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Biomedical subjects

K Hermansen

Publications and source records attributed to K Hermansen.

At least 73 records · Page 4Linked to original sources
PubMed1993

Acute effects of graded alcohol intake on glucose, insulin and free fatty acid levels in non-insulin-dependent diabetic subjects.

Alcohol-induced hypoglycaemia is a well-known phenomenon in insulin-treated diabetic subjects. Less attention has been paid to the impact of alcohol on blood glucose and insulin responses in non-insulin dependent diabetic subjects. The aim of this study was to investigate the acute metabolic effects of different alcohol contents added to a non-alcohol beer in 10 non-insulin-dependent diabetes mellitus (NIDDM) subjects. The patients received 500 ml non-alcohol beer with an alcohol percentage (v/v) of 0 (A), 2.7 (B), and 5.4 (C), implying identical contents of ingredients except for alcohol. Blood glucose (mean +/- SE) responses were similar in the three situations (395 +/- 59, 365 +/- 86 and 261 +/- 26 mmol/l x 240 min). In contrast, the incremental insulin response areas increased dose dependently to alcohol (5430 +/- 1158, 9336 +/- 2172 and 12336 +/- 2922 pmol/l x 240 min) and showed a linear correlation (r = 0.39; P < 0.03). The average suppression of serum free fatty acid was similar in the three situations (72.4 +/- 4.4%, 76.3 +/- 6.0% and 68.2 +/- 6.3%). In conclusion, intake of small amounts of alcohol does not acutely deteriorate the glycaemic control in NIDDM. The fact that alcohol results in a dose-related elevation in insulin levels with unaltered blood glucose and free fatty acid responses in NIDDM points to an aggravation of insulin resistance.

Aged↗
PubMed1992

[Dietary treatment of diabetes mellitus. Background and rationale for recommendations in the 1990's].

Individual dietary regulation is still an important part of all forms of treatment of diabetes. In insulin dependent diabetes (IDDM) it is rational to advise the patient 1) to arrange his diet so that this results in a low glycaemic response, which implies a relatively high intake of dietary fibre and polysaccharides, 2) to distribute the food into 5-6 daily meals and 3) to consume a low-fat diet. This prevents too pronounced postprandial hyperglycaemia and hypoglycaemia between meals. Simultaneously, insulin sensitivity is increased and not only the insulin requirement but also peripheral hyperinsulinism tend to be reduced. Dietary regulation in IDDM is thus a compensation for the defective synchronization of variations in the plasma levels of glucose and insulin in the present day forms of insulin therapy. Nine out of ten diabetic patients are non-insulin dependent (NIDDM). The great majority are obese, 50% have essential hypertension and just as many have dyslipidaemia (raised serum triglyceride and reduced serum high density lipoprotein (HDL)-cholesterol). The condition is characterized pathophysiologically by insulin resistance in muscle, fat and liver tissue and delayed and frequently reduced glucose-stimulated secretion of insulin. The most important element in dietary regulation in NIDDM is, therefore, reduction of the energy content of the food with the object of achieving and maintaining reduction in weight. Even moderate reduction, in the majority of NIDDM patients, will have the effect that metabolism of carbohydrates and lipids becomes approximately normal on account of considerable increase in insulin sensitivity and to a lesser degree increased secretion of insulin.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗
PubMed1992

Influence of the amount of starch on the glycaemic index to rice in non-insulin-dependent diabetic subjects.

To test whether the glycaemic index is altered by the amount of carbohydrate, meals containing 25 and 50 g carbohydrate as white rice and white bread were taken by seven non-insulin-dependent diabetic subjects. The glycaemic indices to parboiled white rice corresponding to 25 and 50 g carbohydrate were similar, being 55 (SE 10) and 60 (SE 8) respectively. The incremental areas of blood glucose (above basal) to parboiled white rice were significantly lower than to white bread after both an amount corresponding to 25 g carbohydrate (85 (SE 24) mM x 180 min v. 181 (SE 55) mM x 180 min; P less than 0.01) and to 50 g carbohydrate 226 (SE 29) mM x 180 min v. 423 (SE 76) mM x 180 min; P less than 0.01). Similar insulin response areas to 25 g carbohydrate given as parboiled white rice and white bread were found, whereas 50 g carbohydrate as white bread caused a significantly higher insulin response area than parboiled white rice (P less than 0.05). In conclusion, the glycaemic index of parboiled white rice is not affected by the amount of carbohydrate ingested, at least under the present study conditions.

