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PubMed1992

Effect of donor islet mass on metabolic normalization in streptozotocin-diabetic rats.

The effect of donor islet mass on the metabolic normalization in streptozotocin-diabetic rats was examined by comparing normal control rats with two transplant groups receiving 800 or 2,000 islets intraportally, i.e. grafts containing respectively, 0.8 or 2 million Beta cells at 70% purity. After transplantation, basal glycaemia and daily urine volumes normalized in all recipients and remained normal in both groups over the 20-week follow-up period. After intragastric glucose challenge, the 800-islet group exceeded the normal range of glycaemia at all tested time points (0-120 min) whereas the 2,000-islet group exhibited higher glycaemia only at 15 and 30 min; no deterioration in glucose tolerance occurred during the 20-week follow-up. Both transplant groups presented lower serum fructosamine levels than diabetic control rats, normal levels being maintained only in the 2000-islet group. At post-transplantation week 21, both recipient groups exhibited the same body weight as age-matched normal control rats, but their serum triglyceride levels were significantly higher. Hepatic insulin contents were comparable to the insulin contents of the grafts at the time of implantation, representing 16 or 40% of the pancreatic insulin content in the age-matched control rats. Although islet grafts with 0.8 million Beta cells can restore basal glycaemia in adult streptozotocin-diabetic rats, implants of 2 million Beta cells are necessary to correct other parameters of glucose homeostasis. The present data indicate the need of determining the number of grafted Beta cells in studies on the metabolic outcome of islet cell transplantation. DNA content and percentage of Beta cells in the graft are proposed as useful parameters.

Analysis of Variance↗
PubMed1992

In vivo insulin action and muscle glycogen synthase activity in type 2 (non-insulin-dependent) diabetes mellitus: effects of diet treatment.

Insulin resistant glucose metabolism is a key element in the pathogenesis of Type 2 (non-insulin-dependent) diabetes mellitus. Insulin resistance may be of both primary (genetic) and secondary (metabolic) origin. Before and after diet-induced improvement of glycaemic control seven obese patients with newly-diagnosed Type 2 diabetes were studied with the euglycaemic clamp technique in combination with indirect calorimetry and forearm glucose balance. Muscle biopsies were obtained in the basal state and again after 3 h of hyperinsulinaemia (200 mU/l) for studies of insulin receptor and glycogen synthase activities. Similar studies were performed in seven matched control subjects. Insulin-stimulated glucose utilization improved from 110 +/- 11 to 183 +/- 23 mg.m-2.min-1 (p less than 0.03); control subjects: 219 +/- 23 mg.m-2.min-1 (p = NS, vs post-diet Type 2 diabetes). Non-oxidative glucose disposal increased from 74 +/- 17 to 138 +/- 19 mg.m-2.min-1 (p less than 0.03), control subjects: 159 +/- 22 mg.m-2.min-1 (p = NS, vs post-diet Type 2 diabetic patients). Forearm blood glucose uptake during hyperinsulinaemia increased from 1.58 +/- 0.54 to 3.35 +/- 0.23 mumol.l-1.min-1 (p less than 0.05), control subjects: 2.99 +/- 0.86 mumol.l-1.min-1 (p = NS, vs post-diet Type 2 diabetes). After diet therapy the increase in insulin sensitivity correlated with reductions in fasting plasma glucose levels (r = 0.97, p less than 0.001), reductions in serum fructosamine (r = 0.77, p less than 0.05), and weight loss (r = 0.78, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1996

Serum lipoprotein (a) in type 1 diabetic children and adolescents: relationships with HbA1c and subclinical complications.

