Search PubMed⌕ Search

Biomedical subjects

N Paquot

Publications and source records attributed to N Paquot.

At least 37 records · Page 2Linked to original sources
PubMed2000

[GLycemic control in the diabetic patient. Recommendations after the DCCT and UKPDI studies].

Diabetes mellitus is a chronic disorder characterized by microvascular and cardiovascular complications that substantially increase the morbidity and mortality associated with the disease. Several studies showed the association between the complications of diabetes and elevated blood glucose levels. Clinical trials have also demonstrated that treatment that lowers blood glucose reduces the risks of diabetic complications (mainly microvascular complications). The control of diabetes is assessed by frequent measurements of HbA1c. A reasonable goal in type 1 diabetes is a value of HbA1c < or = 7.2%. In type 2 diabetes, the optimal goal is a value of HbA1c < or = 6.5%, but a value < or = 8% seems to be an acceptable goal in these patients.

Diabetes Complications↗
PubMed1999

Effects of glucagon in the control of endogenous glucose production in man.

Endogenous glucose production has been shown to increase during administration of glucagon + fructose, but not during administration of fructose alone. To determine the mechanisms by which glucagon exerts this action, endogenous glucose production (EGP) and gluconeogenesis from fructose (GNF) were measured in eight healthy subjects infused 1) with graded doses of glucagon (2 and 4 ng.kg-1.min-1 for 3 h each) during constant infusion of 13C-fructose (3 mg.kg-1.min-1), and 2) with graded doses of 13C-fructose (3 and 6 mg.kg-1.min-1) during constant glucagon infusion (2 ng.kg-1.min-1). GNF was estimated from 13C-glucose synthesis. In both protocols, infusion of 3 mg.kg-1.min-1 fructose + 2 ng.kg-1.min-1 glucagon increased EGP by 5-8% (P < 0.05), while GNF represented 43-49% of EGP. Thereafter, increasing the glucagon infusion rate further increased EGP to 118 +/- 3% of basal values (P < 0.01) without altering the proportion due to GNF. In contrast, increasing the fructose infusion rate at constant glucagonemia increased EGP similarly (by 19 +/- 4%, P < 0.05) but enhanced the contribution of GNF to 76 +/- 2% (P < 0.001). Graded infusion of glucagon or fructose alone failed to stimulate EGP. The present findings indicate that hyperglucagonemia stimulates endogenous glucose production during fructose infusion. This effect is not secondary to a stimulation of gluconeogenesis, but to a channelling of glucose-6-phosphate towards systemic release.

Adult↗
PubMed1999

[Is it necessary to institute primary preventive treatment in women with hypercholesterolemia?].

Limited data are available in women from randomized trials of lipid-lowering therapy for primary prevention of coronary heart disease (CHD). In women with isolate hypercholesterolemia but no clinical symptoms of CHD and no other risk factors, there is no evidence that lipid-lowering therapy is of benefit. In postmenopausal women with hypercholesterolemia and other risk factors (particularly diabetes and family history of CHD), lipid-lowering therapy may be of benefit. In those women, hormone replacement therapy may be proposed in the treatment of postmenopausal hypercholesterolemia.

Cardiovascular Diseases↗
PubMed1999

[Glucotoxicity and lipotoxicity, two implicated accomplices in the vicious circle of type 2 diabetes].

Type 2 diabetes mellitus is a dynamic disease whose natural history is characterized by a progressive aggravation leading to a progressively severe hyperglycaemia, which generally requires a more complex therapy as time progresses. Such an evolution results from a vicious circle where both glucotoxicity and lipotoxicity contribute to reduce insulin secretion and the action of insulin on cell glucose metabolism. These new concepts are able to modify the strategies of prevention and treatment of type 2 diabetes.

Diabetes Mellitus, Type 2↗
PubMed1999

Non oxidative fructose disposal is not inhibited by lipids in humans.

