Biomedical subjects

T S Jap

Publications and source records attributed to T S Jap.

At least 19 recordsLinked to original sources

PubMed2001

A novel mutation in the calcium-sensing receptor gene in a Chinese subject with persistent hypercalcemia and hypocalciuria.

Familial hypocalciuric hypercalcemia (FHH) is an autosomal dominant disorder characterized by high penetrance of relatively benign, lifelong persistent hypercalcemia and hypocalciuria. By contrast, neonatal severe hyperparathyroidism represents a life-threatening form of hypercalcemia that can cause the early newborn mortality if immediate intervention is not undertaken. Both disorders are due to inactivation mutation of the human calcium-sensing receptor (CaSR) gene on chromosome 3q21-24. Up to now, more than 30 mutations in the CaSR gene associated with FHH have been described. In this study, we analyzed one 79-yr-old male with hypocalciuric hypercalcemia without siblings or children to compare with an additional group of 50 normal Chinese subjects in Taiwan. DNA sequence analysis of the CaSR gene was performed. The result showed that the proband had a heterozygous nonsense mutation in exon 7 of the CaSR gene at codon 648 (CGA-->TGA/Arg-->Ter). This mutation, located in the COOH-terminal of the first intracellular loop of the CaSR, predicts a markedly truncated protein. We have identified a novel R648X mutation in the CaSR gene in one patient with FHH in Taiwan

Aged↗

PubMed2000

A novel mutation in the hepatocyte nuclear factor-1alpha/MODY3 gene in Chinese subjects with early-onset Type 2 diabetes mellitus in Taiwan.

AIMS: The goal of this study was to determine the frequency of mutation in hepatic nuclear factor (HNF)-1alpha, a gene recently implicated as causing maturity-onset diabetes of the young (MODY) and to analyse the respective clinical presentations in an ethnically Chinese population. METHODS: Fifteen unrelated subjects (nine females and six males) aged less than 35 years who had early-onset diabetes were analysed to test the possibility that mutation of the HNF-1alpha gene was responsible for this disorder. Genomic DNA extraction, polymerase chain reaction and DNA sequence analysis were performed accordingly. RESULTS: One patient with MODY had a novel missense mutation in exon 3 of the HNF-1alpha gene (Y218C) in a region of the protein that corresponds to a predicted DNA binding domain. CONCLUSIONS: A Y218C mutation in HNF-1alpha gene was identified in one family in Taiwan.

Adolescent↗

PubMed2000

Spuriously high CK-MB isoenzyme activity mimicking acute myocardial infarction in a patient with adenocarcinoma of the rectum.

A 58-year-old Chinese male presented with precordial distress and was found to have elevated creatine kinase (CK)-myocardial bound (MB) (determined by the Kodak Ektachem Clinical Chemistry Slide method) activity and an abnormal electrocardiogram. Eventually, the patient was diagnosed with an annular ulcerative tumor 10 cm above the anal orifice. The tumor was an adenocarcinoma of the rectum and was immunoreactive for CK-BB (brain type). CK isoenzyme electrophoresis disclosed both BB and MM (muscle type) bands. We concluded that the level of CK-MB determined using the Kodak Ektachem Clinical Chemistry Slide method was spuriously elevated in our patient with adenocarcinoma of the rectum, without evidence of myocardial injury. Institutions using the Kodak Ektachem Clinical Chemistry Slide system for CK should be aware of this possibility.

Adenocarcinoma↗

PubMed1998

Genitourinary tuberculosis complicated with adrenal involvement and primary adrenocortical insufficiency: a case report.

Genitourinary tuberculosis (TB) rarely involves the adrenal gland. A 67-year-old man presented with progressively hyperpigmented skin and an enlarged mass over both testes. Early morning plasma cortisol concentration was low and adrenocorticotropic hormone (ACTH) concentration was high. A rapid ACTH stimulation test revealed the absence of plasma cortisol response and confirmed a diagnosis of primary adrenocortical insufficiency. An abdomen computed tomography (CT) scan disclosed enlargement of the right adrenal gland and punctuate calcification over the left one. This is compatible with tuberculous adrenalitis. Currettage biopsy of the prostate demonstrated chronic granulomatous inflammation with Langerhan's giant cells, but without TB bacilli. Anti-TB treatment, in addition to glucocorticoid and mineralocorticoid replacement, was administered. The testicular mass decreased progressively though the results of a subsequent ACTH stimulation test, six months later, disclosed no significant change. A follow-up CT scan, one and a half years later, showed a decrease in the size of the right adrenal mass.

