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R Bernstein

Publications and source records attributed to R Bernstein.

188 records · Page 11Linked to original sources
PubMedDate not supplied

Feasibility of improved blood glucose control in patients with insulin-dependent diabetes mellitus.

An attempt was made to improve the control of blood glucose in patients with insulin-dependent diabetes mellitus. Ten patients were studied over a period exceeding 8 mo in the outpatient department. Each patient was taught to monitor his or her own blood glucose concentration and was enrolled in an exercise program. In addition, they were taught to calibrate insulin, food, and exercise in terms of the response of the blood glucose. After 3 mo of study, there was a significant decrease in hemoglobin A1c (Hb A1c) values from a mean concentration of 10.3 to 7.6%. Hb A1c values correlated well with mean blood glucose levels (r = 0.86). Dietary analysis revealed that the patients selected a diet consisting of 25% protein, 44% fat, and 31% carbohydrate, but there was a wide range in caloric distribution. There was no correlation between blood glucose control as measured by Hb A1c and caloric distribution. Systolic blood pressures decreased greater than 10 mm Hg. Serum alkaline phosphatase also decreased in each patient as control of blood glucose improved. Three of the patients with abnormalities of nerve conduction measurement at the beginning of the study had a complete return to normal at 8 mo. An outpatient program such as this may be cost effective through the avoidance of diabetes-related hospitalizations and may provide a mechanism whereby larger studies can be designed to define further the relationship of glycemia to the sequelae of diabetes.

Blood Glucose↗
PubMedDate not supplied

Effect of blood glucose control on retinal vascular permeability in insulin-dependent diabetes mellitus.

Thirteen patients were instructed in a technique of self-management of insulin-dependent diabetes mellitus, using multiple home-monitored blood glucose determinations and multiple injections of regular insulin in conjunction with once-daily Ultra Lente insulin. Hemoglobin A1c and quantitative fluorescein fluorophotometry were used to assess blood glucose control and retinal permeability, respectively. In those patients achieving normal blood glucose control, retinal vascular leakage was statistically identical to that of a nondiabetic control population. In those patients less well controlled, retinal permeability did not differ statistically from values observed in a population of insulin-dependent diabetic patients under "standard" control. It is concluded that with "tight" control of blood sugar and normalized A1c hemoglobin, retinal permeability similarly is normalized.

Blood Glucose↗
PubMedDate not supplied

ASA-dipyridamole prophylaxis in elective total hip replacement.

A prospective, double-blind clinical study was performed to evaluate the combination of dipyridamole 225 mg/day and acetylsalicylic acid 1 gm/day prophylaxis of postoperative venous thromboembolism in elective total hip replacement. Patients were stratified according to age, and randomly assigned to receive drug or placebo. All patients were followed with 125I-labeled fibrinogen scanning for one week postoperatively, or until fully mobile. Venography was performed in 79/132 patients; in 36 patients the venogram was obtained to confirm a positive fibrinogen scan, in 43 patients an elective venogram was obtained on the seventh postoperative day to evaluate the operated thigh (a blind area for scanning). Thrombosis (by scan or venogram) was found in 17/68 (25%) in the control group, and in 23/64 (36%) in the treated group. Overall incidence was 40/132 (30%). Correlation of scan with venography was 90%. There were no clinically significant pulmonary emboli in either group. The combination of acetylsalicylic acid (ASA) and dipyridamole as given in this study is not effective prophylaxis in elective total hip replacement.

Administration, Oral↗