UNLABELLED: In a population of 106 young type I diabetic patients, we evaluated whether a relationship exists between lipoprotein (Lp)(a) or apolipoproteins and the degree of metabolic control (HbA1c, fructosamine) or the subclinical complications. The patients were subdivided according to puberty and to the presence or not of subclinical complications (no complications [n = 32]; retinopathy at fluorescein angiography [n = 28]; neuropathy diagnosed by reduced peroneal motor nerve conduction velocity [n = 30]; nephropathy determined by presence of micro-albuminuria [n = 15]. Lp(a) concentrations were not significantly increased in the whole group of diabetic patients. There was no difference between girls and boys, nor between the prepubertal children and the others. There were no significant correlations between the markers of metabolic control and Lp(a). Nevertheless, if the diabetic patients were divided into two groups according to the levels of HbA1c (<7.6 or > or = 6% Hb), Lp(a) tends to be higher in the poorly controlled, but not to any significant degree. On the other hand, significant increases of total cholesterol, triglycerides, low density lipoprotein cholesterol and apolipoprotein B levels were observed in poorly controlled patients. Lp(a) concentrations were significantly lower in patients with subclinical neuropathy or nephropathy than in patients without these complications, but not in patients with retinopathy versus no retinopathy. These results are confirmed by categorical analysis (i.e. Lp(a) < or = 30 vs > 30 mg/dl). CONCLUSION: Lp(a) levels are not significantly increased in poorly controlled insulin-dependent diabetes mellitus patients. High controlled insulin-dependent diabetes mellitus patients. High levels of Lp(a), in young diabetic patients, are not markers for subclinical complications (retinopathy, neuropathy and nephropathy). On the contrary, low Lp(a) levels were found in subjects with subclinical neuropathy or nephropathy.

Adolescent↗
PubMed1995

Glycation of lipoproteins and accelerated atherosclerosis in non-insulin-dependent diabetes mellitus.

We used a new and remarkably simple method to examine the extent of in vivo lipoprotein glycation in type II diabetic patients with atherosclerosis and diabetic patients with no complications. Serum glycated lipoprotein levels were determined by agarose gel film electrophoresis in 48 non-diabetic control subjects and 39 diabetic patients, of whom 26 had no complications and 13 had atherosclerotic heart disease. Fasting serum glucose, glycohemoglobin and serum fructosamine concentrations (indicators of glycemia) and total cholesterol, triglyceride, low-density lipoprotein-, very low-density lipoprotein- and high-density lipoprotein-cholesterol concentrations and the low-density lipoprotein/high-density lipoprotein ratio (serum lipid profile) were also determined in the control and diabetic subjects. Glycated low-density lipoprotein and very low-density lipoprotein concentrations were significantly increased in diabetic patients compared with controls; but only glycated very low-density lipoprotein was significantly increased in atherosclerotic patients compared with diabetics without complications. The lipid profile parameters were not significantly increased in patients compared with controls. In diabetics, especially those with poorly controlled hyperglycemia and atherosclerosis, glycation of lipoprotein fractions might be more important than serum lipid and lipoprotein abnormalities. The significant correlation between atherosclerosis and glycated very low-density lipoprotein, suggests that very low-density lipoprotein glycation could be responsible for the development of atherosclerosis in diabetes.

Albumins↗
PubMed1992

Serum nickel levels of diabetic patients and healthy controls by AAS with a graphite furnace.

In this study, serum nickel levels of diabetic patients and healthy controls were determined by AAS with a graphite furnace. The serum nickel concentrations were found to be 1.15 +/- 1.89 micrograms/L in healthy controls and 0.82 +/- 0.74 microgram/L in diabetics. There was, however, no statistically significant difference between the two groups (p = 0.13). The relationship of nickel levels to diabetes type and duration, diabetic complications and treatment, sex, age, and heredity was investigated. However, again no significant differences were found, nor was there any correlation between serum nickel levels and blood sugar, HBa1c, fructosamine, sialic acid levels, and age.

Adult↗
PubMed2002

Mosapride, a 5HT-4 receptor agonist, improves insulin sensitivity and glycaemic control in patients with Type II diabetes mellitus.

