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At least 973 records · Page 54Linked to original sources
PubMedDate not supplied

Nitrendipine does not impair long-term glucose control in hypertensive noninsulin-dependent diabetic patients.

The subjects, 15 noninsulin-dependent diabetic hypertensive patients (mean age, 61 years) and 15 nondiabetic hypertensive patients (mean age, 60 years), received placebo for four weeks and then 20 to 40 mg of nitrendipine once daily for 24 weeks. At the end of the placebo period their blood pressures were greater than or equal to 160 mmHg systolic or greater than or equal to 95 mmHg diastolic. Blood pressures declined significantly during treatment in both patient groups; after 24 weeks, 13 of 15 diabetic patients and 12 of 15 nondiabetic patients were normotensive (diastolic blood pressure less than 90 mmHg). Meanwhile, heart rate, indices of glycemic control (serum glucose, hemoglobin A1c, fructosamine, and C-peptide levels), and serum lipids (cholesterol, high-density cholesterol, triglycerides, apolipoprotein A1 and B levels) did not change. It is concluded that nitrendipine does not impair glucose or lipid metabolism in diabetic hypertensive patients.

Adult↗
PubMed1990

[Feasibility and acceptability of insulin therapy using a pen suitable for injecting regular or intermediate insulin. Results of the French multicenter study conducted by the Optipen-France Study Group].

Most of the commercially available insulin-pens are only suitable for regular insulin and have to be used in combination with syringe injections of long-acting insulin preparations. The aim of the french multicentric study is to estimate the clinical interest of a new insulin-pen (Optipen-Hoechst) with two main characteristics: the ability of a predetermination of the insulin dosage to be administered and the suitability for both regular, intermediate and pre-mixed regular (25%) and intermediate (75%) Hoechst insulin preparations. This new pen can so be used alone in all insulin regimen, consisting only of regular and/or intermediate insulin injection. Ninety five insulin treated patients, with at least two daily injections of these kinds of insulin, have been selected injection in a 8 weeks follow up study: After been included they were treated for two weeks by syringe injections of Hoechst insulin solutions (U40), equivalent to the former insulin preparations. Optipen was then used during 4 weeks to inject similar U100 insulin solution, without any other changes in diet and home blood glucose monitoring. Metabolic control was assessed by glycemic measurements, fructosamine and glycosylated hemoglobin determinations and remained unchanged all over the study. The acceptability of pen-treatment was excellent since 95% of the population decided not to return to syringe injections at the end of the study. Injections by mean of an Optipen are more convenient at home as well as outside. Further long term randomized studies are necessary to definite the clinical indications for Optipen use in insulin treated patient.

Adolescent↗
PubMed1990

Glycated proteins and gestational diabetes mellitus.

The use of assays of glycated serum proteins (glycohemoglobin and fructosamine) as markers of glucose homeostasis is becoming a common modality in the evaluation of the pregnant diabetic patient. The purpose of this review is to provide basic information on the interactions between glucose and the protein molecules that lead to the formations of this complex, and to evaluate these tests for their efficacy in the screening and diagnosis of gestational diabetes mellitus, the identification of fetal congenital anomalies and in their relation to early fetal wastage, fetal macrosomia and neonatal complications.

Female↗
PubMed1989

Platelet function in patients with type 2 diabetes mellitus: the effect of glycaemic control.

In the present study the effects of a short term intensive glycaemic control obtained with subcutaneous insulin therapy on lipids and apoprotein levels, platelet aggregation, platelet sensitivity to prostacyclin and platelet thromboxane production were investigated in 20 patients with type 2 diabetes and vascular disease. In 11 out of the 20 patients there was a significant improvement of glycaemic control (fructosamine reduction). Only with tight improvement of glycaemic control there was significant change in the concentration of ADP and collagen required to produce 50% of the maximum aggregation wave response, in the responsiveness of platelet to PGI2 and in the TxB2 synthesis. Lower Apo B levels were also shown in the tight control group suggesting that Apo B changes may have influenced platelet aggregation and thromboxane synthesis.

Adult↗
PubMed1989

Screening for gestational diabetes mellitus.

Gestational diabetes occurs in 3 to 6 percent of pregnancies and is associated with increased rates of macrosomia, serious birth trauma and cesarean section. Neonatal hyperbilirubinemia, hypocalcemia and hypoglycemia also occur more frequently in this disorder. Perinatal outcome is improved through the identification and management of affected women. It is therefore recommended that all pregnant women be screened for this condition at 24 to 28 weeks of gestation. In addition to plasma glucose levels, a new measurement of glycemic control--the serum fructosamine level--may prove useful in identifying and managing women with gestational diabetes.

Blood Glucose↗
PubMedDate not supplied

Comparison of Monotard and Ultratard insulin at bedtime in a model of optimized insulin therapy in Italy.

