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Biomedical subjects

L Wibell

Publications and source records attributed to L Wibell.

At least 55 records · Page 3Linked to original sources
PubMed1986

The impact of treatment on insulin release and relative peripheral resistance during the oral glucose tolerance test. A study of noninsulin-dependent diabetes mellitus and glucose intolerance.

Using 75 g oral glucose tolerance tests (OGTTs), insulin release and relative peripheral resistance were studied in two groups of subjects before and after treatment; ten mostly obese subjects with glucose intolerance (GI), who had improved glucose tolerance after six months of diet and exercise with weight reduction; nine nonobese patients with noninsulin-dependent diabetes mellitus (NIDDM), who received a daily dose of 5 mg glipizide for three months. Total insulin release was measured as the total area under the insulin curve during the OGTT. The insulin response to glucose was expressed as the ratio of the incremental area under the insulin curve to that of the glucose curve above fasting levels (delta AUCI/delta AUCG), during the first 30 minutes and the latter part of the test. The glucose uptake rate (M) was measured as the difference between the glucose load and the increase of glucose in the glucose space after compared to before the OGTT. The relative peripheral resistance (rel-R) against glucose-uptake-promoting factors was expressed as 1/M. The main effects of therapy in the GI-group appeared to be a decrease of the mean rel-R value and a decrease of the mean total insulin release. This implies a mainly peripheral action of therapy at receptor and/or postreceptor levels. The mean [delta AUCI/delta AUCG]0-30 value was unchanged and the mean [delta AUCI/delta AUCG]30-120 value was only slightly increased at follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1986

Epidemiology of diabetes mellitus in Sweden. Results of the first year of a prospective study in the population age group 15-34 years.

All newly diagnosed cases of diabetes mellitus aged 15-34 years in Sweden, where the population in this age interval is about 2.3 million, were registered on standardized forms. During 1983, the first year of the study, there were 311 males and 161 females, excluding 280 with gestational diabetes. The annual incidence of diabetes was 26.2 per 100,000 in males and 14.2 in females. The respective figures for type I were 18.5 and 10.1, and for type II 5.7 and 2.9. The incidence of type I diabetes was similar for the four age groups (15-19, 20-24, 25-29, 30-34 years), while for type II it was highest in the oldest group. Types I and II, but not the sexes, differed as regards the cumulative distribution curves of the maximum blood glucose concentration during the first two weeks after diagnosis. The present incidence of diabetes in Sweden is higher, particularly in males than the rates for similar age groups in Oslo (1925-64) and Denmark (1970-77).

Adolescent↗
PubMed1985

Glucose intolerance in middle-aged subjects--a cause of hypertension?

At a health survey of 819 middle-aged, 47-54-year-old, males and females in a Swedish urban area with a participation rate of 70%, the prevalence of glucose intolerance (GI) was 6.2%, 51 subjects (7.0% of females and 5.3% of males), as the result of two subsequent 75 g oral glucose tolerance tests according to the WHO criteria. In comparison with normoglycemic subjects from the same health survey, with both fasting and 2-hour glucose values less than 5.0 mmol X l-1, the GI group was characterized by higher mean relative body mass index, higher mean blood pressure and rate of hypertension, higher rate of low-degree physical activity during leisure and had more often a family history of diabetes in first-degree relatives. Smoking was less prevalent in GI subjects. Hypertension was more frequent in obese (relative body mass index (BMI) 120-150%) GI subjects than NGT subjects. Finally, comparison of all GI subjects with all normoglycemic subjects of the survey, with use of analysis of covariance, showed that mean systolic and diastolic blood pressures were higher in GI subjects, independently of age, BMI and also smoking.

Blood Glucose↗
PubMed1985

Glucose tolerance and physical activity in a health survey of middle-aged subjects.

Glucose tolerance and reported physical leisure time activity were studied in middle-aged, 47-54 years old, subjects in a health survey. The mean 2-hour blood glucose value after 75 g oral glucose tolerance tests was higher (p less than 0.001) in 682 subjects with a lower degree of leisure time activity than in 125 subjects who were regularly active at least 2-3 hours per week. The mean 2-hour glucose values in the inactive and active groups, respectively, were 4.61 and 4.09 mmol X l-1 after adjustment for the influence of age, body mass index, smoking and physical job activity by analysis of covariance. The difference between adjusted mean 2-hour glucose values was also significant (p less than 0.001) in the subgroups of 280 low leisure time activity males (4.53 mmol X l-1) and 91 active males (3.93 mmol X l-1). Thus, a relation between physical leisure time inactivity and raised post load blood glucose values seems to exist in the general population.

