the two types of treatment.

Adult↗
PubMedDate not supplied

Negative association between type 1 diabetes and HLA DQB1*0602-DQA1*0102 is attenuated with age at onset. Swedish Childhood Diabetes Study Group.

HLA-associated relative risks of type 1 (insulin-dependent) diabetes mellitus were analysed in population-based Swedish patients and controls aged 0-34 years. The age dependence of HLA-associated relative risks was assessed by likelihood ratio tests of regression parameters in separate logistic regression models for each HLA category. The analyses demonstrated an attenuation with increasing age at onset in the relative risk for the positively associated DQB1*0201-A1*0502/B1*0302-A1*0301 (DQ2/8) genotype (P = 0.02) and the negatively associated DQB1*0602-A1*0102 (DQ6.2) haplotype (P = 0.004). At birth, DQ6.2-positive individuals had an estimated relative risk of 0.03, but this increased to 1.1 at age 35 years. Relative risks for individuals with DQ genotype 8/8 or 8/X or DQ genotype 2/2 or 2/X, where X is any DQ haplotype other than 2, 8 or 6.2, were not significantly age-dependent. An exploratory analysis of DQ haplotypes other than 2, 8 and 6.2 suggested that the risk of type 1 diabetes increases with age for DQB1*0604-A1*0102 (DQ6.4) and that the peak risk for the negatively associated DQB1*0301-A1*0501 haplotype is at age 18 years. There was also weak evidence that the risk for DQB1*0303-A1*0301 (DQ9), which has a positive association in the Japanese population, may decrease with age. We speculate that HLA-DQ alleles have a significant effect on the rate of beta cell destruction, which is accelerated in DQ2/8-positive individuals and inhibited, but not completely blocked, in DQ6.2-positive individuals.

Adolescent↗
PubMedDate not supplied

Pancreatic transplantation for diabetes mellitus. Discussion of indications and surgical technique with reference to 3 cases.

Three patients reveived segmental pancreatic transplants. In two the main indication was hyperlabile diabetes, and in the third progressive loss of vision. Vascular anastomoses were to the iliac vessels, the graft being placed extraperitoneally. The pancreatic duct was ligated in the first case, while the other two, the transected end of the pancreatic graft was implanted into a jejunal Roux-Y loop. Two of the patients had normal blood glucose levels without insulin administration for 40 and 35 days, respectively. The grafts then underwent rejection and were removed. In both cases the postoperative course was complicated by pancreatic fistulae. In the 3rd patient the graft failed on the day after operation, due to venous trombosis.

Adult↗