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Biomedical subjects

R Miccoli

Publications and source records attributed to R Miccoli.

47 records · Page 3Linked to original sources

'Microalbuminuria' in type I (insulin-dependent) diabetic patients with and without retinopathy.

We investigated the frequency of microalbuminuria (albumin excretion rate, AER greater than 15 micrograms/min) ('overnight' urine collection and radioimmunological evaluation) and its relation to retinopathy (assessed by fluorangiography) in 113 type I (insulin-dependent) diabetic subjects (aged 31 +/- 13 years; diabetes duration 11 +/- 7 years), all Albustix-negative. Sixty eight patients (60.2%) were free of retinal lesions, 31 (27.4%) had background retinopathy and 14 (12.4%) had proliferative retinopathy. Microalbuminuria was found in 25 patients (22%). Fifteen patients (13%) showed both retinopathy and microalbuminuria. Fifteen % (10/68) of the patients with no retinopathy and sixteen % (5/31) of those with background retinal lesions had microalbuminuria, while 29% (4/14) of the patients with proliferative retinopathy were normoalbuminuric. Among the 29 patients with diabetes for less than five years, 1 had retinopathy and 4 had microalbuminuria. Out of 15 patients with both retinopathy and microalbuminuria, 13 (87%) had had diabetes for more than 10 years. Diabetic retinopathy is more frequent than microalbuminuria (40 vs 22%). Although the linkage between retinopathy and microalbuminuria is weak, after ten years of diabetes the two complications may frequently coincide.

Adolescent↗

Metabolic control affects plasma lipid and apolipoprotein levels in women, but not in men, with IDDM.

In order to evaluate if in insulin-dependent diabetes lipid and apolipoprotein levels are differently affected by metabolic control in men and women, we measured the concentrations of fasting plasma glucose, mean plasma glucose, glycosylated hemoglobin, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and apolipoproteins A and B in 94 sex matched patients. Diabetic men and women were strictly comparable as far as age, relative body weight and metabolic control were concerned. In women, total and LDL cholesterol, triglycerides and apolipoprotein A correlated positively with HbA1 but not with fasting and mean plasma glucose. In men, no correlation between metabolic control and lipid and apolipoprotein levels was found. We conclude that, in diabetic women, the degree of metabolic control may affect the concentrations of plasma lipids, thus explaining, at least in part, the increased risk for coronary atherosclerosis in these patients.

Adult↗

Individual teaching as a first-step intervention for the education of diabetic subjects.

The effects of individual teaching imparted during routine diabetologic counselling on the knowledge concerning diabetes and metabolic control, were assessed in 42 outpatients (28 IDDM; 14 NIDDM), attending the diabetic clinic (study group, SG). We evaluated the outcome of a multiple-choice questionnaire and fasting blood glucose (FBG), 24-h urine glucose (UG), mean regulation index (MRI) and glycated hemoglobin (HbA1), before and 60 days after providing information about diet (D), physical exercise (E) and hypoglycemic drugs (HD) or insulin therapy (IT). Results were compared with those obtained in a group of 57 age- and sex-matched patients (36 IDDM; 21 NIDDM) who did not receive individual teaching (control group, CG). Knowledge concerning diabetes at the second evaluation was significantly higher (p less than 0.001) in SG than in CG for D and IT, although an improvement was observed in all items. SG patients showed a significant improvement of knowledge (p less than 0.05) for D, a not significant improvement for HD and IT and no change for E. No change was observed for HbA1, MRI and UG, while a significant decrease (p less than 0.05) was observed for FBG in SG. At the second evaluation, FBG of SG patients was significantly lower (p less than 0.05) than that of CG patients. Our results go to show that individual teaching can improve the level of knowledge of patients without affecting metabolic control. Individual teaching during routine diabetologic counselling represents in our opinion an effective and economic educational model.

Adolescent↗

Effects of guar-pasta on serum lipid levels in obese diabetic and non-diabetic women with normal lipids.

Alternative medications for hyperlipidemia management have been continuously searched for above all because currently employed drugs appear not to be effective or are poorly tolerated. Fibers, such as guar-gum, seem to be able to reduce cholesterol levels, but their extensive and long-term use is beset by the high incidence of gastrointestinal side-effects. In this study the administration of guar-enriched pasta has proved to reduce fasting and post-prandial cholesterol levels significantly in 15 obese normocholesterolemic women (5 diabetics and 10 non-diabetics). The women reported good palatableness of guar-pasta without any side-effects.

Adult↗

[Integrin Beta 3 PlA1/PlA2 polimorphism does not contribute to complications in both type 1 and type 2 diabetes].

