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Biomedical subjects

P A Walravens

Publications and source records attributed to P A Walravens.

At least 19 recordsLinked to original sources
PubMed1997

Effectiveness of postprandial Humalog in toddlers with diabetes.

OBJECTIVE: The purpose of this study was to determine whether postprandial administration of the new rapid-acting insulin analog Humalog could effectively reduce glucose excursions in children <5 years old. DESIGN: Human Regular insulin given before a meal was compared with the same dose of Humalog after a meal of equal carbohydrate content in five toddlers with insulin-dependent (type 1) diabetes mellitus. In addition, the use of Humalog before a meal was compared with Humalog given after a meal of equal carbohydrate content in five other toddlers. The dose of long-acting insulin was not changed during the study period. Blood glucose levels were determined at fasting and at 1, 2, and 4 hours postprandially. RESULTS: The 2-hour glucose excursions were significantly lower when postprandial Humalog administration was compared with preprandial Human Regular insulin administration. In contrast, glucose excursions were similar when Humalog was taken before or after the meal. CONCLUSION: These data show that it is efficacious to give Humalog insulin postprandially in toddlers with type 1 diabetes, allowing increased safety for the young child. The insulin dose can be both matched to the actual food intake and timed to give families increased flexibility and control at mealtime.

Blood Glucose↗
PubMed1995

Final adult height and its relationship to blood glucose control and microvascular complications in IDDM.

The effect of longitudinal blood glucose control on final adult height was evaluated in 181 subjects (94 women and 87 men) with IDDM. Diabetes onset was at a median age of 6.9 years with an interquartile range of 4.7 years. Longitudinal glycated haemoglobin values were determined over a mean period of 6.6 +/- 2.6 years during their growth phase. Serial eye and joint examinations and urinary albumin excretion rates were performed with final assessment being carried out at a mean age of 21.1 +/- 3.0 years. The mean adult height standard deviation score of the whole group was -0.22 +/- 1.15 and was reduced compared to the mean height of the general population and to the mean height of the subjects' parents and siblings. There was an inverse correlation with mean longitudinal glycated haemoglobin and final adult height (p < 0.01). There was also an inverse relationship between adult height and the severity of eye, kidney, and joint complications, but when controlled by glycated haemoglobin, this relationship only remained significant for eye complications. Final adult height is reduced in subjects with early onset IDDM who remain in poor blood glucose control during their growth period.

Adult↗
PubMed1993

Selenium status of healthy immigrant Parisian preschool children.

Plasma selenium (Se) concentration and erythrocyte glutathione peroxidase activity (GPx) were assessed in a population of healthy preschool children two to five years old, residing in the city of Paris. In the 118 subjects, mean (+/- SD) plasma Se concentration was 62.10 +/- 13.96 micrograms/L, and mean GPx activity was 23.58 +/- 8.52 U/g Hb. Mean plasma Se of male children was significantly (p = 0.001) higher (12%) than levels of girls. Plasma selenium levels were not correlated with erythrocyte GPx activity. Children from Mediterranean origin had a slightly lower erythrocyte GPx activity (p < 0.05) than children from other regions. Mean plasma Se concentration of this group corresponded to the lower limit of intervals, which characterizes geographical regions of intermediate selenium concentrations.

Analysis of Variance↗
PubMed1993

Plasma zinc and copper in Paris area preschool children with growth impairment.

Plasma zinc, copper, and parameters of growth were measured in a group of 116 French preschool children, 2-5 yr-old from low-income households. Participants were selected on the basis of Z-scores of weight for height (WHZ) and height for age (HAZ). Zinc and copper concentrations of children with growth impairment (GI), defined by a WHZ and/or HAZ < -1 Z-score, were compared to those of age, sex, and ethnic origin matched controls (WHZ and HAZ > -1 Z-score). Mean (+/- SD) plasma zinc concentration was 12.58 +/- 1.84 mumol/L in the GI group, and 13.27 +/- 1.98 mumol/L in the controls. The difference of the means of paired samples was 0.69 +/- 2.34, and by paired t-test the significance reached p = 0.028. This effect was primarily a result of the weight retarded group (WHZ < -1 Z-score, p < 0.009) and to the girls (p < 0.05). There were no significant differences in plasma copper concentrations between groups. These results suggest the presence of marginal zinc deficiency in French preschool children with low weight for height Z-scores.

Age Factors↗
PubMed1992

Zinc supplements in breastfed infants.

Among breastfed infants, growth faltering in comparison with reference growth curves is common in both developing and developed countries. We performed a zinc supplementation trial in Paris, France, to find out whether such growth faltering is due to nutritional zinc deficiency. 57 breastfed infants aged 4-9 (mean 5.7) months were randomly assigned to receive either 5 mg zinc daily or a placebo for 3 months. Most of the infants were from low-income immigrant families and the majority were of African origin. Before supplementation there were no significant differences between the zinc and placebo groups in weight, length, or corresponding Z-scores for age. After 3 months' supplementation, the length-for-age Z-score had increased in the zinc group and fallen in the placebo group (+0.21 vs -0.13, p = 0.029). This difference was due mainly to greater linear growth of boys in the zinc than in the placebo group (6.0 vs 4.6 cm, p = 0.02). Weight gain was also significantly greater with zinc supplementation (1.64 vs 1.28 kg, p = 0.047). Among infants breastfed for longer than 4 months, decreases in growth velocity result partly from inadequate zinc intake.

Body Height↗
PubMed1990

Thyroid hormone replacement and growth of children with subclinical hypothyroidism and diabetes.