Addison Disease↗

PubMed1996

Serum procarboxypeptidase B, amylase and lipase in chronic renal failure.

Procarboxypeptidase B (human pancreas-specific protein) has been reported to be a good serum marker for the diagnosis of acute pancreatitis. The current study was conducted in order to evaluate the frequency and degree of elevated serum levels of procarboxypeptidase B in chronic renal failure and their correlations with serum levels of amylase, lipase and renal function tests. Blood samples were taken from 84 asymptomatic patients with chronic renal failure, including 34 patients with periodical haemodialysis and 50 patients without haemodialysis. Serum levels of procarboxypeptidase B, amylase, lipase, creatinine and blood urea nitrogen were measured. Serum levels of procarboxypeptidase B in 84 patients were 63.4 +/- 5.5 micrograms/L significantly greater than the figure of 29.6 +/- 1.6 micrograms/L in healthy adults in our previous report (P < 0.0001). There was a significant difference in serum levels of PCPB between patients with and without haemodialysis (78.0 +/- 9.4 vs 53.6 +/- 6.3 micrograms/L; P < 0.01). The frequencies of elevated serum levels of procarboxypeptidase B, amylase and lipase greater than upper normal limits were 27.4, 35.7 and 26.2%, respectively. The frequencies of elevated PCPB in patients with and without haemodialysis were 38.2 and 20%, respectively. Only one patient had a serum procarboxypeptidase B level greater than three-fold the upper normal limit. A significant correlation was found between procarboxypeptidase B and lipase (r = 0.785; P < 0.0001). No significant correlation was noted between procarboxypeptidase B vs amylase or renal function tests. In conclusion, in patients with chronic renal failure, the elevation of serum procarboxypeptidase B is as common as the elevations of other pancreatic enzymes.

Aged↗

PubMed1996

Poorly differentiated "insular" carcinoma of the thyroid: a case report.

Poorly differentiated "insular" carcinoma of the thyroid is a rare type of thyroid malignancy, situated morphologically and biologically in an intermediate position between well-differentiated (papillary and follicular) and undifferentiated (anaplastic) carcinoma. Here we report a case of a 56-year-old woman who developed a mass over the left thyroid gland in 1988, and received a thyroid operation in 1990 which was reported as benign lesion. Three years later, a mass recurred over the right lobe of the thyroid, and another thyroid operation was performed. The pathological report was medullary carcinoma. Four months later, recurrent mass over the right thyroid bed developed. Fine-needle aspiration biopsy of the mass showed moderately high cellularity with moderate pleomorphism, and multinucleated giant cells. Distinct cytoplasmic blue granules were also found in Liu's stain. She received total thyroidectomy and right neck radical dissection. Pathology examination showed well-defined nests of tumor cells ('insulae'), and immunohistochemical study showed positive stain for calcitonin. Pathologic diagnosis was poorly differentiated "insular" carcinoma of the thyroid. Four months after operation, recurrent neck mass over the suprasternal notch developed. Computerized tomography of neck and chest showed tumor mass over left thyroid bed with extension to anterior mediastinum. Whole body 131I scan showed mediastinum involvement and multiple bony metastases. Ablative 131I treatments (150 mCi and 200 mCi) were given twice, but in vain. The patient died 14 months after her last operation.

Carcinoma↗

PubMed1995

Hemostatic risk factors of coronary artery disease in the Chinese.

In order to find out the hemostatic risk factors of coronary artery disease in the Chinese, antithrombin III concentration, factor VII and fibrinogen assays, plasminogen activator inhibitor-1 antigen and platelet count were determined in 51 healthy controls (mean age 63.5 years, S.D. 10.3), 55 diabetics (mean age 66.0 years, S.D. 4.8) and 56 patients with arteriographically proved coronary artery disease (mean age 63.8 years, S.D. 8.7). Of the coronary artery disease group, 19 had single vessel disease, 21 had double vessel disease and 16 had triple vessel disease. Sixteen of this group also had a past history of myocardial infarction. There was no significant difference of the hemostasis parameters between diabetics and controls. Fibrinogen and factor VII, but not plasminogen activator inhibitor, were significantly higher in coronary artery disease patients than in controls (P = 0.0001, both) and in diabetics (P = 0.0001, both). No significant difference in the parameters was found in the coronary artery disease group, whether the patients had single vessel disease, double vessel disease, or triple vessel disease, or were with or without past myocardial infarction. In the myocardial infarction group, fibrinogen and factor VII were significantly higher than in the controls (P < 0.00005 and 0.0001, respectively) and in the diabetics (P = 0.0002 and 0.0004, respectively). We suggest that increased levels of fibrinogen and factor VII, but not plasminogen activator inhibitor, would be the hemostatic risk factors of coronary artery disease in the Chinese.

