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Biomedical subjects

S Colagiuri

Publications and source records attributed to S Colagiuri.

16 recordsLinked to original sources
PubMed1992

Double-blind crossover comparison of human and porcine insulins in patients reporting lack of hypoglycaemia awareness.

There has been much debate about reports that some insulin-treated diabetic patients lose awareness of hypoglycaemic symptoms on changing from porcine to human insulin. In a double-blind, crossover study, we sought differences between porcine and human insulin in the frequency and characteristics of hypoglycaemic episodes among patients who reported a reduction of awareness of hypoglycaemia after changing treatment. We studied 50 patients referred by their physicians because of complaints of lack of awareness of hypoglycaemia on human insulin. They had had diabetes for a mean of 20 (SD 12) years and 70% had good or acceptable glycaemic control. Each patient was treated in a double-blind manner for four 1-month periods, two with human and two with porcine insulin, in random order. Only 2 patients correctly identified the sequence of insulin treatments used; 8 or 9 would have been expected to do so by chance alone. The mean percentage of hypoglycaemic episodes associated with reduced or absent awareness was 64% (SD 30%) for human insulin and 69% (31%) for porcine insulin. We could find no statistically significant differences between the insulin species with respect to glycaemic control or the frequency, timing, severity, or awareness of hypoglycaemia. Reduced hypoglycaemia awareness is common with both human and porcine insulins.

Adolescent↗
PubMed1992

Diabetes--insulins and delivery systems.

Improved shared care arrangements between general practitioner and specialist mean that more routine diabetic care should occur in a general practice setting. The author brings the general practitioner up to date on the types of insulins available and describes the most appropriate delivery systems.

Diabetes Mellitus, Type 1↗
PubMed1991

Low-glycemic index foods improve long-term glycemic control in NIDDM.

OBJECTIVE: To compare high- and low-glycemic index (GI) diets in the treatment of non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Sixteen subjects with well-controlled NIDDM and normal lipid profile, 10 of whom continued oral hypoglycemic medication, participated in the study. A diet that emphasized low-GI foods (e.g., porridge, pasta) was compared with a high-GI diet (e.g., processed cereals, potatoes). The GI of the low-GI diet was 15% lower than the high-GI diet (77 +/- 3 vs. 91 +/- 1) but otherwise similar in macronutrient composition and fiber, as determined by a 4-day weighed record. The diets were instituted under instruction from a dietitian who visited subjects at home on a weekly basis. Body weight was maintained within 1-2 kg. RESULTS: Glycemic control was improved on the low-GI diet compared with the high-GI diet (statistically significant findings, P less than 0.05). Mean glycosylated hemoglobin at the end of the low-GI diet was 11% lower (7.0 +/- 0.3%) than at the end of the high-GI diet (7.9 +/- 0.5%), and the 8-h plasma glucose profile was lower (area under the curve above fasting 128 +/- 23 vs. 148 +/- 22 mmol.h-1.L-1, respectively). Mean fasting plasma glucose, total cholesterol triglycerides, and lipoproteins did not show important differences. CONCLUSIONS: A low-GI diet gives a modest improvement in long-term glycemic control but not plasma lipids in normolipidemic well-controlled subjects with NIDDM.

Blood Glucose↗
PubMed1990

The quality of self-monitoring of blood glucose.

The accuracy of self-monitoring of blood glucose (SBGM) was assessed by a quality control programme. Ninety diabetic patients who were routinely performing SBGM were supplied with a series of quality control solutions which they tested with their usual meter and reagent strip. The overall error rate (a result outside the range of the mean +/- 3SD for each quality control solution) was 39% for users of the Ames system and 33% in Boehringer Mannheim system users. The clinical relevance of these errors was determined by examining the effect on the clinical decision which would have been based on the erroneous result, either in taking inappropriate action or in failing to take appropriate action. In 30% of all patients, 25% or more of the errors were of such a degree as to be clinically misleading. The most common error was an underestimation of the result, which gave the impression of better than actual blood glucose control. The main reason for these errors was the failure of patients to take sufficient care in following the manufacturers' instructions when performing the test. Clinically relevant erroneous results are common among patients performing SBGM.