AIMS/HYPOTHESIS: We investigated the potential role of mosapride, a 5HT-4 receptor agonist, in glycaemic control in Type II (non-insulin-dependent) diabetic mellitus patients without autonomic neuropathy. METHODS: Thirty-four inpatients with Type II diabetes mellitus were randomly assigned to receive either mosapride (5 mg orally three times a day, n=17) or a placebo ( n=17) for 1 week (first study). Changes in blood glucose and insulin were determined basally as well as after intravenous glucose loading. Insulin sensitivity was evaluated during hyperinsulinaemic-normoglycaemic-clamp studies and by measuring the number of and the autophosphorylation of insulin receptors on the erythrocytes of patients ( n=9). Sixty-nine outpatients with Type II diabetes were similarly treated with mosapride or a placebo for 8 weeks (second study). Finally, tissue- specific expression of 5HT-4 receptors was examined by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: Mosapride lowered fasting blood glucose and fructosamine concentrations ( p<0.05) (first study). It significantly increased the number of (Mosapride 3323+/-518 vs 4481+/-786 [ p<0.05], Control 4227+/-761 vs 3275+/-554 per 300 microl erythrocytes) and the tyrosine autophosphorylation (Mosapride 3178+/-444 vs 4043+/-651 [ p<0.05], Control 3721+/-729 vs 3013+/-511 insulin receptor unit) of insulin receptors, as well as glucose utilisation (Mosapride 4.92+/-0.53 vs 5.88+/-0.72 [ p<0.05], Control 4.74+/-0.65 vs 4.70+/-0.31 mg/kg x min). Mosapride treatment for 8 weeks significantly reduced fasting glucose (9.91+/-0.34 vs 8.51+/-0.34 mmol/l, p<0.05), insulin (53.2+/-4.62 vs 40.8+/-5.52 pmol/l, p<0.05) and HbA(1c) (8.61+/-0.20 vs 7.67+/-0.19%, p<0.01) concentrations (second study). The RT-PCR analysis demonstrated specific expression of 5HT-4 receptors in the muscle, but not in the liver or fat tissues. CONCLUSIONS/INTERPRETATION: Mosapride could improve insulin action at muscle and glycaemic control in Type II diabetic patients.

Base Sequence↗
PubMed1997

Carotid artery stenosis is related to blood glucose level in an elderly Caucasian population: the Hoorn Study.

Cross-sectional associations between carotid artery stenosis (CAS) on the one hand, and parameters of glycaemia and specific insulin levels on the other, were investigated in an age, sex, and glucose tolerance stratified random sample from a 50-74-year-old Caucasian population. Subjects treated with insulin or oral hypoglycaemic agents were classified as having known diabetes mellitus (KDM) (n = 66). Using two oral glucose tolerance tests, and based on the World Health Organisation criteria, all other participants were classified as having a normal (NGT) (n = 287), an impaired (IGT) (n = 169) or a diabetic (NDM) (n = 106) glucose tolerance. CAS was defined haemodynamically using duplex scanning. The crude prevalences of only moderate (16-49%) CAS were 6.6%, 7.1%, 5.7% and 12.1% in NGT, IGT, NDM and KDM subjects, respectively. For any severe (> or = 50%) CAS, crude prevalences were 2.8%, 4.7%, 9.4% and 7.6%. The prevalence of any severe CAS was higher in NDM (p < 0.01) and KDM subjects (p = 0.07) than in NGT subjects. The prevalence of a history of stroke or transient ischaemic attack was 1.7%, 1.8%, 2.8% and 1.5% in NGT, IGT, NDM and KDM, respectively. In univariate logistic regression analysis, HbA1c, serum fructosamine, fasting and 2-h post-load glucose were significantly associated with any severe CAS. In multivariate analyses controlling for other risk factors, only HbA1c and 2-h post-load plasma glucose remained significantly associated (odds ratios: 1.29 per % and 1.09 per mmol/l, respectively) in separate models. No association could be shown between either fasting or 2-h post-load specific insulin and any severe CAS in either univariate or multivariate analyses. In conclusion, HbA1c and 2-h post-load plasma glucose are independently associated with any severe CAS, whereas specific insulin is not.

Aged↗
PubMed2001

Erythrocyte membrane and cytoskeletal protein glycation and oxidation in short-term diabetic rabbits.