Age Factors↗
PubMed1985

Serum beta 2-microglobulin at remission and relapse in patients with multiple myeloma.

Serum beta 2-microglobulin (S-beta 2m) was determined before treatment in fifty patients with multiple myeloma (MM), twenty-two of which had pure Bence Jones (BJ) myeloma. S-beta 2m was related to clinical stage before, but not after, a correction of S-beta 2m values for co-existent raised S-creatinine values (greater than 106 mumol 1-1). However, S-beta 2m as well as corrected beta 2m was a parameter of prognostic value. The median expected survival time was 14 months at S-beta 2m values greater than 8.0 mg 1(-1) and 56 months at values less than 3.5 mg 1(-1). A response to treatment was associated with a decrease of S-beta 2m and a stationary course with unchanged values, whereas a relapse or progressive disease was connected with an increase. In 'beta 2m producers', i.e. patients with a clear initial high S-beta 2m, serial determinations are of value for monitoring patients with MM. In particular, this is the case in BJ myelomas, as they lack a quantifiable serum M-component. With respect to beta 2m no difference was found between BJ and other patients with MM.

Adult↗
PubMed1985

Ten-year experience of insulin treatment in gestational diabetes.

Between 1975-1984, 119 women with gestational diabetes (GDM) were treated with insulin in Uppsala, representing a mean yearly incidence of 4.5/1,000 pregnancies. Women with GDM were older and more obese than the general pregnant population. Insulin treatment was instituted during a 5-7 day stay in hospital. The mean total daily dose of insulin prepartum, when fasting blood glucose had been normalized, was 53 (SD +/- 25) units (34 +/- 15 units of rapid-acting and 20 +/- 11 units of medium-acting insulin), divided into two doses daily. Mean duration of treatment was 6.4 weeks. The perinatal mortality was 0.8%, compared with 7.4% in previous pregnancies in the same women. The perinatal morbidity was generally mild and included hypoglycaemia (10.9%), hyperbilirubinaemia requiring treatment (2.5%), shoulder dystocia (2.5%) and one case of mild respiratory distress syndrome. The rate of macrosomia was reduced in the present pregnancies compared with previous ones in the women with GDM, but not abolished completely, probably because of too short a duration of improved metabolic control. Spontaneous delivery was favoured and the rate of Caesarean section was 13.5%. Thus, treatment with high doses of insulin in an unselected group of women with GDM is feasible. Normal perinatal mortality, reduced macrosomia, and no gross perinatal morbidity was found in the infants. Though the extent to which insulin treatment per se contributed to the favourable outcome is difficult to assess, it is suggested that the case for a high level of ambition for metabolic normalization in GDM should be a subject of further study.

Adult↗
PubMed1985

Magnesium and zinc in diabetic pregnancy.

The concentrations of zinc and magnesium in serum were investigated in 23 non-pregnant and 14 pregnant women with insulin-dependent diabetes (IDDM) and 20 with gestational diabetes, and in cord blood from newborns of the latter two groups. These groups were compared with healthy women, non-pregnant as well as parturient, and newborns of the latter. In the non-pregnant state the mean serum concentrations of zinc and magnesium were lower in IDDM patients than in healthy control women. Although a decrease in S-Zn and S-Mg was observed during pregnancy in both IDDM and control subjects, the difference between carefully insulin-treated IDDM patients and controls was no longer apparent at term of pregnancy as regards S-Zn, whereas S-Mg was lower at term both in IDDM patients and in insulin-treated women with gestational diabetes. Besides the probable importance of a nearly normalized glucose metabolism in IDDM patients during pregnancy, it is postulated that the altered pattern of plasma proteins in diabetes and pregnancy, and possibly also exogenous insulin may influence the serum concentrations of zinc and magnesium seen at the end of pregnancy.

Adult↗
PubMed1985

Evaluation of insulin release and relative peripheral resistance with use of the oral glucose tolerance test: a study in subjects with normoglycaemia, glucose intolerance and non-insulin-dependent diabetes mellitus.