Blood Glucose↗
PubMed1992

Blood glucose and insulin responses to different meals in non-insulin-dependent diabetic subjects of both sexes.

The influence of sex on glucose and insulin responses in patients with non-insulin-dependent diabetes was studied in 12 men and 11 matched women. Two meals of either 100 g white bread or 60 g (raw weight) white rice were given. Blood glucose response areas to white bread (517 vs 509 mmol/L) and to rice (306 vs 353 mmol/L) over a 300-min observation period were similar in females and males, respectively. Insulin responses showed an identical pattern to that of glucose in females and males--35784 vs 28230 pmol/L after white bread and 28044 vs 19464 pmol/L min after rice (NS) over a 300-min observation period, respectively. Within the two study groups, blood glucose-response areas to white bread were significantly higher than those to rice (P less than 0.05), whereas there were no differences in insulin-response areas within or between the two groups. The glycemic index of rice for females (62 +/- 9; mean +/- SE) and males (66 +/- 5) was similar.

Blood Glucose↗
PubMed1992

Influence of ripeness of banana on the blood glucose and insulin response in type 2 diabetic subjects.

Banana is a popular and tasty fruit which often is restricted in the diet prescribed for diabetic patients owing to the high content of free sugars. However, in under-ripe bananas starch constitutes 80-90% of the carbohydrate content, which as the banana ripens changes into free sugars. To study the effect of ripening on the postprandial blood glucose and insulin responses to banana, 10 type 2 (non-insulin-dependent) diabetic subjects consumed three meals, consisting of 120 g under-ripe banana, 120 g over-ripe banana or 40 g white bread on separate days. The mean postprandial blood glucose response area to white bread (181 +/- 45 mmol l-1 x 240 min) was significantly higher compared with under-ripe banana (62 +/- 17 mmol l-1 x 240 min: p < 0.01) and over-ripe banana (106 +/- 17 mmol l-1 x 240 min: p < 0.01). Glycaemic indices of the under-ripe and over-ripe bananas differed (43 +/- 10 and 74 +/- 9: p < 0.01). The mean insulin response areas to the three meals were similar: 6618 +/- 1398 pmol l-1 x 240 min (white bread), 7464 +/- 1800 pmol l-1 x 240 min (under-ripe banana) and 8292 +/- 2406 pmol l-1 x 240 min (over-ripe banana). The low glycaemic response of under-ripe compared with over-ripe bananas may be ascribed to the high starch content, which has previously been found to be only hydrolysed slowly by alfa-amylase in humans.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗
PubMed1992

Day-to-day variation of blood glucose and insulin responses in NIDDM subjects after starch-rich meal.

OBJECTIVE: To study day-to-day variation of postprandial blood glucose and insulin increments in non-insulin-dependent diabetes mellitus (NIDDM) subjects and to analyze intra- and interperson variance of response. RESEARCH DESIGN AND METHODS: Ten NIDDM subjects attending the outpatient clinic at Aarhus Kommunehospital were studied. The subjects ate three meals of 90 g of white bread, with 7 days between tests. RESULTS: Mean +/- SD areas under the blood glucose response curve (above basal) over a 3-h period were 557 +/- 60, 569 +/- 74, and 565 +/- 67 mM x 180 min (NS), and areas under the insulin-response curve were 3350 +/- 448, 2815 +/- 359 and 3551 +/- 679 mU/L x 180 min (NS) on each of the three occasions. The 95% confidence intervals of blood glucose and insulin areas for the test meal repeated three times were 564 +/- 120 mM x 180 min and 3240 +/- 1645 mU/L x 180 min, respectively. Intra- and interperson components of variance were 25 vs. 75% (glucose) and 78 vs. 22% (insulin) of the total variance. The intraperson components of variance included all sources of variation other than between-person variation. There was no significant correlation between blood glucose and insulin response areas. CONCLUSIONS: A valid estimate of the glycemic response in a single patient is obtained after a single meal. Because of the large between-person variation, paired data should preferably be used when comparing glycemic responses to different foods.

