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Biomedical subjects

P Raskin

Publications and source records attributed to P Raskin.

At least 109 records · Page 6Linked to original sources
PubMed1981

The effect of chronic insulin therapy on phosphate metabolism in diabetes mellitus.

Plasma and urine phosphate concentrations were improved in 21 patients with diabetes mellitus during "optimal" metabolic control as compared with "suboptimal" control. During the "suboptimal" control phase the daily insulin dosage averaged 38 +/- 22 (SD) U/day and the mean plasma glucose levels averaged 17.1 +/- 1.8 mmol/l, while during the "optimal" control phase the daily insulin dosage averaged 84 +/- 59 U/day and the mean plasma glucose level was 6.2 +/- 1.4 mmol/l. The institution of rigid diabetic control over 4-10 days significantly raised serum phosphorus from 1.12 +/- 0.16 to 1.26 +/- 0.19 mmol/l (p less than 0.001), and decreased urinary phosphorus excretion from 686 +/- 125 to 588 +/- 88 mg/day (p less than 0.001). These changes were associated with significant reductions in urinary calcium, urinary glucose, plasma immunoreactive glucagon and serum parathyroid hormone. This diminution in urinary phosphorus loss may have been due to diminished glycosuria but equally could have been influenced by a direct action of insulin on the renal tubule or suppression of glucagon and parathyroid hormone secretion. Under the conditions of this study, reduced urinary phosphorus may have been sufficient to cause a rise in serum phosphorus despite the known effects of insulin on the cellular influx of phosphorus.

Adolescent↗
PubMed1981

Plasma lipid and lipoprotein levels with continuous subcutaneous insulin infusion in type I diabetes mellitus.

Plasma lipid and lipoprotein-cholesterol levels were measured in 10 insulin-dependent (Type I) diabetics taking their usual dose of conventionally administered insulin during 6 months of a continuous subcutaneous insulin infusion delivered with a small, portable, battery-powered pump. With this insulin delivery system we were able to provide near normal glucoregulation 24 hours a day for the entire study. This improved glucoregulation resulted in significant reductions in total plasma cholesterol and triglyceride, and very low density and low density lipoprotein-cholesterol levels within 2 to 4 weeks of treatment. These changes persisted for the entire 6 months of observation. High density lipoprotein-cholesterol levels rose significantly after 2 months of treatment and continued to increase during the 6-month study. These changes in plasma lipid and lipoprotein-cholesterol levels in response to treatment with continuous subcutaneous insulin infusion would favorably alter the predicted risk for the development of premature atherosclerosis in these patients.

Adolescent↗
PubMed1980

A simple and reliable method for calcium balance using combined period and continuous fecal markers.

Calcium balances were determined in 13 patients during 2--4 3-day periods following both period marking (with carmine) and continuous marking (with polyethylene glycol or chromium). The reliability coefficient for the uncorrected fecal calcium (obtained from period marking) from one period to another was 0.82, whereas it was 0.97 for corrected fecal calcium (determined from recovery of continuous marker in 3-day fecal pools). Thus, the addition of continuous marking yielded a significantly more reliable measure of fecal calcium than obtainable by the use of period marking alone (p < 0.05); the error variance for corrected fecal calcium from one period to another was 3%, whereas it was 18% for uncorrected fecal calcium. It is concluded that a reliable measure of fecal calcium, and hence calcium balance, could be obtained by combined use of continuous and period markers, involving fecal collection over only one 3-day study period (marked by period marker), and correction of fecal calcium for the completeness of fecal collection (determined from continuous fecal marker).

Adult↗
PubMed1980

Metoprolol in diabetes mellitus: effect on glucose homeostasis.

1. In eight hypertensive diabetic subjects receiving hydrochlorothiazide, glucose homeostasis as measured by the changes in plasma glucose, insulin and glucagon after an oral glucose load was not significantly affected by 8 weeks of therapy with metoprolol. 2. The combination of metoprolol plus hydrochlorothiazide significantly lowered blood pressure in all subjects. 3. Plasma renin activity was suppressed by therapy with metoprolol.