With use of 75 g oral glucose tolerance tests (OGTTs), insulin release and relative peripheral resistance were evaluated in groups of normoglycaemic subjects, subjects with glucose intolerance (GI) and patients with non-insulin-dependent diabetes mellitus (NIDDM). Insulin release was expressed as the total area under the insulin curve (AUCI) and as the area under the insulin curve above the fasting insulin level (delta AUCI). The insulin response to glucose was expressed as the ratio of the area under the insulin curve to that of the glucose curve above fasting levels (delta AUCI/delta AUCG). The glucose uptake rate during the OGTT (M) was measured as the difference between the glucose load and the increase of the amount of glucose in the glucose space after, compared to before, the OGTT. The relative peripheral resistance against glucose uptake promoting factors (rel-R) was expressed as 1/M. With application of these indices in the non-obese groups, there was an increased mean total insulin release (AUCI, delta AUCI) while the mean insulin response to glucose (delta AUCI/delta AUCG) was decreased in GI-subjects compared with normoglycaemic subjects. The mean relative peripheral resistance (rel-R) was higher in GI-subjects than in normoglycaemics. Mean values of AUCI and delta AUCI were decreased (lower than in the normoglycaemics, NS), mean values of delta AUCI/delta AUCG were further decreased and mean values of rel-R were further increased in the NIDDM-groups compared with the GI-group. Insulin release was delayed in GI and NIDDM. Obese normal and obese GI-subjects with similar rel-R values as the corresponding non-obese normal and non-obese GI-subjects, had higher mean values of insulin release than the non-obese counterparts. Thus, it seemed possible to use a technique in general use, the OGTT, with a partly new approach to simultaneously obtain indices for insulin release and relative peripheral resistance, which may have clinical applicability.

Aged↗
PubMed1985

Aspects on tubular proteinuria.

Tubular proteinuria, or low molecular weight (LMW) proteinuria, is less common than glomerular proteinuria, but is often of clinical significance. Both qualitative analysis of the urinary protein pattern by electrophoresis and quantitative estimations of various LMW-proteins are now usually available in the clinical routine laboratories. It is thus possible to look for LMW-proteinuria, as a sign of damage to the function of proximal renal tubules. For this purpose beta 2-microglobulin may be used as marker protein. Chronic cadmium poisoning and the Balkan nephropathy are examples of conditions which have been extensively studied by the use of LMW-protein determinations. In this context also some rare hereditary disorders deserve to be specially mentioned. Toxic injury to the kidneys, by drugs or other agents, often affect the kidney tubules early in the course and may be identified by LMW-protein analysis. Also in other clinical situations LMW-proteins in the urine may be used for investigative or research purposes.

Absorption↗
PubMed1985

Renal handling of 125I-labelled insulin in the hen.

Renal handling of 125I-insulin was studied using a modification of the Sperber technique. Results showed 125I-insulin to be extracted at the peritubular side of the nephron in a process that was competitively inhibited by increasing amounts of unlabelled insulin, but not ACTH, in the injection mixture. When unlabelled insulin instead was injected 30 sec after the labelled insulin it showed significantly less interference with peritubular extraction of 125I-insulin, indicating strong attachment to the cell membrane or possible internalization of 125I-insulin into proximal tubular cells. Light microscope autoradiography 1 min after injection of 125I-insulin showed grains over proximal tubules only. On the ligated side localization was preferably peritubular while on the control side it was luminal. Electron microscope autoradiography showed sparsely distributed grains, however, frequently located over basal parts of proximal tubular cells. Pretreatment with lysine hydrochloride lowered renal extraction of 125I-insulin and increased urinary recovery of iodine label bilaterally. 125I-glucagon and 125I-C-peptide were not extracted from the peritubular circulation. In conclusion, the model has provided evidence of a rapid and significant peritubular extraction of 125I-insulin by proximal tubular cells in a process probably involving specific insulin receptors. Following receptor binding probably only minor amounts of 125I-insulin enters the proximal tubular cells, while the greater part is degraded at the cell surface or released into the circulation.

Adrenocorticotropic Hormone↗
PubMed1985

Glucose metabolism during long-term treatment with prazosin.

The metabolic effects of the alpha 1-adrenoceptor blocking drug prazosin was evaluated in 8 premenopausal women undergoing treatment for essential hypertension. Intravenous glucose tolerance (IVGTT) and the early insulin response was studied before treatment, after 1 and 12 months and 3 weeks after cessation of drug treatment. The k-value for the glucose disappearance decreased from 2.9 to 2.0 after 1 month. No further change occurred after 12 months. After cessation of the drug the k-value returned to the pre-treatment level. The decreased glucose tolerance was accompanied by a decrease in the early insulin response. It is suggested that the reversible decrease in glucose tolerance is due to an inhibition of the early insulin response, mediated by the increase in circulating catecholamines reported during prazosin treatment.