The objective of this study was to elucidate the glycation and oxidation processes in plasma and erythrocyte membrane proteins as well as the major erythrocyte cytoskeletal protein, spectrin, using a short-term experimental rabbit diabetes model. Diabetes was induced with a single-dose alloxan injection. Spectrin was purified from erythrocyte ghosts with selective solubilization followed by gel filtration chromatography techniques, and tested for purity using sodium dodecyl sulfate-poly-acrylamide gel electrophoresis. Glycation in plasma proteins was measured as fructosamine using the nitroblue tetrazolium method, and in erythrocyte membrane and purified spectrin, as ketoamine equivalents, by the hydrazine/phenylhydrazine method. Protein oxidation in plasma, erythrocyte membrane proteins, and purified spectrin was evaluated in terms of sulfhydryl oxidation, based on cis-dichlorodiammine platinum (II) binding. Carbonyl formation was also measured in plasma and membrane proteins. Sulfhydryl oxidation, carbonyl groups and glycated protein levels showed statistically significant differences between the diabetic and control groups for both the plasma and the erythrocyte membrane proteins. The cis-dichlorodiammine platinum (II) binding was significantly different in diabetic rabbit erythrocyte spectrin, while glycation was not significantly different for this protein. Our data clearly demonstrate that both protein glycation and oxidation are biochemical alterations occurring in diabetes, even of short duration.

Animals↗
PubMed1986

Glycated haemoglobin and glycated plasma protein, a comparative study.

Three different analytes reflecting the degree of glycation of different proteins have been used in order to determine which showed best correlation with the glycaemic control of different groups of diabetic patients. 1, Glycated haemoglobin by a semi-automatic colorimetric technique was able to discriminate between the best and worst controlled of the selected diabetic groups; 2, a semi-automated colorimetric glycated plasma protein assay was unable to distinguish between any of the diabetic groups in the study; 3, a dye reducing estimation of glycated plasma protein (Fructosamine) was best able to distinguish between the groups in the study.

Adolescent↗
PubMed1987

Increased urinary excretion of the retinol-binding protein in insulin-dependent diabetes mellitus in the absence of microalbuminuria.

Urinary excretion of the retinol-binding protein (RBP) was studied in 36 insulin-dependent diabetics with serum creatinine concentrations within the normal range and no microalbuminuria. The excretion was significantly (p less than 0.05) higher in the diabetics as compared to a group of apparently healthy persons. The diabetes control indices HbA1 and serum fructosamine showed no correlation to the rate of urinary RBP excretion. The present data support the idea that tubular dysfunction may be an early symptom of diabetic nephropathy.

Adolescent↗
PubMed1989

N-acetyl-beta-glucosaminidase and albuminuria in normal and diabetic pregnancies.

Fourteen diabetic women without signs of nephropathy were examined during pregnancy. Serum fructosamine concentration indicating short-term metabolic control of diabetes was normalized at the beginning of the second trimester and was within the normal limits till the delivery. A gradual increase of N-acetyl-beta-glucosaminidase activity in serum and urine has been found during pregnancy in diabetic and healthy women. No significant differences of N-acetyl-beta-glucosaminidase activities were observed between the above groups. A successive increase of albuminuria during pregnancy was present in diabetic and healthy women with about 10-times higher values at delivery. A significant positive correlation was observed between albuminuria and urinary NAG activity in both groups of pregnant women (r = 0.77). We did not find any deterioration in N-acetyl-beta-glucosaminidase activities and albuminuria in seven diabetic women one year after delivery.

Acetylglucosaminidase↗
PubMed1991

Investigation and validation of the affinity chromatography method for measuring glycated albumin in serum and urine.

Affinity chromatography on m-aminophenyl boronate columns together with albumin measurement by radioimmunoassay has been validated as a method for determining glycated albumin in serum and urine. Optimisation of sample volume and of elution buffer composition and volume ensured reproducibility of results. Fructosamine assay confirmed the absence of glycated albumin species from the non-glycated fraction. It was possible to elute the glycated fraction from the affinity columns with Tris or glycine which do not contain 1,2 diols but have similar functional groups. Column affinity was, therefore, not specific for glycated protein moieties. Inhibition of binding by glucose, and other small molecules in urine, necessitated ultrafiltration or dialysis of samples before analysis. Reference ranges for glycated albumin in non-diabetic subjects were 0.6-1.8% in serum and 0.9-2.6% in urine. In patients with diabetes mellitus, glycated albumin ranged from 1.4-10.9% in serum and from 1.5-12.5% in urine.