Adult↗

PubMed1995

Pituitary apoplexy diagnosed by magnetic resonance imaging: a case report.

Pituitary apoplexy is a neuroendocrine emergency produced by hemorrhage or infarction of pituitary tumors, and its accurate diagnosis has relied mainly on clinical manifestations and computed tomography (CT) scan of sella in the past. A case is reported of pituitary apoplexy which was demonstrated on magnetic resonance imaging (MRI). The 72-year-old male patient was admitted to the Nephrology Section of VGH-Taipei with symptoms of general malaise, poor appetite for four months and apparent hyponatremia (Na 102 mEq/L) on laboratory findings. Under the impression of syndrome of inappropriate secretion of antidiuretic hormone (SIADH), fluid restriction and infusion of isotonic saline were prescribed, but in vain. The patient was transferred to the Endocrinology Section because of lowered serum cortisol, T3, T4, and hs-TSH levels. Dynamic pituitary function tests confirmed the diagnosis of panhypopituitarism. Contrast enhanced CT scan of sella revealed displacement of the pituitary stalk to the right side. T1-weighted MRI showed persistent high intensity in left sella and T2-weighted MRI showed persisting isointense to white matter. The hyponatremia and clinical symptoms resolved within a few days after replacement therapy with glucocorticoid and thyroid hormone. It was concluded that MRI is more sensitive than CT scan for detecting subacute or chronic pituitary apoplexy.

Aged↗

PubMed1995

Polyethylene glycol method is superior to ammonium sulfate and protein-A sepharose-4B method in fractionating thyroid stimulating immunoglobulin in Graves' disease.

BACKGROUND: The purpose of this study is to compare the performance of three methods, i.e., ammonium sulfate, polyethylene glycol (PEG) and protein A sepharose 4B in fractionation of thyroid stimulating immunoglobulin. METHODS: Twelve patients with Graves' disease and twelve age-, sex-matched normal controls were recruited. 0.9 ml of saturated ammonium sulfate was added slowly to 1.1 ml of sera of all subjects and was stirred until reaching 45% saturation. The precipitation was allowed to form at 4 degrees C overnight. The solution was centrifuged at 10,000 x g for 5 minutes. The precipitate was washed twice with 45% ammonium sulfate, dissolved in 0.55 ml of distilled water equal to half of the initial volume of the serum and dialyzed against 200 volumes of phosphate-buffered saline (PBS) for 48 hours. Another 0.5 ml of serum sample from the same patients was mixed with 1.5 ml of 20% polyethylene, followed by centrifugation at 2,800 g for 20 minutes. The pellet was dissolved in 0.6 ml of Hanks' medium without NaCl containing 1.5% bovine serum albumin, 20mM HEPES: 1 ml of sera was applied to 0.75 g of protein A sepharose-4B in PBS buffer and eluted with glycine, pH 2.3. By adding immunoglobulin (Ig) from the different methods to the FRTL-5 tissue culture, we determined the cAMP generation. RESULTS: Patients with Graves' disease were found to have higher serum thyroxine and triiodothyronine concentrations (p < 0.001) and significantly higher free thyroxine concentration than normal subjects. Ig elicited stronger response in cyclic AMP generation when prepared with PEG method, as compared with the other two methods (p < 0.001). With sepharose-4B Ig preparation, 10 out 12 patients (83.33%) showed positive thyroid stimulating immunoglobulin (TSI) while with ammonium sulfate precipitation, nine out 12 patients (75%) showed positive TSI. On the other hand, all patients showed positive TSI with PEG precipitation. When the degree of thyrotoxicosis was classified in terms of thyroid hormone concentrations, there was no correlation between TSI titers and thyroid hormone concentration. CONCLUSIONS: Polyethylene glycol is superior to both ammonium sulfate and protein A sepharose-4B in fractionating TSI in terms of sensitivity and convenience in operation.

Adult↗

PubMed1994

Do smoking and diabetes change the hemostatic parameters?--a study in the Chinese people.