Aged↗
PubMed1980

The effect of improved diabetic control on plasma lipid and lipoprotein levels: a comparison of conventional therapy and continuous subcutaneous insulin infusion.

We studied short-term changes in plasma lipid levels in type I diabetics treated with either a conventional insulin regimen or continuous subcutaneous insulin infusion. Mean plasma glucose dropped from 260 +/- 18 to 134 +/- 8 mg/dl when conventional treatment was used and from 194 +/- 18 to 108 +/- 8 mg/dl with CSII. Both forms of therapy were associated with a significant fall in plasma triglyceride levels. However, only CSII treatment produced significant changes in total plasma cholesterol and LDL cholesterol levels. Total cholesterol fell from 195 +/- 17 mg/dl to 161 +/- 11 mg/dl and LDL cholesterol fell from 129 +/- 13 mg/dl to 102 +/- 9 mg/dl. We conclude that improved diabetic control by any method is effective in lowering plasma triglyceride levels, but it requires almost perfect metabolic control to affect plasma cholesterol and LDL cholesterol levels. The changes in plasma lipid and lipoprotein achieved with CSII may favorably alter the prediction for the development of premature atherosclerosis in our patients.

Adult↗
PubMed1980

Effect of streptozotocin-induced diabetes on renal ornithine decarboxylase activity.

The effects of streptozotocin(SZ)-induced diabetes on renal ornithine decarboxylase (ODC) activity, the rate-limiting enzyme in polyamine biosynthesis, were studied. Sixteen hours after the injection of SZ, renal ODC activity increased 50% above that of the vehicle-injected controls. The maximum increase in activity--600%--was observed from 24 to 72 h after SZ. Within a week, ODC activity fell below control levels and remained suppressed during a 3 wk follow-up period. Insulin treatment within 10 h of the SZ injection prevented the increase of ODC activity; however, insulin given after enzyme activity had increased did not restore ODC activity to control levels. The early increase of ODC activity occurred in the presence of mild hyperglycemia without ketosis or hyperglucagonemia, but the levels were much higher in severely diabetic animals. Adrenalectomy, performed before the initial increase in enzyme activity, prevented the subsequent increase in diabetic animals; however, when adrenalectomy was performed after the enzyme had increased, enzyme activity did not normalize.

Adrenalectomy↗
PubMed1980

Changes in nerve conduction velocity after six weeks of glucoregulation with portable insulin infusion pumps.

Near normal glucoregulation was maintained in 10 patients with insulin-dependent (type I) diabetes mellitus for 6 wk with preprogrammed continuous subcutaneous insulin infusion using a portable battery-powered infusion pump (CSII). This form of therapy resulted in a statistically significant increase in motor nerve conduction velocity in the median and peroneal nerves compared with baseline values. There was no significant change in the motor nerve conduction velocity in the ulnar nerve or in the sensory nerve conduction studies. No changes occurred in five additional patients studied in similar fashion while on a conventional insulin regimen. These results suggest that the prevention of sustained hyperglycemia with CSII could theoretically result in the prevention of diabetic neuropathy. However, only long-term studies of CSII will provide the information necessary to determine the clinical relevance of the findings.

Artificial Organs↗
PubMed1980

Effect of somatostatin infusion on jejunal water and electrolyte transport in a patient with secretory diarrhea due to malignant carcinoid syndrome.

The effect of intravenous somatostatin infusion was investigated in a patient with severe secretory diarrhea due to malignant carcinoid syndrome. Continuous somatostatin infusion for 48 hr (4 microgram/kg/hr) reduced stool volume from 2.2 to 0.7 liters/day. Intestinal perfusion studies before intravenous somatostatin infusion revealed decreased water and sodium absorption and jejunal chloride secretion. Somatostatin infusion for 2 hr (8 microgram/kg/hr) reversed chloride secretion to absorption and markedly enhanced water and sodium absorption. These results suggest that somatostatin inhibited a secretory component of water and ion movement in the small bowel of the patient with malignant carcinoid syndrome.

