Biomedical subjects

T Lauritzen

Publications and source records attributed to T Lauritzen.

93 records · Page 6Linked to original sources

PubMedDate not supplied

Repeated screening for albumin-creatinine ratio in an unselected population. The Ebeltoft Health Promotion Study, a randomized, population-based intervention trial on health test and health conversations with general practitioners.

Albumin-creatinine ration (ACR) has been correlated to increased morbidity and mortality in diabetic as well as in nondiabetic populations. We investigated the albumin-creatinine ratio in 898 randomly selected persons aged 30-50 years, 471 women and 424 men (year 0). ACR was remeasured 1 year later in 811 (90%) of these persons (year 1). This was done in the framework of a prospective, randomized, population-based intervention trial evaluating the effect of health test and health conversations in general practice. The mean age of the study population was 39.8 (range, 30-51) years with a mean body mass index of 24.3 (15.9-44.3) kg/m2. The 50th, 95th, and 99th percentiles of ACR were 0.6, 2.0, and 5.0 mg/mmol at year 0 and 0.5, 2.0, and 5.3 mg/mmol at year 1. There was no significant difference between ACR values at year 0 and year 1. ARC values were slightly higher in women than in men, 0.6, (0.2-20.4) mg/mmol versus 0.5 (0.2-16.3) mg/mmol (p < 0.001, median and range). Albumin concentrations were slightly higher in men than in women 8.0 (2.0-196.0) mg/mmol versus 6.5 (2.0-121.0) micrograms/mL, p < 0.001. The correlation between ACR values measured year 0 versus year 1 was 0.43, p < 0.001 (Spearman rho). The agreement from year 0 to year 1 between normal ACR values (< or = 2.5 mg/mmol) and abnormal values (> 2.5 mg/mmol) were 0.33 expressed by Cohen's kappa.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Co-ordination of diabetes care in the primary and the secondary health care system in Denmark. Danish National Board of Health.

In Denmark the co-operation between the primary and secondary health care system is organized through referrals. Recommendations for improving interaction between the diabetes team (diabetologists, diabetes nurses, dietitians, chiropodists etc.) at the diabetes clinic, and general practice have been prepared by a working party for the Danish National Board of Health. General recommendations: (a) Appointment of a liaison committee in each county consisting of general practitioners (GPs), diabetologists, administrators, etc. (b) Employment of a GP at the diabetes clinic to take care of improving communication, teaching, research, quality assessment, etc. (c) Referral of all newly diagnosed patients with Type 1 diabetes and younger or complicated patients with Type 2 diabetes to the diabetes clinic. More far-reaching forms of co-operation to be discussed in the liaison committees include: (a) Based upon his own knowledge of where to look for help to solve a specific health problem, the diabetic patient may on his own initiative consult either the diabetes clinic or general practice. (b) Provision of access to consult the diabetes nurse/dietitian at the diabetes clinic for instruction without a formal referral. (c) Patients treated solely in general practice and thus unknown to the diabetes clinic may be referred or reported systematically to the diabetes clinic.

Denmark↗

PubMedDate not supplied

Insulin pharmacokinetics.

Where adjustments of diet, physical activity, and dosage of insulin are well known to diabetologists and diabetic patients, present-day knowledge of factors of importance to the pharmacokinetics of insulin is frequently ignored. The pharmacokinetics of insulin comprise the absorption process, the distribution including binding to circulating insulin antibodies, if present, and to insulin receptors, and its ultimate degradation and excretion. The distribution and metabolism of absorbed insulin follow that of endogenous insulin. The distribution and metabolism cannot be actively changed, except in the case of circulating insulin antibodies, which in rare cases also may cause insulin resistance. The use of insulin preparation of low immunogeneity will avoid or reduce this course of variation in action. The absorption process, the detailed mechanisms of which are still unknown, is influenced by many variables where some can be controlled, thereby reducing the intrapatient variability in insulin absorption, which may reach 35%, causing a corresponding metabolic lability. Besides the known differences in timing among different preparations, the size of dose, the injected volume, and the insulin concentration are determinants of absorption role. Fortuitous injection technique contributes to variance, as do changes in blood flow of the injected tissue. This may be induced by changes in ambient temperature, exercise of injected limb, or local massage. Regional differences are also due to differences in blood flow. Serum insulin peaks may peak up to 1 h after injection of soluble insulin into the thigh versus into the abdominal wall. Local degradation of insulin seems of less importance but may, in rare cases, be the cause of high insulin "requirements." Available evidence is reviewed and the importance of implementing the consequences in the daily care of the insulin-treated patient is emphasized.

Absorption↗