Plasma plasminogen activator inhibitor-1 (PAI) antigen, fibrinogen, antithrombin III (ATIII), protein C, beta-thromboglobulin (BTG), platelet count, fibrinogen degradation product (FDP) D-dimer, factors VII and XII, as well as cholesterol, triglyceride (TG) and glucose were determined in 163 subjects. First we compared the difference of these parameters between 50 diabetics (Group D, mean age 64.9 years) and 50 age-matched healthy controls (Group C, mean age 63.1 years). Nineteen of the diabetics and 19 of the healthy controls were smokers. Plasma glucose, cholesterol, TG and protein C were significantly higher in Group D than in Group C (p = 0.0010, 0.0308, 0.0083 and 0.0068, respectively), whereas ATIII and factor XII were significantly lower in Group D (p = 0.0213 and 0.0061). Secondly, we divided 113 healthy controls (Group C, including Group C plus 63 subjects at various ages) into smokers (mean age 56.7 years) and non-smokers (mean age 40.0 years) and compared the difference between them. Fibrinogen and glucose were higher in the smokers than in the non-smokers (p = 0.0139 and 0.0402, respectively). Other parameters were not different. In conclusion, our study did not find any important hypercoagulation state in the diabetics. Smoking can only increase fibrinogen and glucose without the change of other hemostatic parameters.

Adult↗

PubMed1994

The effects of in vitro and in vivo exposure to insulin upon prostaglandin E1 stimulation of platelet adenylate cyclase activity in healthy subjects.

Insulin treatment of platelets is associated with increased prostaglandin E1-stimulated adenylyl cyclase activity and decreased platelet aggregation. Because non-insulin dependent (Type II) diabetes mellitus is associated with hyperinsulinemia, we sought to determine the effect of insulin treatment in vivo and in vitro upon stimulation of platelet adenylyl cyclase by prostaglandin E1. Incubation of platelet-rich plasma obtained from normal subjects with 2 microM prostaglandin E1 resulted in a 16-fold increase in cAMP accumulation. Pre-incubation of platelet-rich plasma with 0.7 nM insulin resulted in a 62% increase in prostaglandin E1 (2 microM)-stimulated cAMP accumulation (p < 0.005). Pretreatment of platelets with cholera toxin prior to incubation with insulin had no effect on subsequent prostaglandin E1-stimulated cAMP accumulation. By contrast, pretreatment of platelets with pertussis toxin prior to incubation with insulin resulted in a nearly 2-fold increase in prostaglandin E1-stimulated cAMP accumulation (p < 0.005). To determine whether platelets exposed in vivo to elevated concentrations of insulin would show similar responses, we isolated platelet-rich plasma from subjects before and after a 120 minute euglycemic clamp study in which insulin was infused (40 mU m-2min-1) intravenously. Patients who underwent the euglycemic clamp study achieved steady state serum levels on insulin of 0.70 +/- 0.19 pmol/ml. Platelets obtained after insulin infusion had a 65% increase in prostaglandin E1-stimulated cAMP. Our results indicate that serum levels of insulin that are common in patients with type II diabetes mellitus can increase the sensitivity of platelet adenylyl cyclase to stimulation by prostaglandin E1.

Adenylate Cyclase Toxin↗

PubMed1993

Relationship of plasminogen activator inhibitor-1 with plasma insulin, glucose, triglyceride and cholesterol in Chinese patients with diabetes.

Plasminogen activator inhibitor-1 (PAI) activity, plasma insulin, glucose, cholesterol and triglyceride (TG) concentrations were determined in 32 Chinese diabetic patients (mean age 61.4 yr) and 41 healthy controls (mean age 64.5 yr) to establish the relationships between these parameters. Insulin, glucose, cholesterol and triglyceride levels were significantly higher in the diabetics, whereas no significant difference of PAI activity was noted between groups. PAI activity was not affected by the increase of plasma insulin, cholesterol, TG or glucose. We have shown that PAI activity in Chinese diabetics was not affected by the common pathologic changes found in diabetes. This might be one of the reasons why fibrinolytic activity is not impaired in Chinese diabetics.

Aged↗

PubMed1993

Insulin-like growth factor-I receptor increases in aortic endothelial cells from diabetic rats.