Adult↗
PubMed1991

Significance of variation in turnover of glycated albumin on indices of diabetic control.

We measured the half-time of disappearance of 125I-labelled glycated albumins in a rat model of diabetes with continuous infusion of physiological saline and insulin. Our results indicate that (i) in non-diabetic rats, continuous infusion of saline per se did not affect the concentrations of glucose or of fructosamine, and the half-time of disappearance of albumin was unaffected by degree of glycation; (ii) hyperglycaemia (mean plasma glucose concentration of 18-27 mmol/l) caused a small but significant increase in half-time of labelled glycated albumin disappearance from a mean of 42 h to a mean of 47 h; (iii) this effect of hyperglycaemia outweighed any effect of increase in albumin excretion detected in poorly controlled diabetic rats without infusion. We conclude that the effect of hyperglycaemia in slowing turnover of glycated albumin is likely to be insignificant in relation to its effect in promoting glycation, and may be species-dependent. However, in nondiabetics, variation of turnover of glycated albumin may well be significant in explaining the wide interindividual variation in concentration of glycated protein.

Albuminuria↗
PubMed1996

Serum lipoprotein-a levels and glyco-metabolic control in insulin and non-insulin dependent diabetes mellitus.

OBJECTIVES: Conflicting results for lipoprotein-a (Lp(a)) levels in diabetic patients exist in the literature. Normal, increased, and decreased values are described, and a relation to glycometabolic control is not unequivocally established. DESIGN AND METHODS: In our study Lp(a) was measured in a large group of diabetiee (80 patients with IDDM and 90 patients with NIDDM) in relation to glycometabolic control and the presence of microalbuminuria, retino and/or neuropathy. Long-term and short-term glycometabolic control were assessed by HbA1 and fructosamine assays, respectively. RESULTS: Statistically significant differences between Lp(a) levels in IDDM and NIDDM-and a control group of 110 healthy nondiabetics could not be established. It appeared that the level of Lp(a) in IDDM and NIDDM is independent of short-term and long-term glycometabolic control or the occurrence of microalbuminuria, neuro or retinopathy. However, poor glycometabolic control affected the number of Lp(a) levels elevated above a threshold of 0.25 g/L in IDDM. CONCLUSION: These results suggest that the level of Lp(a) in serum is not influenced by diabetes mellitus, glycemic control, or the occurrence of microalbuminuria, neuro or retinopathy.

Adult↗
PubMed1991

An open prospective study on the effects on carbohydrate metabolism of an oral monophasic contraceptive containing gestodene (WL-70).

The effects of a monophasic oral contraceptive (gestodene 75mcg + ethinylestradiol 30 mcg) on plasma glucose (PG) and insulin (IRI) responses to an oral glucose load (OGTT) and on glycosylated haemoglobin Alc (HbAlc), fructosamine (Fr), total cortisol (FT) and transcortin (CBG) were studied in 30 healthy women. Blood samples were taken before treatment and after 6 and 12 cycles. After 6 and 12 months, OGTT-PG and IRI levels showed substantially unchanged values; for HbAlc and Fr the same behaviour was seen with the exception of the latter between 6 and 12 months; FT and CBG showed significant rises. All recorded values were in the normal range. The basal and dynamic PG and IRI behaviour failed to show any significant variations between pre-treatment values and those after 6 and 12 months of OC administration. Other data showed a substantial neutrality for this oral contraceptive containing gestodene.

Adolescent↗
PubMed1993

Accelerated cholesteryl ester transfer in noninsulin-dependent diabetes mellitus.