The italian habit of having a low calorie breakfast suggests an insulin treatment made up of two daily injections of soluble insulin before lunch and dinner, adding at bed time an injection of retard insulin. Aim of this study was to verify whether Monotard or Ultratard proved more effective as retard insulin in this regimen. Sixteen insulin-dependent diabetics treated with the above-mentioned insulin regimen were studied for 16 weeks. They were divided in two groups: group 1 was treated initially with Ultratard and group 2 with Monotard, with a cross-over after 8 weeks. The metabolic control achieved with the treatment was considered good with either retard insulin used. HbA1c, fructosamine, body weight and glycemic values measured after 8 and 16 weeds failed to reveal any differences between the treatment with Monotard on Ultratard. Either Monotard or Ultratard can be successfully used as bedtime retard insulin in this multiple injection insulin treatment.

Adult↗
PubMed1987

[Evaluation of stress indicators in 2 groups of video display terminal operators].

The results of a study on 68 VDT operators are hereby presented. Various biochemical indexes are evaluated as markers of stress. In particular, urinary catecholamines and their metabolites (E, NE, DA, HVA, VMA), ACTH, cortisol, NEFA and fructosamine have been tested by the Authors. Each assay has been performed both in basal conditions, and after the completion of subjects workshift, taking into account the normal hormonal biorhythms. The data which emerged have been analyzed by statistical method ("Student t" with coupled data). Each subject data was confronted before and after workshift. The number of hours of VDT exposure and the different types of duties have been considered and evaluated. The results show that, although the data are all included within the normal range, some of the tested parameters after workshift are significantly higher, compared with the same parameters referring to the basal condition. In particular, Epinephrine and Norepinephrine seem to be the most effective markers of stress. Analogous studies will be pursued in the future by the Authors on a larger number of VDT operators.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Metabolic and psychological evolution of insulin dependent diabetic patients during a 6 months insulin-pen treatment.

The aim of the study is to assess whether an insulin pen-treatment (NovopenR) could be of interest in 10 type I insulin dependent diabetic patients (C-peptide: 0.04 +/- 0.01 pmol/ml, mean +/- SEM), with metabolic and psychological parameters being together taken into account. The daily insulin doses were comparable during the previous treatment with conventional syringes (2-3 daily injections of ActrapidR and MonotardR) and the pen therapy: 0.65 +/- 0.05 vs 0.68 +/- 0.04 U/kg b.w. The metabolic control assessed by HbA1 levels was unchanged before and after 6 months pen treatment: 10.7 +/- 0.7 vs 10.9 +/- 0.6%, respectively. However, fructosamine increased from 2.89 +/- 0.26 to 3.92 +/- 0.20 mmol/l (p less than 0.01) during pen treatment. The psychological objective variables showed no significant changes after pen treatment. In contrast, the staff ratings about the patients attitude toward illness and the spouse evaluation of subjective well-being increased from 40.2 +/- 8.4 to 49.5 +/- 7.8 (p = 0.03) and 34.8 +/- 23.4 to 51.1 +/- 21.1 (p = 0.04), respectively. In conclusion, in a limited group of patients, a multiple injection regimen by pen treatment did not lead to an improved metabolic control. However, subjective psychological tests showed that some aspects of well-being tended to improve.

Blood Glucose↗
PubMed1988

The management of diabetes in general practice.

Over a period of 3 months 32 general practitioners in the Waikato kept copies of all consultations with patients with noninsulin-dependent diabetes mellitus. Of 229 patients with diabetes known to the practices 189 were seen on a total of 438 occasions. Mean fructosamine level was 2.93 mmol/L. Each consultation was analysed as to history obtained, examinations performed, investigations ordered and referrals made. Overall care was satisfactory except for the low incidence of checking for early signs of peripheral vascular disease or diabetic neuropathy affecting the feet and for diabetic nephropathy.

Aged↗
PubMed1984

Simple colorimetry of glycated serum protein in a centrifugal analyzer.

A recently described (Clin Chim Acta 127: 87-95, 1982) colorimetric assay for glycated proteins in serum exploits their ketoamine activity to reduce 3,3'-(3,3'-dimethoxy-4,4'-biphenylylene)bis [2-(p-nitrophenyl)-5-phenyl-2H-tetrazolium chloride] (nitroblue tetrazolium) in alkaline solution; the authors termed this the "fructosamine assay." The method is simple, requiring only the addition of one reagent and measurement of the absorbance change during 5 min; results are expressed relative to a synthetic standard. We have adapted this for use in a centrifugal analyzer and report its performance, both analytically and as an index of hyperglycemia. Precision is good (between-batch CV 2.1%), the reagent is stable and inexpensive, and the procedure is rapid (75 samples per hour). Albumin influences the measurement, but for concentrations greater than or equal to 35 g/L this was not a serious problem. Normal and diabetic populations can be clearly discriminated (p less than 0.001). The test detected 25 (84%) of the 30 untreated diabetics studied and gave four false positives (8%). The results correlate well with those for glucose in plasma of fasting subjects (r = 0.87) and for hemoglobin A1 (r = 0.80).