Blood Glucose↗
PubMed1992

Phaeochromocytoma--an unusual cause of haematuria.

A patient was admitted to hospital because of haematuria. A papillomatous bladder tumor was removed. Histological examination revealed a phaeochromocytoma. Fourteen days postoperatively the urinary excretion rates of catecholamines were elevated but normalized afterwards. Abdominal computed tomography and metaiodobenzylguanidine scintigraphy were normal. No hypertension or characteristic micturitional attacks preceded removal of the tumor.

Cystoscopy↗
PubMed1992

Glycaemic and insulinaemic responses to orange and apple compared with white bread in non-insulin-dependent diabetic subjects.

To study the postprandial blood glucose and insulin responses to exchangeable amounts of simple and complex carbohydrates, eight non-insulin-dependent diabetic subjects consumed 227 g apple, 280 g orange or 50 g white bread on three separate days. The mean postprandial blood glucose response area to white bread (404 +/- 95 mM x 240 min) was significantly higher compared with orange (131 +/- 34 mM x 240 min; P less than 0.05) and apple (157 +/- 57 mM x 240 min; P less than 0.05). Thr glycaemic indices of the fruits were identical: 44 +/- 13 (orange) and 40 +/- 11 (apple). The low glycaemic response to orange and apple may be ascribed to the high content of fructose which is rapidly cleared and metabolized by the liver, without elevating the blood glucose.

Blood Glucose↗
PubMed1991

Galanin-induced inhibition of insulin secretion from rat islets: effects of rat and pig galanin and galanin fragments and analogues.

The 29-amino acid neuropeptide galanin occurs in intrapancreatic nerves and inhibits insulin secretion. To study the structure-activity relations of galanin, we examined the effects of pig and rat galanin, three galanin fragments (galanin-(1-11), galanin-(1-16) and rat galanin-(17-29) and four galanin analogues ([Ala2]pig galanin, [Ala2]rat galanin, [D-Trp2]rat galanin and [D-Trp2]galanin-(1-16] on glucose-stimulated insulin secretion from isolated rat islets. Pig and rat galanin and galanin-(1-11) equipotently inhibited glucose-stimulated (8.3 mM) insulin secretion at and above 10(-7) M (P less than 0.05), whereas galanin-(1-16), inhibited insulin secretion at 10(-6) M (P less than 0.01). In contrast, the C-terminal rat galanin-(17-29) and the galanin analogues did not influence insulin secretion. Thus, rat and pig galanin are equipotent in inhibiting glucose-stimulated insulin secretion from rat islets. The active site resides in the N-terminal part of the molecule. Furthermore, the binding of galanin to its receptor depends on structural characteristics governed by the N-terminal position and in particular by the Trp2 residue.

Amino Acid Sequence↗
PubMed1991

[Perioperative treatment of diabetics].

The metabolic changes in connection with fasting, anaesthesia and surgery in diabetic patients and non-diabetic patients are reviewed. Various perioperative forms of treatment are described. The forms of treatment most commonly employed are infusion of glucose-insulin-potassium (GIK) and subcutaneous administration of insulin followed by infusion of glucose (KON). The more intensive GIK regime provides the diabetic patient with a biochemical regulation which resembles that found in non-diabetics. It has not been proved whether this marginal regulation influences the well-being, morbidity or mortality of the patients. In critically ill patients or patients with concurrent diseases, the GIK regime is recommended as this provides optimal regulation of the diabetes. In the remaining patients, local conditions will influence the choice of form of treatment.

Anesthesia↗
PubMed1991

Preprandial blood glucose values and glycemic responses in insulin-dependent diabetes mellitus at constant insulinemia.