Aged↗
PubMed1979

Somatostatinoma syndrome. Biochemical, morphologic and clinical features.

Diabetes mellitus, steatorrhea, cholelithiasis and a tumor distorting the duodenum prompted a work-up for somatostatinoma in a 52-year-old man. The responses of pancreatic B-cells but not of A-cells to nutrient stimuli were inhibited, and growth-hormone release was suppressed, suggesting somatostatin resistance in some target tissues. Plasma somatostatin-like immunoreactivity ranged from 9000 to 13,000 pg per milliliter (normal: 88+/-8, mean +/- S.E.M.) and was distributed in four molecular forms, including free somatostatin. The primary tumor contained 5 microgram of somatostatin-like immunoreactivity per milligram of wet tissue, distributed in three of the molecular forms noted in plasma. Plasma calcitonin was also elevated (4650 pg per milliliter; normal: less than 120). Immunocytochemical studies showed that cells of the primary tumor contained somatostatin and calcitonin but no other peptide hormones. Only somatostatin was present in the metastases. Somatostatin was localized electron microscopically in all secretory granules, irrespective of size and shape, whereas calcitonin was present only within a single subpopulation of small granules in the same cells.

C-Peptide↗
PubMed1979

Treatment of diabetes mellitus: the future.

For more than half a century the management of hyperglycemia in diabetes mellitus has included rigid diets and intermittent subcutaneous insulin administration. These methods have been totally unsuccessful in restoring glucose homeostasis to normal in most diabetic patients. This review focuses on techniques that offer promise as alternatives or adjuncts to the current modalities of treatment. Specific areas discussed include pancreatic transplantation, islet cell transplantation, artificial beta cell devices, and the glucagon-suppressing agent somatostatin. Although many of these show promise for the future, a cure for the metabolic abnormalities of diabetes is not imminent.

Adult↗
PubMed1979

Effects of insulin on the response of immunoreactive glucagon to an intravenous glucose load in human diabetes.

The effects of exogenous insulin upon the response of immunoreactive glucagon (IRG) to i.v. glucose were studied in diabetic and nondiabetic subjects. In nondiabetics, a rapid injection of 25 g of glucose lowered plasma IRG levels. In adult-onset diabetics, the glucose-induced decline in IRG was normal despite a subnormal glucose-induced insulin rise, in contrast to impaired IRG suppressibility previously reported when such patients received an oral glucose load. The magnitude of their glucose-induced IRG decline was not augmented by exogenous insulin, even when insulin levels were acutely raised above 300 micro units/ml. In juvenile-type diabetics, basal IRG levels were normal following overnight insulin infusion, but the glucose-induced IRG decline was only half that of the nondiabetics. However, it became normal when hyperinsulinemia was acutely produced by supplementary insulin. Thus, whenever insulin levels rise in response to an increase in hyperglycemia, as they do spontaneously in nondiabetics and in adult-type diabetics and as they do when juvenile diabetics are given supplementary insulin together with the glucose bolus, the decline in IRG in response to an i.v. glucose load is as great as in nondiabetics. The findings are compatible with the view that glucose-induced suppression of IRG may require a concomitant rise in insulin.

Adult↗
PubMed1979

Changes in glucagon levels after four to five weeks of glucoregulation by portable insulin infusion pumps.

Near-normal glucoregulation was maintained in five patients with juvenile-onset diabetes mellitus for 4--5 wk with a preprogrammed, continuous, subcutaneous insulin infusion using a portable battery-powered infusion pump. This form of therapy significantly lowered immunoreactive glucagon (IRG) levels below those observed while on conventional insulin treatment at several times during the 24-h profile. The maximum IRG levels were also reduced in all five subjects. Thus, a flexible system of insulin delivery, as is provided by certain open-loop pump systems, can overcome inappropriate glucagon secretion that occurs with conventional insulin therapy.

Adolescent↗