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L Groop

Publications and source records attributed to L Groop.

179 records · Page 10Linked to original sources
PubMed1983

Increased frequency of HLA-Cw4 in type 2 diabetes.

UNLABELLED: In order to investigate whether there is an association between the HLA system and type 2 diabetes, we have determined HLA-A, B- and C-antigens in 227 patients with onset of diabetes between the ages of 35 and 70 years and compared them with the HLA-antigen frequencies in Finnish blood donors. One hundred and sixty-eight patients (74%) were treated with diet or oral antidiabetic drugs (non-insulin dependent), whereas 59 patients (26%) were treated with insulin (insulin-dependent). The HLA-antigen Cw4 was found in 38.7% of the non-insulin dependent patients (relative risk 2.67, p = 0.00005) and in 15.6% of the insulin dependent diabetics (relative risk 0.785 NS) compared with 19.1% in blood donors. In addition, there was an increase in the frequency of HLA-Bw35 antigen among the non-insulin dependent patients (relative risk 1.6, P = 0.007), which could be explained by the known positive linkage disequilibrium between HLA-Bw35 and HLA-Cw4. In insulin-dependent patients there was a decrease in the frequency of HLA-B7 (relative risk 0.226, P = 0.001) and an increase in the frequencies of HLA-B8 (relative risk 1.91, P = 0.031), B12 (relative risk 2.22, P = 0.01) and B15 (relative risk 2.04, P = 0.019) compared with blood donors. CONCLUSION: these data provide evidence that genes in the HLA region may have some influence in genetic susceptibility to type 2 diabetes. They further suggest that maturity onset (type 2) diabetes is a heterogeneous disease in terms of HLA antigens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Metabolic effects of sulfonylurea drugs. A review.

Although sulfonylureas have been used in the treatment of type 2 diabetes for more than 25 years, their mode of action is still largely unresolved. A number of pancreatic and extrapancreatic effects have been invoked to explain the hypoglycemic action of the drugs. It seems established that sulfonylureas enhance insulin secretion during short- and, possibly, also during long-term therapy, but differences between the various drugs are possible. Preserved beta-cell function is, however, a prerequisite for the blood glucose-lowering effects of these drugs. Among these, suppression of hepatic glucose production and enhancement of peripheral insulin sensitivity are clinically the most important. Reported effects relating to other hormones have proved difficult to confirm, and can often be explained by simultaneous changes in insulin secretion. Recent data provide evidence that sulfonylureas may differ in their metabolic effects. However, it remains to be determined, whether the differences are real or a consequence of different pharmacokinetics.

Animals↗
PubMed1983

Proliferative responses to insulin antigens in diabetics and controls.

The proliferative responses of IDDM or NIDDM patients and normal controls to monocomponent pork and beef insulins was assayed over a period of 5 days. No difference was detected in the proliferative responses between the groups. About 25-30% responded to insulin antigens by giving stimulation indices of 1.5 or higher. The exception was the HLA-B8/15 group of patients where no responses (less than or equal to 1.5) were observed. The evidence that the responses detected were insulin specific is discussed, as is the HLA and possible immune response gene linkage.

Adult↗
PubMed1982

Influence of beta-blocking drugs on glucose metabolism in patients with non-insulin dependent diabetes mellitus.

Two beta-blocking agents, non-selective propranolol and beta1-selective metoprolol, were investigated with respect to their effects on glucose metabolism in 10 hypertensive patients with non-insulin dependent diabetes mellitus (NIDDM). The patients were treated randomly for two weeks in double-blind cross-over manner with (a) propranolol, (b) metoprolol, and (c) placebo. Propranolol impaired glucose tolerance when compared to placebo. The increase in blood glucose was associated neither with changes in concentrations of serum insulin, plasma glucagon of free fatty acid nor with alterations in peripheral insulin sensitivity as measured by 125I-insulin binding to mononuclear leukocytes. Although metoprolol had no effect on blood glucose, it increased 125I-insulin binding to mononuclear leukocytes. The increase in insulin binding could contribute to blood glucose control during metoprolol treatment. In search for reasons for poor metabolic control in NIDDM, treatment with non-selective beta-blockers should be kept in mind.

Adrenergic beta-Antagonists↗
PubMed1982

Glibenclamide and gliquidone in the treatment of non-insulin-dependent diabetes mellitus.