Elevated free fatty acid concentrations are known to decrease insulin-mediated glucose uptake, glucose oxidation and glycogen synthesis. In order to determine whether free fatty acids inhibit glycogen synthesis at the level of liver cells, the effects of an infusion of lipids on carbohydrate metabolism were investigated in healthy subjects during a two-step (16.7 and 33.4 mumol/(kg.min) 13C-fructose infusion. Fructose infusion dose-dependently stimulated fructose (measured from 13CO2 production) and net carbohydrate oxidation (measured with indirect calorimetry). It also stimulated systemic 13C glucose appearance, indicating a dose-dependent stimulation of gluconeogenesis. Net glucose output (measured with 6,6 2H glucose) was however not altered. Lipid infusion significantly reduced fructose oxidation (measured from 13CO2 production) at both rates of fructose infusion, but did not alter plasma fructose or lactate concentrations, nor plasma 13C glucose appearance or net glucose production. Non oxidative fructose disposal was increased by 31% (p < 0.05) at the lowest, and by 18% (p < 0.01) at the highest infusion rate. Since nonoxidative fructose disposal corresponds mainly to liver glycogen deposition, these results suggest that lipid infusion increased hepatic glycogen synthesis, and hence that hepatic glycogen synthase is not inhibited by fatty acids.

Adult↗
PubMed1999

[Type II diabetes: diagnostic approaches, glycemia objectives and therapeutic strategies].

Type 2 diabetes is a prevalent disease, with high morbidity and mortality rates, which is usually managed by general practitioners. We will discuss the new diagnostic approaches, the glycaemic goals and the therapeutic strategies which may contribute to improve both adequate management and prognosis of diabetic patients with type 2 diabetes. As far as possible, the management should be both individualized and integrated, not only focused on blood glucose control but also on the correction of other vascular risk factors frequently associated with diabetes (mainly arterial hypertension and dyslipidaemias). Obviously, the reduction of the incidence and severity of microangiopathy and macroangiopathy diabetic complications would require a tight collaboration between general practitioners and specialized physicians.

Blood Glucose↗
PubMed1999

[Thiazolidinediones].

Explore the source record for details and available documents.

Chemical and Drug Induced Liver Injury↗
PubMed1998

Effects of regular insulin or insulin LISPRO on glucose metabolism after an oral glucose load in patients with type 2 diabetes mellitus.

Seven obese Type 2 diabetic patients were studied for two 4-h periods after ingestion of a glucose load to determine the effects of preprandial subcutaneous injection of Insulin Lispro (5 min before the meal) or regular insulin (20 min before the meal) on glucose metabolism. Glucose production and utilisation were measured using a dual isotope method. After Lispro, the mean postprandial increase in plasma glucose was 29% lower and the increase in insulin concentration 25% higher than after regular insulin (p < 0.05). Suppression of endogenous glucose production was similar with both types of insulin. Thus, preprandial injection of Lispro reduced postprandial glucose increments in Type 2 diabetic patients as compared to regular insulin. This effect is best explained by the increased postprandial bioavailability of Lispro.

Administration, Oral↗
PubMed1997

Acute functional iron deficiency in obese subjects during a very-low-energy all-protein diet.

We examined whether a very-low-energy all-protein diet (VLED) would produce detectable changes in iron as well as in other trace elements. Twenty-five obese patients consumed for 2 wk a VLED containing 70 g protein after a 1-wk period during which total daily energy intake was progressively reduced to 1.26 MJ. Serum iron fell sharply by approximately equal to 50% (P < 0.0001), and despite a small decrease in total-iron-binding capacity, transferrin saturation decreased from 30 +/- 11% to 18 +/- 5% (P < 0.0001). Serum ferritin did not change significantly but serum soluble transferrin receptor (sTfR), an indicator of iron deficiency, increased progressively from 4630 +/- 1110 to 6070 +/- 1390 micrograms/L (P < 0.0001). Changes in sTfR correlated inversely with prior changes in serum iron. Changes in iron metabolism did not translate into changes in erythropoiesis or red cell indexes, but the white blood cell count decreased from 7.3 +/- 1.6 to 6.2 +/- 1.9 x 10(9)/L (P < 0.002). There was no evidence of deficiency for the other trace elements and minerals tested. Daily supplementation with 200 mg Fe in 18 other subjects only partially corrected these observations despite some increase in iron stores. These results indicate that during a 2-wk VLED serum iron is significantly depressed, inducing functional tissue iron deficiency too short in duration to produce alterations in red blood cell indexes. These changes are not mediated by absolute iron deficiency, inflammation, or protein malnutrition but could be related to alterations in the iron storage and release behavior of the reticuloendothelial cell during energy deprivation alone.