Adolescent↗
PubMed1985

Peripheral and autonomic nerve function in glucose intolerance.

In 19 middle aged subjects, glucose intolerant according to WHO criteria, obtained from a health survey, peripheral and autonomic nerve function were studied in comparison with 25 control subjects with normal glucose tolerance. Clinically detectable signs of peripheral nerve dysfunction were not more common in glucose intolerant subjects than in the control group. In measurements of sensory thresholds for vibration, nerve conduction velocities and autonomic nerve function, small differences, mainly non-significant, were found in favour of the controls. It is concluded that minor reduction of some peripheral nerve function may be associated with glucose intolerance, but it is not readily demonstrated. Clinically apparent polyneuropathy is not likely to develop.

Autonomic Nervous System↗
PubMed1984

Relationship between the cardiovascular effects and steady-state kinetics of clonidine in hypertension. Demonstration of a therapeutic window in man.

Clonidine was given orally as monotherapy in increasing daily doses from 3.1 to 25.7 micrograms/kg to patients with essential hypertension (n = 6). When a steady state concentration in plasma was reached at each dose level, the blood pressure (BP) and heart rate were measured during a dosage interval. Effect time-plasma concentration data were submitted to nonlinear regression analysis, which showed that the observed BP effects could be dissociated into depressor and pressor components. A window for the anti-hypertensive effect was established. At a plasma clonidine concentration of 0.65 +/- 0.07 ng/ml 50% of the maximal depressor effect was found, and it was only separated by a factor of 2 from the half maximal pure pressor concentration in plasma. No relationship between the change in heart rate and the plasma clonidine was observed. The findings strengthen the importance of close monitoring of clonidine therapy.

Adult↗
PubMed1984

Cyclosporin A treatment in a case of relapsing polychondritis.

A patient with relapsing polychondritis and high titres of anti-collagen II antibodies developed a progressive destruction of tracheal cartilage in spite of treatment with corticosteroids, Dapsone, Azathioprine and cyclophosphamide. Assumptions regarding the role of anti-collagen immunity, together with immunohistochemical studies on affected cartilage, suggested macrophage-T cell interactions to be important in the pathogenesis of the disease. Cyclosporin A treatment was instituted and has been continued for 2 years, concomitant with a steady improvement and remission of the disease.

Autoantibodies↗
PubMed1984

Comparison of glycosylated hemoglobin with the oral glucose tolerance test. A study in subjects with normoglycemia, glucose intolerance and non-insulin-dependent diabetes mellitus.

At a health survey of 819 subjects, 47-54 years old, the rate of glucose intolerance (GI) was 6.2% (51 subjects) according to 75 g oral glucose tolerance tests (OGTT) and WHO criteria. In GI-subjects, the mean HbA1 was 7.3% (10th-90th percentile range 6.2-8.3%), and significantly higher than the mean HbA1 in 150 subjects with normal OGTT, which was 6.5% (10th-90th percentile range 5.7-7.4%). With an upper normal limit of 7.8% (mean + 2 SD) only 20% of all GI-subjects had a raised HbA1. The differences between 31 GI-subjects, with low HbA1 (mean 6.9%), and 20 GI-subjects, with relatively high HbA1 (mean 7.9%), were not significant with respect to fasting and 2-hour blood glucose, area under glucose curve, body mass index, index of physical activity, rate of hypertension or rate of first degree relatives with diabetes. In an unselected group of 157 subjects, sampled consecutively during the first part of the survey, the mean HbA1 was 6.6% (10th-90th percentile range 5.8-7.5 %) 150 subjects were those with normal OGTT, 6 subjects had GI and only one subject had previously unknown diabetes. No distinct correlations between HbA1 and OGTT fasting or 2 hour values were found in this sample. No correlation was found within the separate groups of 51 GI-subjects and 150 normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗
PubMed1983

Muscle fibre composition in relation to blood pressure response to isometric exercise in normotensive and hypertensive subjects.

A positive relationship was demonstrated between the blood pressure and the fibre composition of the vastus muscle at rest in 17 hypertensive and 17 age- and sex-matched normotensive subjects. The hypertensive group had a higher proportion of fast twitch (FT) fibres (p less than 0.1). The circulatory response was measured during isometric exercise (IE) and cold pressor test (CPT). During IE the blood pressure increase was positively related to the percentage of FT fibres. No such relationship was demonstrated during CPT. It was thus found, particularly in hypertensive subjects, that an individual's muscle fibre profile is of importance for the blood pressure response during IE.

Adult↗