Blood Glucose↗
PubMed1989

Metabolic effects of adding sucrose and aspartame to the diet of subjects with noninsulin-dependent diabetes mellitus.

This study compared the effects of adding sucrose and aspartame to the usual diet of individuals with well-controlled noninsulin-dependent diabetes mellitus (NIDDM). A double-blind, cross-over design was used with each 6-wk study period. During the sucrose period, 45 g sucrose (9% of total daily energy) was added, 10 g with each main meal and 5 g with each between-meal beverage. An equivalent sweetening quantity of aspartame (162 mg) was ingested during the aspartame period. The addition of sucrose did not have a deleterious effect on glycemic control, lipids, glucose tolerance, or insulin action. No differences were observed between sucrose and aspartame. Sucrose added as an integral part of the diabetic diet does not adversely affect metabolic control in well-controlled NIDDM subjects. Aspartame is an acceptable sugar substitute for diabetic individuals but no specific advantage over sucrose was demonstrated.

Aged↗
PubMed1988

Comparison of the activity of Rapitard and Actraphane insulins.

This study examined the activity of two intermediate acting premixed insulins, Rapitard and Actraphane, in non diabetic individuals using the euglycaemic clamp technique. Rapitard, a mixture of 25% soluble porcine insulin and 75% bovine insulin crystals was compared to porcine Actraphane, a mixture of 30% soluble and 70% isophane insulins. Glucose requirements and serum insulin levels were monitored over a 12 h period. The mean (+/- SEM) total glucose requirements were higher following administration of Actraphane (246.7 +/- 37.2 g) compared to Rapitard (188.7 +/- 15.4 g) but this difference did not reach statistical significance. Following injection of Actraphane significantly higher glucose infusion rates for the half hour periods from 240, 270, 300, 330 and 420 min and serum insulins at 180, 210, 240, 270, 300, 330, 360 and 480 min were observed compared to Rapitard. These differences are likely to be of clinical relevance and should be considered when changing a diabetic subject from Rapitard to Actraphane insulins.

Adult↗
PubMed1987

Quality control of portable reflectance meter capillary blood glucose results by measurement of glucose on filter paper.

The capillary blood glucose (CBG) estimated by some of the most frequent users of portable reflectance meters (PRMs) were assessed using blood applied to Whatman 31 ET filter paper at the time of the performance of the CBG. The performance of nursing staff on hospital wards, community groups screened for diabetes and patients exercising self monitoring of blood glucose (SMBG) at home were evaluated. The glucose was extracted from the filter paper with 5% trichloroacetic acid (TCA) and analyzed within 5 days of collection on a Technicon RA-1000 analyzer using Merck glucose dehydrogenase reagents. Of the 1255 samples collected, 385 were rejected due to inadequate sample collection, and a further 196 were rejected as they were received more than 5 days after collection, the time interval allowed for glucose stability on the filter paper. The CBGs obtained by the nursing staff were 2.2 - 17.1 mmol/l with a mean of 7.6 mmol/l; the community screened subjects CBGs were 1.5 -22.4 mmol/l with a mean of 5.2 mmol/l; and the SMBG users at home obtained CBGs of 1.0 - 15.1 mmol/l with a mean of 5.07 mmol/l. Of the 674 samples analyzed only 36.6% were within 10% of the laboratory blotting paper glucose (BPG) result. An alarming 35.8% exceeded 20% and 10.2% exceeded 50% of the BPG result. The correlation of all 3 groups with the BPG obtained by the laboratory were similar (correlation coefficient = 0.86, 0.85, 0.87 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗
PubMedDate not supplied

Conventional and sprinkler needle injection of magnesium insulin.

Currently available short-acting insulin preparations fail to mimic the postprandial insulin profile of non-diabetic individuals. The activity of a novel insulin designed for faster absorption has been tested after subcutaneous injection. Magnesium insulin (50 U ml-1) given by sprinkler needle was compared with unmodified human insulin (100 U ml-1) given by conventional needle and unmodified human insulin (50 U ml-1) given by sprinkler needle in normal volunteers using a euglycaemic clamp. Magnesium insulin had a significantly faster onset of action resulting in a higher exogenous insulin level by 15 min, peak level was reached after 60 min compared with 75 min for the unmodified insulins, and duration of action was significantly shorter than both unmodified insulins. No significant differences were observed between the unmodified insulins for the first 5 h after injection, indicating that the observed differences to magnesium insulin could not be attributed to the insulin concentration or the type of needle used for insulin administration. Injection of magnesium insulin prior to a test breakfast in people with Type 2 diabetes resulted in significantly lower total and 0 to 120 min areas under the glucose curve, an earlier rise in exogenous insulin levels and a higher area under the insulin curve from 0 to 120 min compared with unmodified 100 U ml-1 human insulin.