The influence of preprandial blood glucose (PPBG) concentration on glycemic responses was studied in seven subjects with insulin-dependent diabetes who, by means of the artificial pancreas, had achieved PPBG concentrations of 6, 9, and 17 mmol/L. A test meal of 50 g parboiled rice was given at the three different occasions and a constant insulin infusion was provided during the observation periods. The mean postprandial-blood-glucose-response area (above basal) differed significantly at the three blood glucose concentrations of 6, 9, and 17 mmol/L, reaching 1371, 621, and 179 mmol/L x 240 min, respectively (P less than 0.01). A negative correlation between the PPBG concentrations and the glycemic responses to the test meal was found (r = 0.94; P less than 0.001). The fasting insulin concentration at a PPBG concentration of 17 mmol/L was lower than at a PPBG concentration of 6 and 9 mmol/L. In conclusion, the glycemic responses to a carbohydrate meal are inversely correlated to the PPBG concentration in insulin-dependent diabetic subjects.

Adult↗
PubMed1991

Galanin fragments and analogues: effects on glucose-stimulated insulin secretion from isolated rat islets.

Galanin occurs in intrapancreatic nerves and inhibits insulin secretion both in vivo and in vitro. To investigate which part of the galanin molecule accounts for this inhibition, we studied the effect of porcine galanin, four galanin fragments and three galanin analogues with substitutions of the 2nd amino acid in galanin, on glucose-stimulated insulin secretion from isolated rat islets cultured overnight. The islets were incubated for 1 h at 8.3 mM glucose. Porcine galanin1-29 inhibited insulin secretion at dose levels from 10(-8) M to 10(-6) M (p less than 0.001). Also, the galanin fragments GAL1-15, GAL2-29, and GAL3-29 significantly inhibited insulin secretion at and above concentrations of 10(-7) M (p less than 0.001), 10(-8) M (p less than 0.001), and 10(-7) M (p less than 0.001), respectively. Galanin analogues where the 2nd N-terminal amino acid had been changed from tryptophan to tyrosine (GAL-TYR2) or isoleucine (GAL-ILE2) inhibited insulin secretion, as did porcine galanin1-29, whereas after substitution with phenylalanine (GAL-PHE2) no effect was observed. Furthermore, the C-terminal fragment GAL10-29 did not influence insulin secretion. We conclude that the inhibitory action by galanin on glucose-stimulated insulin secretion from normal islets resides in the N-terminal part of the molecule. In contrast, the C-terminal part of galanin apparently does not influence insulin secretion.

Animals↗
PubMed1991

Glycaemic responses to different types of bread in insulin-dependent diabetic subjects (IDDM): studies at constant insulinaemia.

To study the glycaemic effect of various Danish bread types in insulin-dependent diabetic subjects (IDDM) we looked at the incremental blood glucose areas after isocaloric meals of grained wholemeal rye bread, wholemeal bread (graham bread) and white bread in seven C-peptide negative diabetic subjects. Furthermore, we evaluated the glycaemic potency of dried fruits by exchanging 40 per cent of the starch of grained wholemeal rye bread as dried figs. Prior to the meal intake the patients had attained normoglycaemia and isoinsulinaemia by means of the artificial pancreas. The four test meals containing 50 g of available carbohydrate were taken in random order. The postprandial blood glucose response areas after whole-meal bread (1037 +/- 113 mM X 180 min) and white bread (1021 +/- 100 mM X 180 min) were significantly higher than that to grained wholemeal rye bread (786 +/- 66 mM X 180 min, P less than 0.05). Exchange of 40 per cent of the complex carbohydrate as grained wholemeal rye bread with simple sugars, such as figs, had no influence on the blood glucose response (786 +/- 66 mM X 180 min vs. 766 +/- 56 mM X 180 min). Constant and identical serum-free insulin levels at 30 mU/l and similar amounts of glucose lost in the urine were found after the four test meals. In conclusion, the difference in extraction rate of wheat in the form of white flour (0, 7) and wholemeal flour (1, 0) was not reflected in the glycaemic responses in IDDM subjects. Grained wholemeal rye bread is a fibre-rich, cheap nutrient which elicits a significantly lower glycaemic response compared to wholemeal and white bread and can be recommended to diabetic subjects.