Adolescent↗
PubMed1996

Effects of ingested fructose and infused glucagon on endogenous glucose production in obese NIDDM patients, obese non-diabetic subjects, and healthy subjects.

Increased endogenous glucose production (EGP) and gluconeogenesis contribute to the pathogenesis of hyperglycaemia in non-insulin-dependent diabetes mellitus (NIDDM). In healthy subjects, however, EGP remains constant during administration of gluconeogenic precursors. This study was performed in order to determine whether administration of fructose increases EGP in obese NIDDM patients and obese non-diabetic subjects. Eight young healthy lean subjects, eight middle-aged obese NIDDM patients and seven middle-aged obese non-diabetic subjects were studied during hourly ingestion of 13C fructose (0.3 g.kg fat free mass-1.h-1) for 3 h. Fructose failed to increase EGP (measured with 6,6 2H glucose) in NIDDM (17.7 +/- 1.9 mumol.kg fat free mass-1.min-1 basal vs 15.9 +/- 0.9 after fructose), in obese non-diabetic subjects (12.1 +/- 0.5 basal vs 13.1 +/- 0.5 after fructose) and in lean healthy subjects (13.3 +/- 0.5 basal vs 13.8 +/- 0.6 after fructose) although 13C glucose synthesis contributed 73.2% of EGP in lean subjects, 62.6% in obese non-diabetic subjects, and 52.8% in obese NIDDM patients. Since glucagon may play an important role in the development of hyperglycaemia in NIDDM, healthy subjects were also studied during 13C fructose ingestion + hyperglucagonaemia (232 +/- 9 ng/l) and during hyperglucagonaemia alone. EGP increased by 19.8% with ingestion of fructose + glucagon (p < 0.05) but remained unchanged during administration of fructose or glucagon alone. The plasma 13C glucose enrichment was identical after fructose ingestion both with and without glucagon, indicating that the contribution of fructose gluconeogenesis to the glucose 6-phosphate pool was identical in these two conditions. We concluded that during fructose administration: 1) gluconeogenesis is increased, but EGP remains constant in NIDDM, obese non-diabetic, and lean individuals; 2) in lean individuals, both an increased glucagonaemia and an enhanced supply of gluconeogenic precursors are required to increase EGP; this increase in EGP occurs without changes in the relative proportion of glucose 6-phosphate production from fructose and from other sources (i.e. glycogenolysis + gluconeogenesis from non-fructose precursors).

Administration, Oral↗
PubMed1995

Assessment of glucose metabolism in humans with the simultaneous use of indirect calorimetry and tracer techniques.

Concomitant measurements of sytemic glucose delivery and carbohydrate oxidation are frequently performed in human investigations. Systemic glucose delivery (SGD) is usually determined using dilution of infused glucose tracers; net carbohydrate oxidation rate (net CHOOX) can be calculated from respiratory gas exchanges and urinary nitrogen excretion (indirect calorimetry); alternatively, glucose oxidation can be measured from labelled CO2 production during infusion of carbon-labelled glucose tracers. In this paper, the theory underlying the use of each of these techniques is briefly reviewed and qualitative differences are outlined. SGD represents the sum of hepatic glucogenolysis, gluconeogenesis from amino acids or glycerol, and, according to the glucose tracer used, glucose cycles (glucose-phosphate cycle, fructose-phosphate cycle, Cori and glucose-alanine cycles); systemic delivery of exogenous glucose after oral or i.v. glucose administration is also measured. Net CHOOX represents oxidation of glucose arising from hepatic or muscle glycogen or from exogenous glucose; it does not take into account oxidation of glucose formed from amino acids or glycerol, which is included in net protein or lipid oxidation. In contrast, isotopic determination of glucose oxidation corresponds to oxidation of glucose originating from hepatic glycogen breakdown, of exogenously administered glucose, and of glucose formed from amino acids and glycerol. Non-oxidative glucose disposal, calculated as SGD-net CHOOX, corresponds to the sum of gluconeogenesis from amino acids or glycerol (which are included in net protein and lipid oxidation), glucose cycles, and glycogen synthesis.

Blood Glucose↗