The effect of glibenclamide and gliquidone on fasting blood glucose, 24-hour urinary glucose excretion, HbA1 concentrations and on the blood glucose and plasma insulin responses to an oral glucose load were investigated in 11 patients with non-insulin-dependent diabetes mellitus. The study was carried out as an open, ambulatory, cross-over trial during 24 weeks. After a 4-week diet period the patients were randomly allocated to treatment with either glibenclamide or gliquidone. After a 8-week period on a constant drug dose, they switched over to the corresponding dose of the other drug, each patient thus being his own control. Glibenclamide and gliquidone reduced fasting blood glucose values (p less than 0.001), diurnal urine glucose concentrations (p less than 0.001, resp. p less than 0.01) and HbA1 concentrations (p less than 0.02 resp. p less than 0.05) compared to the values in the diet period. Glibenclamide proved more effective than gliquidone in lowering fasting blood glucose concentrations (p less than 0.01), but no difference in 24-hour urine glucose and HbA1 concentrations was seen between the two drugs. Glibenclamide and gliquidone improved the glucose tolerance after an oral glucose load (p less than 0.01 resp. p less than 0.05) compared to diet values. The improved glucose tolerance during sulfonylurea treatment was, however, not associated with significant changes in insulin levels.

Aged↗
PubMed1982

Propranolol does not inhibit sulphonylurea-stimulated insulin secretion in patients with non-insulin dependent diabetes mellitus.

In a double-blind cross-over trial we compared the effects of placebo and propranolol on iv tolbutamide and oral glipizide-stimulated insulin secretion in 10 non-insulin dependent diabetics. The patients were randomly allocated for 2 weeks treatment with placebo and propranolol 80 mg twice daily. At the end of each period an iv tolbutamide test and an oral glipizide-glucose-test were performed. Tolbutamide-stimulated insulin secretion was not affected by propranolol. There was no change in blood glucose levels during the iv tolbutamide test (IVTT), which excluded an effect of blood glucose on insulin secretion. During the oral glipizide-glucose challenge propranolol decreased blood glucose at 60 min (P less than 0.01) and increased C-peptide at 0 min (P less than 0.01) and 30 min (P less than 0.05) compared with placebo. In contrast to earlier results obtained in animals and healthy subjects propranolol does not inhibit insulin- or C-peptide responses to sulphonylurea in patients with non-insulin dependent diabetes mellitus.

Aged↗
PubMed1982

Physical training in juvenile diabetes.

In normal man, physical training increase insulin binding to receptors and body sensitivity to insulin in vivo. In addition, serum lipid and lipoprotein profile changes which may decrease the risk for coronary heart disease. In juvenile onset diabetics, insulin requirements fall during physical training, the mechanism of this decline being yet unknown. There are no prospective studies regarding the prognostic effects of physical training in juvenile diabetes. However, if physical training can improve metabolic control and enhance body sensitivity to insulin resulting in lowered levels of plasma insulin, this may reduce the risk for both micro- and macrovascular complications. The possible adverse effects of exercise, hypoglycemia and excessive rise in counterregulatory hormones can be largely avoided by adequate insulin therapy.

Adult↗
PubMed1982

The influence of rapid changes in blood glucose on glycosylated hemoglobin measured by microcolumn and macrocolumn chromatography.

The effect of a rapid rise in blood glucose on glycosylated hemoglobin (HbA1) was measured by two different cation exchange chromatographic methods. Blood samples were taken after fasting and one hour after breakfast from 32 insulin treated diabetics for the measurement of 1) HbA1 with a microcolumn procedure with and without prior incubation of the samples in saline overnight and 2) HbA1 and HbA1c with the macrocolumn chromatographic method of Trivelli with and without prior dialysis of the hemolysates. Mean (+/- SEM) blood glucose concentration rose significantly one hour after breakfast from 9.8 +/- 0.8 mmol/l to 14.9 +/- 0.8 mmol/l (p less than 0.001). The corresponding HbA1-concentrations measured by microcolumn chromatography without incubation of the samples were 15.2 +/- 0.5% (fasting) of total hemoglobin and 15.8 +/- 0.6% (postprandial) (p less than 0.001) and after incubation 13.3 +/- 0.4% and 13.2 +/- 0.4%, respectively (NS). The HbA1-concentrations measured by the method of Trivelli without dialysis were 14.7 +/- 0.5% (fasting) and 14.9 +/- 0.5% (postprandial) (p less than 0.01) and after dialysis of the hemolysates 14.3 +/- 0.5% and 14.3 +/- 0.5%, respectively (NS). The HbA1c-concentrations measured by the macrocolumn method without dialysis were 11.1 +/- 0.4% (fasting) and 11.2 +/- 0.4% (postprandial) (p less than 0.05) and after dialysis 10.9 +/- 0.4% and 10.8 +/- 0.4%, respectively (NS). Acute hyperglycemia may cause an increase in HbA1-values determined by microcolumn chromatography, the magnitude of which can exceed 20% in an individual case. The acute effect can be abolished by incubation of the samples in saline overnight.