Adult↗
PubMed1990

Dual effects of calcitonin gene-related peptide on insulin secretion in the perfused dog pancreas.

Calcitonin gene-related peptide (CGRP) is an intrapancreatic neuropeptide with potential effects on islet hormone secretion. To investigate its pancreatic actions, we examined the effects of a 10 min perfusion of synthetic human CGRP on islet hormone release from the isolated dog pancreas (n = 6) at 5.5 mM glucose. At 0.1 nM, CGRP inhibited insulin secretion (P less than 0.01), which was already observed at 2 min after its introduction. After CGRP perfusion was stopped, a stimulatory off-response occurred. In contrast, at higher dose levels, CGRP stimulated insulin secretion. At 1.0 nM, the stimulation was weak and transient (P less than 0.01), occurring only during the first 3 min of CGRP perfusion. At 10 nM, the stimulation continued for 6 min (P less than 0.05), and at 50 nM, the stimulation was marked and sustained throughout the 10 min perfusion period (P less than 0.01). After the CGRP perfusion at 1.0 and 10 nM, but not at 50 nM, a marked stimulatory off-response in insulin secretion was seen. Glucagon and somatostatin secretion were not significantly affected by CGRP at any of the examined concentrations. We conclude that CGRP exerts dual effects on insulin secretion from the perfused dog pancreas: inhibition at low concentrations and stimulation at high concentrations. This pattern of effect might represent a new regulatory concept for neural influences on islet function: the qualitative response being determined by the amount of neurotransmitter released.

Animals↗
PubMed1990

Water volume and consumption time: influence on the glycemic and insulinemic responses in non-insulin-dependent diabetic subjects.

The present study was carried out to see if either the volume of water or the duration of ingestion time influence the postprandial blood glucose and insulin responses in non-insulin-dependent diabetic (NIDDM) subjects. Small test meals containing 40 g carbohydrate as rye bread (100 g) with butter (10 g) and tomatoes (75 g) were given to 10 NIDDM subjects. The meals were taken in random order with either 90 or 600 mL tap water. The meal with 90 mL tap water was ingested over 10 and 30 min. The glycemic responses to isocaloric meals of large and small volumes were similar (338 +/- 56 vs 384 +/- 67 mmol/L.240 min) as were the insulinemic responses (29,424 +/- 6512 min vs 27,140 +/- 6548 mumol/L.240 min). An extension of eating time from 10 to 30 min did not alter the glycemic (384 +/- 67 vs 370 +/- 54 mmol/L.240 min) or the insulinemic response (27,140 +/- 6548 vs 35,670 +/- 10,245 mumol/L.240 min) in the NIDDM patients.

Aged↗
PubMed1990

The predictive capability of the glycaemic response to spaghetti in non-insulin dependent (NIDDM) and insulin dependent (IDDM) diabetic subjects.

To evaluate the predictive capability of the postprandial blood glucose response after consumption of a starch-rich meal, we compared the glycaemic effects of spaghetti (60 g) taken alone and with bolognese sauce (167 g). The study was carried out in both NIDDM (n = 6) and IDDM (n = 6) subjects. The latter had achieved normoglycaemia 120 min prior to the test meal by means of an artificial pancreas (Biostator) which provided constant insulinaemia during the observation period of 4 h. We found that the areas of blood glucose (above basal) were identical irrespective of whether spaghetti was taken alone or as part of a mixed meal in both NIDDM (484 +/- 154 mmol l-1 240 min-1 vs. 393 +/- 126 mmol l-1 240 min-1) and IDDM subjects (610 +/- 143 mmol l-1 240 min-1 vs. 770 +/- 135 mmol l-1 240 min-1). The insulin levels were identical in the IDDM diabetics. By contrast, the mixed meal caused a more marked insulinaemic response than spaghetti per se in the NIDDM subjects (3187 +/- 637 mU l-1 240 min-1 vs. 1940 +/- 235 mU l-1 240 min-1; P less than 0.05). In conclusion, the predictive capability of the glycaemic response to spaghetti was good in both IDDM and NIDDM diabetic subjects, at least under the conditions of the present study.

Blood Glucose↗