Optimal and early control of recent onset, type I diabetes by intensive insulin therapy has been reported to allow insulin withdrawal in about two thirds of subjects treated. We used continuous s.c. insulin infusion (CSII) in the attempt to induce a temporary remission of insulin dependence in 18 newly diagnosed young adult diabetics. After 10 days of optimized glycometabolic control, insulin infusion was stopped and patients were switched to glibenclamide (15 mg/die) plus metformin (1 g/die). Diabetics were considered in remission of insulin dependence when their metabolic control fulfilled the following criteria for at least 3 months: absence of glycosuria, pre- and post-prandial blood glucose less than or equal to 120 and 180 mg/dl, respectively, HbA1c less than or equal to 7%. Insulin therapy could be discontinued for periods of over three months in 11 subjects (61%) and for as long as 18 months in one case. Insulin requirement during CSII was slightly higher in nonremitters (NR) than in remitters (R): 0.36-0.64 vs 0.26-0.41 U/kg/die. After 24 months from CSII, R still showed lower insulin requirement (0.35-0.42 U/kg/die) than NR (0.55-0.75 U/kg/die). Further, the role of some hormonal and immunologic factors was investigated. Plasma C-peptide and glucagon were measured, fasting and 2h after each meal, both on admission and immediately after CSII, when patients were switched to oral therapy. No difference in hormone levels could be detected on admission, whereas, after CSII, mean post-prandial increase of C-peptide over basal was significantly higher in R than in NR (1.18 +/- 0.37 vs 0.22 +/- 0.16 ng/ml, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Somatomedin-C (SM-C). Study in diabetic patients with and without retinopathy.

In the present study we evaluated somatomedin-C (Sm-C) plasma levels in diabetic patients, with and without retinopathy. One hundred and thirty four diabetic patients (65 type I and 69 type II) and 90 controls, strictly matched for age and sex, were enrolled in the study. Ophthalmoscopy and fluorescein angiography allowed to distinguish: 49 patients without retinopathy, 45 patients with background retinopathy, and 40 with proliferative retinopathy. Growth hormone (GH) and Sm-C plasma levels were measured using a pool of 20-24 blood samples over 24h. Sm-C levels in type I (0.62 +/- 0.11 U/ml) and type II (0.56 +/- 0.09 U/ml) patients were significantly decreased (p less than 0.01) when compared to controls (0.89 +/- 0.30 U/ml). The mean daily secretion of GH was significantly (p less than 0.01) greater in diabetic patients (7.8 +/- 2.6 ng/ml) than in controls (4.1 +/- 1.5 ng/ml), but no correlation was found between Sm-C and GH (r = 0.15; p = n.s.). Our findings did not show any correlation between Sm-C plasma levels and either the existence of retinopathy, regardless of the degree of microvascular damage, or duration of the disease, or degree of metabolic control, as evaluated by HbA1c.

Blood Glucose↗

PubMedDate not supplied

Duration of residual B-cell function in maturity-onset diabetes.

In order to evaluate factors influencing the duration of residual B-cell function in maturity-onset diabetics we investigated 104 patients (age 60 +/- 11 years) with a mean duration of disease of 11.3 +/- 8.7 years by measuring fasting C-peptide (FCP) and fasting blood glucose levels (FBG), C-peptide increment after a standardized breakfast and both mean diurnal plasma glucose (MBG) and mean diurnal C-peptide levels (MCP). C-peptide levels were found to be reciprocally dependent on both the age at onset (positively) and, conversely, on the duration of diabetes (y = 0.75 + 0.026x1-0.049x2; R = 0.52, t1 = 2.76, t2 = -4.08). In particular, the present B-cell secretory capacity appears to be lower the younger the patients were at onset, thus suggesting that inherent impairment of B-cell capacity may play a crucial role in determining age at onset of type II diabetes and thus the duration of their residual B-cell function. Moreover, by analyzing separately the data from patients treated with insulin and oral agents respectively, we found that the influence of the duration of the disease on the rate on B-cell exhaustion is unrelated to the mode of treatment even though B-cell capacity at onset appears to be more severely reduced in insulin-treated subjects who, apart from anything else, were younger at onset.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMedDate not supplied

Plasmatic levels of fibronectin in diabetics with and without retinopathy. Correlation with some hormonal and metabolic parameters.

Fibronectin is a high molecular weight alpha-2-glycoprotein. Its peculiar role in the structure of connective tissue, together with its wide involvement in coagulative dynamics, justified the increasing interest for fibronectin in the pathogenesis of diabetic disease and its vascular sequelae. In the present work, we evaluated the levels of plasma fibronectin (PF) in diabetics with and without retinopathy, and studied the possible correlation between the glycoprotein and some hormonal and metabolic parameters, expression of glycometabolic balance. We examined 26 type I and 24 type II diabetics, further divided into retinopathics and not retinopathics, and 43 normal subjects. We did not find any significant difference in PF levels either between normals and diabetics, or between type I and type II patients, or between retinopathics and not retinopathics. PF was significantly correlated to age, both in normals and in diabetics. Diabetic patients showed a significant positive correlation of PF to total cholesterol (r = 0.56; p less than 0.05) and triglycerides (r = 0.36; p less than 0.05). This seems to suggest, although indirectly, the existence of a relationship between the levels of PF and the degree of large vessel involvement. No significant correlation was found with HbA1c, beta-OH, AcAc, lactate, pyruvate, C-peptide, total and free insulin or GH. We further indicated an inverse correlation between PF and plasma glucagon (IRG). Very low levels of PF are commonly associated with high IRG plasma values during acute energy deprivation such as prolonged fasting and ketoacidotic coma. Therefore, PF levels might represent an index of latent to overt energy depletion.