Adult↗
PubMedDate not supplied

Comparison of plasma glucose, serum insulin, and C-peptide responses to three isocaloric breakfasts in non-insulin-dependent diabetic subjects.

While differences in glucose and insulin responses to specific carbohydrate foods have been reported, few data are available for mixed meals incorporating such foods. This study compared the plasma glucose (PG), serum insulin (SI), and C-peptide (CP) responses to three different isocaloric test breakfasts given in random order to eight insulin-treated non-insulin-dependent diabetes mellitus (NIDDM) patients. The test meals were selected from a hospital food exchange list and contained similar quantities of carbohydrate, protein, fat, and dietary fiber. The postprandial PG, SI, and CP responses to two of the test breakfasts (meal A: eggs, toasted wholemeal bread, orange juice, margarine, and milk; meal B: wheatflake biscuits, toasted wholemeal bread, milk, and margarine) were similar (meal A: 104.3 +/- 23.0 mg X h X dl-1, 5996 +/- 1108 microU X min X ml-1, and 89.8 +/- 25.4 pmol X min X ml-1, respectively; meal B: 104.9 +/- 21.6 mg X h X dl-1, 6268 +/- 1161 microU X min X ml-1, and 99.8 +/- 26.4 pmol X min X ml-1, respectively). Meal C, consisting of toasted muesli and skim milk, produced smaller glycemic and insulin responses (46.8 +/- 8.8 mg X h X dl-1; P less than .02, and 4369 +/- 700 microU X min X ml-1; P less than .05, respectively) than meals A and B and less endogenous insulin secretion (CP response 62.8 +/- 19.9 pmol X min X ml-1; P less than .05 compared with meal A, NS compared with meal B).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Assessing effect of mixing insulins by glucose-clamp technique in subjects with diabetes mellitus.

The glucose-clamp technique was used to assess the effect on insulin activity of mixing clinically relevant doses of short- and longer-acting insulins in insulin-treated diabetic subjects. Mixtures of porcine regular and lente insulins resulted in a reduction in activity of the mixture compared with separate injection that was more apparent with premixing for 5 min before injecting than with premixing for 2 min. These findings were not explained by differences in volume of the injected insulin preparations. Mixing of porcine regular and bovine ultralente insulins for 2 min before injecting resulted in a reduced activity compared with separate injection. No difference in activity was obvious for porcine regular and NPH insulins given separately or premixed for 5 min. A reduction of activity during the 1st h after injection was observed when separate injection of one brand of these insulins (Velosulin or Insulatard) was compared with the manufactured mixture (Mixtard). These results indicate that premixing regular and NPH insulins in a 1-to-2 ratio does not alter the biological activity compared with separate administration of the insulins. However, the mixing of regular and insulin-zinc suspensions results in a loss of insulin activity, the magnitude of which depends on the time between mixing and injecting the insulin. The clinical significance of the effect of mixing on the efficacy of subcutaneous insulin therapy should be considered in the context that this is only one of many factors that may affect the activity of subcutaneously injected insulin.

Adult↗
PubMedDate not supplied

Effectiveness of mass screening for diabetes mellitus using random capillary blood glucose measurements.

The results of 23 228 finger-prick capillary blood glucose tests (the taking of which was coordinated by the Diabetic Association of New South Wales) were reviewed. All non-diabetic persons (n = 860) with a blood glucose result of greater than or equal to 8.0 mmol/L were surveyed and 459 responded (53.4%). The responders were typical of the surveyed group with respect to age and capillary blood glucose level. Sixty-four new cases of diabetes were detected, representing 15.8% of the replies from persons who were not known to have diabetes and 0.28% of the total number of persons screened.

Age Factors↗