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Biomedical subjects

T Deckert

Publications and source records attributed to T Deckert.

At least 145 records · Page 8Linked to original sources
PubMed1978

Prognosis for juvenile diabetics with nephropathy and failing renal function.

A total of 157 consecutive patients with juvenile diabetes (onset before the 31st birthday), diabetic nephropathy, and impaired renal function were followed up until 1.1.1976. All the patients had been admitted to the Steno Memorial Hospital, Copenhagen, between 1934 and 1972. Independently of the patients' age at onset of diabetes, it was found that persistent proteinuria appeared after an average of 19 years, and that death ensued 5--6 years thereafter. Division of the patients into two groups, according to whether the diabetes had set in before or after 1940, showed no signs of an improved prognosis during the past few decades. Once the serum creatinine has started to rise, the prognosis is very grave. Only 50% were alive 21 months after serum creatinine levels of 2--5 mg/100 ml had been ascertained. Among patients whose serum creatinine exceeded 5 mg/100 ml, 50% succumbed in 9 months. It is concluded that renal transplantation, if it is to be done, should be instituted early.

Adolescent↗
PubMed1978

Growth, body weight and insulin requirement in diabetic children.

The weight and height development of 51 boys and 48 girls who had developed diabetes prior to the age of 15 years was followed for a minimum of 3 years, mean 8.3 years, up to the age of 18 for the girls and 20 for the boys. In addition, the insulin requirements were recorded. Weight and height proved to be within the normal range, and height at onset of diabetes was normal. After a long duration of diabetes, however, there occurred a reduction of height increment of obout 1/2cm/year. This reduction was greater in children who rarely attended as compared with those who frequently attended a sub-specialized clinic. The daily dose of insulin increased with age, the greatest increase coinciding with the growth spurt. During the first 4 years of diabetes the 24-hour dose/kg body weight increased, indicating a decreasing endogenous insulin production. Later it was constant at around 0.9 i.u./kg. Modern management of diabetic children leads to normal adult stature.

Adolescent↗
PubMed1977

The effect of epinephrine and isoproterenol on insulin secretion and glucose utilization in isolated islets of Langerhans from mice.

The effect of epinephrine and isoproterenol in different concentrations and adrenergic blocking agents on glucose induced insulin secretion and glucose utilization was studied in isolated islets of Langerhans from mice. Epinephrine in physiological concentrations significantly inhibited the glucose induced insulin secretion. This effect was not mediated by a change in glucose utilization but involved alpha-adrenergic stimulation. Isoproterenol significantly stimulated the glucose induced insulin secretion but had no effect on glucose utilization. Beta-adrenergic stimulation by isoproterenol at low glucose concentration was not sufficient to stimulate insulin secretion. The results are discussed in relation to current therories on the mechanism of glucose induced insulin secretion.

Animals↗
PubMed1976

The effect of metabolic regulation on microvascular permeability to small and large molecules in short-term juvenile diabetics.

The microvascular permeability to small and large molecules was studied during good and poor metabolic regulation in ten short duration juvenile diabetics. The following variables were measured; daily urinary albumin and beta2-microglobulin-excretion rates, whole body transcapillary escape rate of albumin (TER), glomerular filtration rate (GFR), capillary filtration coefficient (CFC), and capillary diffusion capacity (CDC). The urinary albumin and beta2-microglobulin concentration were measured by sensitive radioimmunoassays; TER was detemined from the initial disappearance of intravenously injected 125I-labelled human serum albumin; GFR was measured on the forearm by straingauge plethysmography and CDS for 51Cr-EDTA clearance; CFC was measured on the forearm by straingauge plethysmography and CDC, for 51Cr-EDTA was determined in the jyperaemic anterio tibial muscle by the local clearance technique. All the above mentioned variables, except CDC, were significantly increased during poor metabolic regulation, indicating a functional microangiopathy. The mechanisms of these alterations appear to be increased filtration pressure in the microcirculation and/or increased porosity of the microvasculature. The findings of increased microvascular albumin passage are compatible with the hypothesis that the organic - histologicallly demonstrated - diabetic microangiopathy is a long-term effect of periods of increased extravasation of plasma proteins, with subsequent protein deposition in the microvascular wall, i.e. the concept to plasmatic vasculosis.