Adult↗

PubMedDate not supplied

In vitro secretion of interleukin-1 beta and interferon-gamma by peripheral blood lymphomononuclear cells in diabetic patients.

There is evidence that cytokines, in particular interleukin-1 beta (IL-1 beta) and interferon-gamma (IFN-gamma) might mediate beta cell destruction in type 1 diabetes. Therefore the secretion of these cytokines by peripheral blood lymphomononuclear cells (PBMNC) was investigated in basal conditions and 48 h after stimulation with T-cell mitogen phytohaemagglutinin (PHA) in 33 diabetic patients and in 10 normal controls. The patients were divided in 4 groups (Group 1, 10 controls; Group 2, 13 newly diagnosed type 1 diabetics, the onset had occurred from 5 days to 3 months before the study; Group 3, 10 Long Standing (LS) type 1 diabetics with duration of the disease between 2 years and 10 years; and Group 4, 10 type 2 diabetics). No difference was found among the 4 groups considered in IL-1 beta secretion by unstimulated cultures, although the percentage of TAC+ cells was significantly higher in type 1 newly diagnosed diabetic patients with respect to the LS, the type 2 diabetics and the controls. After PHA stimulation a significant increase of IL-1 beta was found in newly diagnosed type 1 diabetic patients in comparison with the control subjects, the LS and type 2 diabetic patients (P < 0.001). The supernatants of newly diagnosed type 1 diabetics also showed a significant reduction in IFN-gamma production both in basal (P < 0.01) and in stimulated conditions (P < 0.001) in comparison with the controls, the LS (P < 0.002 in basal, and P < 0.001 in stimulated conditions) and the type 2 diabetic patients (P < 0.001 both in basal and stimulated conditions).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Sperm count suppression without endocrine dysfunction in lead-exposed men.

To determine if increased lead absorption was associated with sperm count suppression or perterbation of the hypothalamopituitary system, we compared battery workers (N = 18), who were exposed to high airborne lead levels, with cement workers (N = 18), who were exposed to ambient lead levels. Blood lead, urinary lead, semen lead, and zinc protoporphyrin concentrations were markedly elevated (p less than .001) in battery workers. Battery workers had a significantly shifted (p less than .025) frequency distribution of sperm count (median count, 45 vs. 73 X 10(6) cells/cc, respectively). There were no significant differences between the two groups in mean follicle-stimulating hormone, testosterone, prolactin, luteinizing hormone, or total neutral 17-ketosteroid levels. Potential confounding factors (alcohol, cigarette, and coffee consumption, frequency of intercourse, and days of abstinence prior to semen donation) were not significantly different between the two groups. These results suggest a direct toxic effect of increased lead absorption on sperm production or transport in man.

Alcohol Drinking↗

PubMedDate not supplied

Sperm count suppression without endocrine dysfunction in lead-exposed men.

Adult↗

PubMedDate not supplied

Circannual rhythms in reproductive functions of human males, correlations among hormones and hormone-dependent parameters.

In a longitudinal study one healthy man aged 26 yrs underwent semen collections and blood samplings at monthly interval from January to December 1985. The ejaculated samples were analyzed for sperm density, motility, relative proportion of early (ab) and late (cd) spermatids, concentrations of Fructose, L-Carnitine and Transferrin. In a transverse study, 248 serially independent samplings were performed of normal men, 28.9 +/- 7.5 yrs old, consulting for infertility from January 1981 to December 1983. The Cosinor method was employed for searching on circannual rhythms of the studied parameters. The longitudinal study did not detect circannual rhythms of the considered seminal parameters nor of the studied hormones. However, peaks, significantly above the mean values throughout the year (p less than 0.005), were observed of Cortisol, PRL, FSH, LH, Testosterone, Fructose and L-Carnitine levels. Young spermatids and sperm motility showed significant (p less than 0.001) acrophases between June and July; an acrophase was also evident for late spermatids but shifted by six months, between December and January. Mesors and amplitudes were respectively: 28 +/- 1.5 and 9.6 +/- 4.3 (mean +/- SE) for motility; 33.4 +/- 1.6 and 9.9 +/- 5 for early spermatids; 46.6 +/- 1.9 and 13 +/- 6.2 for late spermatids.

Adult↗

PubMedDate not supplied

Exploration of the testis in infertile men. Relationships among serum levels of FSH, LH, 17-alpha-OH-progesterone and testosterone.

A considerable body of evidence is available indicating a paracrine relationship between the seminiferous tubules and the Leydig cells. In 113 adult subjects in basal conditions the blood levels were determined of FSH (follicle stimulating hormone), LH (luteinizing hormone), 17-alpha-OH-P (17-alpha-OH-progesterone) and T (testosterone) either as a whole or as a free fraction. According to the sperm counts and the FSH levels, the studied subjects were divided into three groups: a group N (Normozoospermia) with sperm counts greater than 20 million/ml and FSH levels of 2.5 +/- 1.5 (mean +/- SD, mIU/ml), a group MO (moderate oligozoospermia) with mild degree of oligozoospermia (5-10 mill) and FSH levels in the range found in group N, a group SO (severe oligozoospermia) with severe degree of oligozoospermia (sperm count less than 5 mill/ml) and FSH levels greater than 2 SD the mean value in the N. Serum levels of LH, 17-alpha-OHP, total T, free T and FSH/LH, LH/T, 17-alpha-OHP/T ratios in group MO and SO were compared with those found in the group N.(ABSTRACT TRUNCATED AT 250 WORDS)

17-alpha-Hydroxyprogesterone↗