Adult↗
PubMed1981

[Mason diabetes].

Explore the source record for details and available documents.

Chlorpropamide↗
PubMed1980

Diurnal pattern of plasma insulin and blood glucose during glibenclamide and glipizide therapy in elderly diabetics.

The effect of a single and a split dose of glibenclamide and glipizide on the diurnal levels of blood glucose and plasma insulin were compared in 15 insulin-independent diabetics. The patients were treated for two weeks with a) glibenclamide or glipizide 5 mg b.i.d., b) diet alone, c) glibenclamide or glipizide 7.5 mg o.d., and d) crossing over of c). The patients were on isocaloric diet and the diurnal levels of blood glucose and plasma insulin were determined after each period. As compared to the diet, the single morning dose of both drugs reduced the blood glucose values to the same extent (p < 0.001) without any effect on corresponding insulin-levels. The single morning dose was sufficient to provide adequate blood glucose control for up to 24-hours. There was no further benefit of the (even greater) split doses. In accordance with the augmented physiologic insulin release in the morning, a single morning dose of sulfonylureas may be the preferable dosage regimen in the treatment of elderly insulin-independent diabetics of moderate degree.

Aged↗
PubMedDate not supplied

Clinical and metabolic characteristics of type 1 and type 2 diabetes: an epidemiological study from the Närpes community in western Finland.

Clinical and metabolic characteristics of all known Type 1 and Type 2 diabetic patients in a well-defined area in Western Finland are described. Retrospective data from the time of diagnosis and follow-up data were examined. Overall prevalence of diabetes was 25.4 cases per 1000 population. Patients were defined as having Type 1 or Type 2 diabetes based upon early insulin requirement and C-peptide levels. Applying these criteria 84% of the patients had Type 2 diabetes. Onset before the age of 40 years was observed in only 3% of Type 2 diabetic patients. This age limit therefore had a sensitivity of 97% and a specificity of 90% in correctly predicting Type 2 diabetes. At diagnosis, hypertension was observed in 2% of Type 1 and in 75% of Type 2 diabetic patients; the corresponding numbers at follow-up were 6 and 63%. At investigation, 27% of Type 1 and 22% of Type 2 diabetic patients had microalbuminuria. Retinopathy was observed in only 12% of Type 2 compared with 54% of Type 1 diabetic patients. The presence of retinopathy was associated with longer diabetes duration both among Type 1 and Type 2 diabetic patients. A significant decrease in C-peptide concentration was observed in Type 2 diabetic patients with increasing diabetes duration. The data therefore suggest that Type 2 diabetes is associated with a deterioration of beta-cell function with time.

Age Factors↗
PubMedDate not supplied

Iohexol and metrizoate in urography of insulin dependent patients.

A double blind urographic study with the ionic contrast medium metrizoate or the non-ionic medium iohexol was performed on 69 insulin dependent diabetic patients. Metrizoate caused 24 per cent and iohexol 11 per cent mild adverse reactions and metrizoate a significant decrease in creatinine clearance values. Thus iohexol turned out to be better tolerated by these diabetic patients than metrizoate.

Adult↗
PubMedDate not supplied

Comparison of pharmacokinetics, metabolic effects and mechanisms of action of glyburide and glipizide during long-term treatment.

Fourteen non-insulin-dependent diabetic (NIDDM) patients continued their previous medication (7 on glyburide, 7 on glipizide) for 6 mo, after which they switched to the alternate treatment for another 6 mo. The treatment periods were followed by 1 mo of placebo. The sulfonylurea dose was increased to achieve fasting plasma glucose levels less than 9 mM or to a total maximum daily dose of 25 mg. The mean final doses of glyburide (14.7 +/- 2.4 mg/day) and glipizide (15.2 +/- 2.2 mg/day) were similar. Postprandial (postdose) glipizide levels were higher than those of glyburide, whereas fasting (predose) glyburide concentrations were higher than those of glipizide. Both treatments improved glucose control by 25% compared with placebo. Glipizide therapy evoked higher postprandial insulin concentrations than did glyburide, whereas basal insulin concentrations were higher during glyburide. Insulin sensitivity, assessed by an insulin tolerance test, was more improved with glyburide than with glipizide. In conclusion, overall glucose control is similarly improved by glyburide and glipizide. However, glipizide amplifies the plasma insulin response to meals more than glyburide, whereas glyburide enhances basal insulin secretion more than glipizide. Both pharmacokinetic and pharmacodynamic factors may contribute to these differences.

Blood Glucose↗