Endothelial cells are likely to play an important role in the development of diabetic vascular diseases, since they are exposed directly to the abnormal circulating metabolites of diabetes and may be easily damaged early in the natural course of vascular complications. In this study, aortic endothelial cells were cultured from diabetic BB rats. Their binding and internalization of insulin-like growth factor-I (IGF-I) were measured. IGF-I binding was higher in cells of diabetic rats than of control rats at both 37 degrees C (4.5% +/- 1.6% v 2.74% +/- 0.9% per mg protein, P < .05) and 4 degrees C (20.6% +/- 5.6% v 13.7% +/- 4.6% per mg protein, P < .01). Internalization of IGF-I also increased (1.62% +/- 0.2% v 0.74% +/- 0.15% of total count at 37 degrees C after 60 minutes, P < .05). Cross-linking studies showed that in cells from diabetic rats, the major band of 140 kd corresponding to the alpha-subunit of the IGF-I receptor increased in density by 50% compared with those from control rats. The IGF-I-stimulated tyrosine kinase activity (TKA) of partially purified receptor from cells of diabetic rats, measured using poly-glu-tyr as substrate, was normal. Since the biological effects of IGF-I are initiated by its binding to the IGF-I receptor, which is able to transduce mitogenic and metabolic signals, our results support the hypothesis that the IGF-I receptor is involved in the development of diabetic vascular complications.

Affinity Labels↗

PubMed1993

Program description and preliminary health survey data in Kin-Hu, Kinmen.

The study subjects were those over 30 years of age in Kin-Hu, Kinmen. From January to February 1991, demographic data, physical data, life style and blood chemistry parameters were collected from 2929 respondents (1368 men and 1561 women) out of 4475 eligible subjects. The study, conducted by the Yang-Ming Crusade, used a structured questionnaire and venipuncture technique. After clarifying missing values, a total number of 2868 (64.1%; 1334 men and 1534 women) subjects had completed the data set. Of the total subjects, 32.3% were 30-39 years of age, 24.3% were 40-49 yrs, 22.4% were 50-59 yrs, and 21.0% were above 60 years old. Fifty-two percent of men and 2.8% of women, were current smokers. Most of the surveyed subjects described themselves as having infrequent physical activity (men vs. women, 66.4% vs. 81.0%, p < 0.001). Men had significantly lower body mass index (BMI) and higher waist-hip ratio (W/H) than women (BMI: 22.9 +/- 3.2 vs. 23.2 +/- 3.7, p < 0.01; W/H: 0.89 +/- 0.06 vs. 0.84 +/- 0.07, p < 0.01). Men also had higher fasting plasma glucose (FPG), systolic/diastolic blood pressure (SBP/DBP) than women (FPG: 99 +/- 25.3 vs. 95.7 +/- 25.3 mg/dl, p < 0.0001; SBP: 132.1 +/- 19 vs. 126.4 +/- 21.5 mmHg, p < 0.0001; DBP: 80.4 +/- 12.5 vs. 76.5 +/- 12.3 mmHg, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Rapid quantification of adenosine cyclic 3',5'-monophosphate by competitive enzyme-linked immunosorbent assay.

A reliable and rapid enzyme-linked immunosorbent assay (ELISA) for cyclic AMP determination is described. Succinyl cyclic AMP, coupled to human albumin, was injected into rabbit to elicit antibodies to cyclic nucleotide hapten. Succinyl cyclic nucleotide to human albumin as immunogen or the cyclic AMP to porcine thyroglobulin as coating antigen was conjugated by a carbodiimide coupling procedure. The latter conjugate, captured to microplate with coating buffer and blocked with 0.8% gelatin for 30 minutes, was bound to antibody in inverse proportion to free cyclic AMP in a sample or standard. Bound antibody was then quantified with horseradish peroxidase-labelled goat antirabbit immunoglobulin and ABTS (2, 2'-Azinobis (3-ethylbenzthiazolinesulfonic Acid). Our results showed that concentration of both standard and sample cyclic AMP could be measured as low as 2.5 fmol/well (0.05 pmol/ml). The intra- and inter-assay coefficients of variation for samples were 6.0-8.0% and 8.9-9.5%, respectively. In addition, there was no cross-reaction of the antisera with ADP, ATP, 5'-AMP or cyclic GMP. Short period of incubation at room temperature seems as good as long period of incubation at 4 degrees C. The biological study demonstrated a consistency between increase in platelet-cyclic AMP generation after prostaglandin E1 stimulation and its biological effects. Our approach to ELISA is validated by showing agreement in levels, obtained in parallel by ELISA and RIA, of cyclic AMP content in extracts of prostaglandin E1-stimulated platelet cells.

Cyclic AMP↗

PubMed1993

The characterization of adenyl cyclase activity in FRTL-5 cell line.