BACKGROUND: The glycoprotein IIIa (beta3 integrin) is an integral part of two glicoprotein receptors of platelets and, respectively, endothelium and vascular smooth muscle cells. The gene encoding the GPIIIa, a receptor for fibrinogen, vWF and fibronectin, shows polymorphism (PlA1/PlA2); the PlA2 allele has been associated with myocardial infarction, stroke and cardiovascular disease. METHODS: Seven hundred and thirty-two subjects with type 1 diabetes and 605 subjects with type 2 were recruited. The prevalence of complications in type 1 diabetes was: microalbuminuria (uA) 17%, overt nephropathy (MA) 10%; background retinopathy (bR) 27%, proliferative retinopathy (pR) 22%; hypertension (HYP) 13%; coronary heart disease (CHD) 9%. The respective figures for type 2 diabetes were: uA 34%, MA 21%; bR 38%, pR 18%; HYP 80%; CHD 26%. A 247 bp fragment (exon 2) was amplified by PCR. For the detection of the point mutation CDGE (Constant Denaturing Gel Electrophoresis) after optimum denaturing conditions setting by DGGE (Denaturing Gradient GE) and/or RFLP by NciI digestion were employed. RESULTS: In type 1 diabetes, PlA1PlA1/PlA1PlA2 distribution was 77/23%. No differences were found among normoalbuminuric (nA: 76/24%), microalbuminuric (uA: 79/21%) and macroalbuminuric subjects (MA: 75/25%, p=0.79) as well as among subjects with no retinopathy (Ret-) (74/26%), bR (76/24%) and pR (78/22%, p=0.81), and between HYP- (78/22%) and HYP+ (72/28%, p=0.27) as well as CHD- (76/24%) and CHD+ (75/25%, p=0.72). Systolic blood pressure, HbA1c and retinopathy were independent predictors of nephropathy. No contribution of diastolic BP, sex, BMI, duration of diabetes and PlA2 allele was found for the risk of nephropathy. In type 2 diabetes, PlA1PlA1/PlA1PlA2/PlA2PlA2 distribution was 74.4/23.3/2.3%, with no differences foud among nA (73/25/2%), uA (75/23/2%) and MA (81/17/2%, p=0.66). No significant difference was detected among subjects with Ret- (74/22/4%), bR (77/22/1%) and pR (77/22/1%, p=0.62). Also, no differences were found between HYP- (81/17/2%) and HYP+ (74/24/2%, p=0.28) as well CHD- (76/22/2%) and CHD+ (74/24/2%, p=0.93). Systolic BP, HbA1c, presence of retinopathy, gender and BMI were independent predictors of nephropathy. Diastolic BP, duration of diabetes and PlA2 allele did not contribute to the risk of nephropathy. CONCLUSIONS: The PlA1/PlA2 polymorphism of the GPIIIa gene does not contribute to the development of nephropathy or retinopathy in type 1 and type 2 diabetes. Furthermore, no association was found between the PlA1/PlA2 polymorphism, hypertension, and coronary heart disease.

Adult↗

Prevalence of sexual dysfunctions in non-insulin dependent (type II) diabetic males.

Since previous papers about the frequency of sexual dysfunctions (SD) in diabetic males did not consider the genetical and clinical heterogeneity of diabetes mellitus, we studied the prevalence and the pathogenesis of SD in 77 non insulin dependent diabetics (NIDD). The diagnostic procedures consisted of physical and psychological examinations, compilation of a questionnaire, evaluation of autonomic and peripheral nervous systems, measurement of penile arterious flow, dosage of hormonal and metabolic parameters. SD were present in 52% of patients: 24% of them had organic impotence, 28% psychological sexual impairment. Age, duration of diabetes and metabolic control were superimposable in the patients with and without SD. Most patients with organic impotence had an alteration of parasympathetic nervous system; less frequently a reduced penile arterious flow was observed. The relief of such a high prevalence of SD in NIDD males suggests that future studies should consider the various groups of diabetics separately.

Adult↗

A computerized information system for diabetes services.

The utilization of a computer-assisted information system may be both useful and efficacious in the care and follow-up of diabetic patients. The model developed by us operates under GCOS-6 on a Microsystem 6/10 Honeywell computer (20 MB hard-disk storage, 512 kb central memory) and allows the creation of clinical data files for individual patients, statistical analysis of the data, and a print-out of clinical records. The package, which may be employed on a multi-user system, is supplied with an easy to understand user's manual. It represents an effective tool for the precise management of the care of diabetic patients and also provides several opportunities for research.

Diabetes Mellitus↗