Growth potential among people with Type 1 diabetes and subclinical hypothyroidism may be significantly reduced. Growth was evaluated in 25 children with diabetes who had thyromegaly and elevated thyrotrophin (TSH) levels. All patients appeared clinically euthyroid except for four with short stature. Basal growth rate was significantly lower (p less than 0.005) in Group 1 (TSH greater than 50 mU l-1) and Group 2 (TSH level 10.1-50 mU l-1) than in patients with TSH levels between 5 and 10 mU l-1 (Group 3) or control diabetic children. Serum thyroxine (T4) levels were significantly lower (p less than 0.05) in Group 1 than in Groups 2 or 3. Significant improvement in growth velocity after thyroxine treatment was observed in Group 1 patients compared with those in Groups 2 or 3 (p less than 0.05). More prepubertal test children demonstrated improved growth after beginning thyroxine compared with matched diabetic controls (p less than 0.02). Postpubertal subjects treated with thyroxine did not show significant differences in growth velocity compared with controls. Z-scores for height were not different (p greater than 0.05; ANOVA) between control and test patients for any of the groups. Early detection of subclinical hypothyroidism by thyromegaly, reduced growth velocity, and elevated TSH levels, with institution of thyroxine treatment, can improve growth in prepubertal diabetic children.

Adolescent↗
PubMed1989

Zinc supplementation in infants with a nutritional pattern of failure to thrive: a double-blind, controlled study.

The objective of this study was to determine whether zinc deficiency is one of the factors involved in nutritional failure to thrive in infants and toddlers. Participants were selected on the basis of anthropometric criteria, particularly a decline in weight velocity preceding changes in length gains. The investigation was designed as a double-blind, randomized, pair-matched, controlled study of dietary zinc supplementation of 6 months' duration. Anthropometric data were collected at 0, 1, 3, and 6 months. Twenty-five pairs of infants completed the project. When compared with placebo-treated control children, the zinc-supplemented group (combined sexes) and the supplemented boys showed significant improvements in standard deviation scores for weight for all three intervals, the largest differences occurring for the 0- to 3-month interval (P less than or equal to .0001). The zinc-supplemented girls demonstrated a trend toward improvements in changes in standard deviation scores for weight (P = .056). There were no differences in length gains for either boys or girls. This improvement in weight gains after zinc supplementation demonstrates that mild zinc deficiency can be one of the etiologic factors in nutritional failure to thrive during infancy.

Body Height↗
PubMed1984

Increased food intake of young children receiving a zinc supplement.

Food intake was calculated in 30 young children with evidence of mild zinc deficiency. In a double-blind controlled study of one year's duration, the test children (n = 15, including ten boys) received a zinc supplement (average, 4.2 mg/day), and the controls received a placebo syrup. Increases during the study period in calculated intakes of energy, protein, and nine other nutrients were attributable to the zinc supplementation. A significant treatment effect on nutrient intakes was also observed for the boys but not for the girls. Calculated daily energy intakes of the test boys increased from an initial mean of 1,280 kcal (88% Recommended Dietary Allowance [RDA] ) to a final mean of 1,880 kcal (118% RDA). Zinc deficiency should be considered in the differential diagnosis of anorexia in young children.

Anorexia↗
PubMed1983

Linear growth of low income preschool children receiving a zinc supplement.

The effects of a zinc supplement on growth velocity were assessed in a double-blind, pair-matched controlled study in 40 children with low growth percentiles. Participants were low-income Spanish-American children, 2 to 6 yr of age with heights below the 10th percentile and nutritional or biochemical evidence of zinc deficiency. After 1 yr, the mean height velocity of the zinc-supplemented children was slightly, but significantly (p less than 0.005), greater than that of control children. This effect was primarily due to a greater height achievement of the zinc-supplemented boys. Increases in height-for-age z-scores were also significant for the supplemented males (p less than 0.001) and for the combined sexes (p less than 0.05). This study indicates the existence of a growth-limiting syndrome of mild zinc deficiency in children.

Anthropometry↗
PubMed1981

Availability of zinc: loading tests with human milk, cow's milk, and infant formulas.

Uptake of zinc with human milk, cow's milk, and four infant formulas investigated using a standard zinc loading test. Female subjects consumed 25 mg of zinc with the milk or formula, the amount of which was calculated to provide 5 gm of protein, after an eight-hour fast. Blood samples were taken prior to (base line) and at 30-minute intervals for three hours after consumption of zinc. Plasma zinc response was calculated as the area under the curve change in plasma zinc from the base line value, plotted against time over three hours. The plasma response with human milk was significantly greater (P less than .005) than with cow's milk and all the formulas. The response with cow's milk and a cow's milk-based formula was one third that with human milk; responses with a soy-based and two casein hydrolysate-based formulas were lower. These results are compatible with the concept, strongly suggested by indirect evidence, that the bioavailability of zinc with human milk is better than with cow's milk or infant formulas.

Animals↗
PubMed1980

Prostaglandins in human duodenal secretions.

Prostaglandins E1, E2 and F2 alpha were measured in duodenal secretions from two healthy, fasting male subjects. Secretions were collected by duodenal intubation prior to, and following, stimulation by secretin and cholecystokinin. Prostaglandins were measured with a radioimmunoassay technique. The ranges of concentrations found were PGE1: 2.4-110 ng/ml, PGE2: 0.004-1.51 ng/ml, and PGG2 alpha: 0.44-14.6 ng/ml.

Adult↗
PubMed1980

Molybdenum in the diet: an estimate of average daily intake in the United States.

Previous studies have estimated the average intake of molybdenum (Mo) from the diet at approximately 300 to 400 micrograms/day. Foods collected in a grocery basket sampling program were analyzed for Mo content. The Mo concentration of these foods was combined with published United States Department of Agriculture estimates of food consumption to estimate the average daily dietary intake of Mo in the United States. This estimate is less than those previously reported and varies between 120 and 240 micrograms Mo/day, depending on age, sex, and income.

Adolescent↗