Adolescent↗
PubMed1976

Regulation of brittle diabetics by a pre-planned insulin infusion programme.

Eleven brittle diabetics, mean duration 11.5 years, all treated with highly purified porcine NPH insulin twice daily, were placed on highly purified porcine regular insulin 4 times daily for 2 days. Thereafter pre-planned intravenous insulin infusion was started. Insulin in an amount corresponding to the daily insulin requirement was infused by a mobile electric infusion pump at precalculated rates between 30 and 7 ml/hour during 2 days. The patients were ambulatory. Capillary blood glucose was taken every 30 min after meals and every two hours during the night. After an equilibration period of 7 hours, blood glucose fluctuations were in the physiological range in nearly all patients during the infusion period. [Only 1.3% of the blood samples showed glucose levels lower than 2.5 mmol/l and 2.9% levels exceeding 10.0 mmol/l during the infusion days]. Mean blood glucose (MBG) was 6.0 +/- 0.9 mmol/l (mean +/- s.d.), the standard deviation of MBG was 1.8 +/- 0.5 mmol/l, the mean amplitude of blood glucose excursions (MAGE) 4.7 +/- 1.4 mmol/l, and glucosuria 3.1 +/- 3.9 g/day. All these data of glucose homeostasis were significantly lower during the infusion days. The incidence of hypoglycaemic attacks was low (0.32/patient/day) and not significantly higher than during NPH treatment. It is concluded that near normal blood glucose fluctuations can be achieved in brittle diabetics by preplanned insulin infusion without blood glucose monitoring.

Adolescent↗
PubMed1976

Secretin-induced insulin response. I. Cubital insulin concentration in normal, obese and pancreatectomized patients, including portal insulin concentration in normals after secretin.

Intravenous injection of the gastro-intestinal hormone secretin elicits an increase in the insulin concentration in the cubital vein. In 10 normal weight non-diabetics and 10 obese non-diabetics the latter group gave a hypernormal insulin response. By the simultaneous determination of the insulin concentration in the cubital and portal veins and also by an investigation of 2 pancreatectomized patients, it was demonstrated that an increase in the cubital insulin concentration following intravenous injection of secretin was due to an altered secretion from the pancreas and not to an altered elimination of insulin.

Adult↗
PubMed1975

Portal and cubital serum insulin during oral, portal and cubital glucose tolerance tests.

Oral, intracubital, and intraportal glucose tolerance tests have been performed on 7 non-obese non-diabetics, and glucose and insulin concentrations have been followed in the peripheral and portal blood. A significant rise in portal glucose and insulin was found 1/2-2 min after oral glucose intake. There was no lag between the rise in insulin and glucose concentrations. The portal glucose concentration after oral glucose intake was significantly higher than after cubital glucose infusion for 45 min, although the peripheral glucose concentrations were identical. In the cubital vein the insulin concentration after oral glucose intake was significantly higher than after i.v. glucose infusion, but in the portal blood there was no difference. After portal glucose infusion the cubital insulin concentration did not differ significantly from the concentration after i.v. glucose infusion. Thus, it seems unlikely that a high portal glucose concentration is responsible for the higher peripheral insulin concentration after oral glucose intake. A high portal glucose concentration does not seem to influence the hepatic uptake or release of glucose.

Administration, Oral↗
PubMed1975

Effect of vagotomy on insulin release after oral and intravenous glucose administration.

In 9 non-diabetic, non-obese patients, oral and intravenous glucose tolerance tests were carried out before and after vagotomy, and the serum insulin was determined. The potentiating effect on insulin release of orally administered glucose was not abolished by total vagotomy, meaning that vagal mechanisms are not likely to play a major role in this potentiation in man.

Adult↗