Alterations in core lipid composition of lipoproteins in noninsulin-dependent diabetes mellitus (NIDDM) patients have suggested that the heteroexchange of neutral lipids between HDL and the apo B-containing lipoproteins may be enhanced. For this reason, we studied cholesteryl ester transfer (CET) in ten sulfonylurea-treated patients with stable NIDDM. CET measured in all NIDDM subjects with an assay of mass transfer was significantly greater than that of controls at 1 and 2 h (P < 0.001); the transfer of radiolabeled CE also was increased in a subset of four of the NIDDM group (NIDDM k = 0.21 +/- 0.04 vs. control k = 0.10 +/- 0.05; P < 0.05). A weak correlation was demonstrable between the mass of CE transferred at 1 h and diabetic control expressed as plasma fructosamine (r = 0.58, P < 0.09). To characterize this disturbance in CET further, the donor (HDL + VHDL) and acceptor (VLDL + LDL) lipoprotein fractions were isolated by ultracentrifugation at d 1.063 g/ml from NIDDM and control plasma and a series of recombination experiments were performed. Combining NIDDM acceptor with control donor fractions that contained HDL and CETP and not the combination of NIDDM donor and control acceptor lipoproteins resulted in an accelerated CET response identical to that observed in NIDDM whole plasma. This observation indicated that the abnormality in CET in NIDDM was associated with the VLDL + LDL fraction.(ABSTRACT TRUNCATED AT 250 WORDS)

Carrier Proteins↗
PubMed1990

Qualitative and quantitative abnormalities of von Willebrand antigen in patients with diabetes mellitus.

Previous reported studies of vVWf antigen (vWf:Ag) in patients with diabetes mellitus have not shown qualitative abnormalities despite frequent documentation of raised vWf:Ag. Twenty two patients with established diabetes mellitus have been studied and qualitative abnormalities of vWf:Ag multimers were found in 10 patients who had poorer glycaemic control (as judged by plasma fructosamine) than the other 12 patients. Seven of the 22 patients were restudied after a 3 month period of improved glycaemic control and the vWf:Ag multimer abnormalities disappeared in 6 of these. Some of the structural abnormalities were accompanied by loss of vWf functional activity. As vWf:Ag is synthesised in the endothelial cell, vWf:Ag abnormalities during periods of poor glycaemic control may reflect endothelial cell damage with vWf:Ag release and possibly subsequent proteolysis.

Antigens↗
PubMed1990

The relevance of persistent C-peptide secretion in type 1 (insulin-dependent) diabetes mellitus to glycaemic control and diabetic complications.

The effect of residual C-peptide secretion in longer standing IDDM on glycaemic control and the prevalence and evolution of complications over 2 years was evaluated. Thirty-one subjects with IDDM of 15.4 (1.5) years duration (mean SEM)) and residual C-peptide secretion, were matched for age, duration of diabetes and body mass index with 31 subjects without detectable C-peptide secretion. At trial entry and over 2 years, levels of HbA1, fructosamine and mean blood glucose were essentially similar in both groups. Levels of glycated albumin (GSA) were significantly higher in the C-peptide negative group after 3 and 9 months (P less than 0.05). An increased prevalence of proliferative retinopathy in the C-peptide negative group and of peripheral vascular disease in the C-peptide secretor group was apparent at entry to the study (both P less than 0.05), although no significant differences were observed after 1 or 2 years. There was no difference in the prevalence of peripheral or autonomic neuropathy, hypertension, nephropathy or ischaemic heart disease. Subjects with C-peptide concentrations greater than 0.100 pmol/ml at entry to this study had lower daily insulin requirements after 1 and 2 years, but behaved like the larger group with any detectable C-peptide secretion in all other respects. Residual C-peptide secretion was lost after 1 year in 7 patients, in whom glycaemic control during the year had been particularly poor. Insulin antibody titres were no different in the 2 groups at any time point. This study suggests that residual C-peptide secretion in longer standing IDDM confers the potential for limited improvements in glycaemic control. This effect appears to be insufficient to prevent the evolution of microvascular complications over a 2-year period. Residual C-peptide secretion and relative hyperinsulinaemia may be associated with an excess of peripheral vascular disease.

Adult↗