The purpose of this study is to characterize the adenyl cyclase (AC) activity in Fisher rat thyroid cell line when stimulated with several agonists, such as: forskolin, sodium fluoride, Gpp(NH)p (guanosine-5'-(beta, gamma -imino) triphosphate or thyrotropin. The following studies such as: dose-response, pH, temperature, time-response, millieu concentration, 3H-thymidine uptake, Km and Vm study were also performed. Adenyl cyclase activity was measured as adenosine 3', 5'-cyclic monophosphate generated by cell cultures in 120- minutes incubation at 37 degrees C. The basal AC activity was 15.0 +/- 7.0 (mean +/- SEM, n = 6) pmol/100,000 cells/120 minutes. Forskolin at 0.1 mM increased the AC activity to 10 folds of basal AC activity. Thyroid stimulating hormone at 1 mU/ml and 10 mU/ml increased the AC activity 2 and 15 folds, respectively. Sodium fluoride stimulation study demonstrated dual actions of fluoride on adenylate cyclase; when the cells were assayed with increasing concentration of NaF, the AC activity increased as the concentration of NaF increased from 0.01 to 1 mM, but decreased strikingly as that concentration increased from 1 mM to 100 mM. When the concentration of nonhydrolyzable guanine nucleotide analogs increased in the presence of TSH, there was first an increase in adenylate cyclase activity, followed by a decrease at higher concentration. The amount of cAMP generation was much higher (P < 0.05) in hypotonic than in isotonic millieu. When the incubation temperature raised to 56 degrees C, all the AC activity was diminished. The optimal pH for AC activity was in the range of 7.4 and 8.0.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenylyl Cyclases↗

PubMed1992

Measurement of creatine kinase isoforms by agarose gel electrophoresis in the diagnosis of myocardial infarction.

To evaluate a method to quantitate the isoforms of serum creatine kinase isoenzyme MM (CK-MM) by agarose gel electrophoresis, sera of normal subjects (n = 74) and patients with acute myocardial infarction (n = 21) and other diseases (n = 67) were studied. The within-assay imprecision (CV) for CK-MM1, -MM2, and -MM3 was 1.9%, 0.8%, and 2.2% at the activity of 79, 105, and 64 U/L (30 degrees C, CK-NAC), respectively; while the assay-to-assay imprecision was 4.8%, 3.2% and 3.9%, respectively. The method could detect 5 U/L or more of any CK-MM isoform and was linear with respect to CK activity at values less than 1100 U/L. Sera from healthy subjects (n = 74) contained mainly CK-MM1 (mean = 48.5%), with lesser amounts of CK-MM2 (mean = 30.6%) and CK-MM3 (mean = 20.8%). The central 95-percentile reference range for the ratio of MM3/MM1 was 0.12-1.34 with mean = 0.49. The sensitivity of CK-MM3/MM1 ratio greater than 1.3 in the diagnosis of acute myocardial infarction employing the first available sample was 90% at a specificity of 91%, compared with a sensitivity of 81% and specificity of 87% for the conventional CK-MB assay. At CK-MM3/MM1 ratio of 1.6 or more, the specificity increased to 96% while sensitivity remained unchanged at 90%. This procedure for the quantitation of serum CK-MM isoforms is convenient, practical and suitable for inclusion in the routine panel of cardiac tests.

Adult↗

PubMed1992

Insulin-pen: preliminary report on its use for multiple injection regiment in insulin-dependent diabetic patients.

Insulin pens are pen-like devices for multiple injection of insulin. They can cut down the equipment necessary for a multidose regimen and thus make the therapy more convenient and flexible to help improve daily-life quality. It is of interest for us to known whether the average diabetic patients are motivated to achieve better metabolic control by means of insulin-pens. Seven insulin-dependent diabetic patients (male: 3, female: 4, age: 21-34 years) from the Veterans General Hospital participated in the study. None of them had diabetic proliferative retinopathy or proteinuria. They are initially treated with twice daily injection of mixtures of short- and intermediate-acting insulin (run-in period, 8 weeks). A multi-dose regimen with three premeal injections of short-acting insulin with insulin-pen plus one injection of long-acting insulin at bedtime was then used during the study period (12 weeks). Improved in metabolic control as assessed by HbAlc (7.6 +/- 0.9 vs 6.9 +/- 0.8%) and mean blood glucose (175.2 +/- 34 vs 152.3 +/- 28.1 mg/dl) in all patients was found. The frequency and severity of hypoglycemic episodes were not changed. In addition, all patients chose to continue multiple injection using insulin-pen, indicating a high acceptability of such device.

Adult↗