Adult↗
PubMedDate not supplied

[The course of pregnancy and fetal outcome in diabetic patients with anamnestic fetal death].

Of 116 pregnant patients with diabetes mellitus type 1 or gestational diabetes, 12 (10.3%) had previously suffered stillbirth, while in four (3.4%) cases spontaneous abortion after the 6th month had occurred. In these 16 cases, we examined the mean daily blood glucose concentration, glycosylated hemoglobin (HbA1c), fructosamine as well as glucose and albumin elimination via urine. These control data on carbohydrate metabolism were correlated with the intensity of gestational monitoring in relation to course of pregnancy and neonatal morbidity and/or mortality. In addition, we retrospectively analyzed the cause of prior intrauterine death. In six of eight cases evaluable, we could hereby demonstrate disturbed carbohydrate metabolism. Pregnant women with diabetes mellitus type 1 were hospitalized twice as often (on average four times) as patients with gestational diabetes (2.1 admissions on average). While five of seven type 1 diabetics were primarily admitted prior to the 20th week of gestation, the majority of gestational diabetics (7/9) were first examined by qualified medical personnel trained in the care of gestational diabetes after the 28th week of gestation. Two of nine were first diagnosed post partum. 13 of 14 patients with prepartally known diabetes demonstrated mean blood glucose values under 110 mg/dl. While one of the two patients with postpartally diagnosed diabetes suffered stillbirth once again, the other had to be delivered by emergency C-section because of fetal distress (pH art. 7.08). Our results show that adequate monitoring of carbohydrate metabolism and proper care of diabetic pregnant women can lower obstetrical/neonatal risks to more acceptable levels, especially in those patients who have had stillbirth in their prior medical history.

Blood Glucose↗
PubMed1993

Increased fetal hemoglobin in insulin-treated diabetes mellitus contributes to the imprecision of glycohemoglobin measurements.

An increased prevalence of fetal hemoglobin (HbF) has been described in pediatric insulin-dependent patients. The popular electroendosmotic method for glycohemoglobin includes HbF. In an adult population comprising 50 insulin-treated and 57 non-insulin-treated diabetic patients and 57 control subjects, we measured HbF by HPLC and measured glycohemoglobin by both HPLC and an electroendosmotic method. Of the insulin-treated patients, 46% had concentrations of HbF > or = 0.5%, compared with 25% of non-insulin-treated patients and 23% of controls (P < 0.02). In the insulin-treated patients, the two glycohemoglobin methods correlated best when the HPLC measurements included HbF (r = 0.92 vs r = 0.84). Fructosamine concentrations correlated best with glycohemoglobin concentrations determined by methods that accounted for HbF. The true between-batch CV of the electroendosmotic assay increased (from 4.33% to 8.33%) when variable interpatient HbF concentrations were included. Thus, HbF must be considered when interpreting glycohemoglobin measured by an electroendosmotic method and when comparing it with other measures of glycemic control.

Adolescent↗
PubMed1994

Amelioration of diabetes and cataract by Na3VO4 plus U-83836E in streptozotocin treated rats.

Experimental work in our laboratory has confirmed the protective activity of vanadium compounds on hyperglycemia and glycosuria in streptozotocin (STZ) diabetes. Furthermore, diabetic cataract has also been partially prevented. Nevertheless, the combination of a natural antioxidant, vitamin E, with Na3 VO4 has not further enhanced this ameliorating effect. Our experimental approach has been an attempt to block the prooxidant activity of both STZ and vanadate, with the purpose of eliciting the best possible antidiabetic protection. More recently, a lipid soluble synthetic antioxidant U-78517F, a 2-methylaminochroman, has been reported to have a significant protective effect against brain injury and ischemia. This compound inhibits the iron-dependent lipid peroxidation 100 times more effectively than vitamin E. This investigation has introduced a combination of the vanadium compound plus the aforesaid lazaroid, as its (-) enantiomer, U-83836E, in order to improve the insufficient protection when vitamin E was used. For twelve weeks, male Wistar rats, rendered diabetic with STZ, were administered Na3VO4 in drinking water along with the lazaroid carried by the food. Four, eight and twelve weeks after the beginning of the protective treatment, fluid and food intake, diuresis and excreted feces, glycosuria and proteinuria were determined on biological samples obtained in metabolic cages; body weight and glycemia were also recorded. At weeks 6 and 12 of the treatment, the opaqueness of the eye lenses was controlled and registered. At the end of the experiment, circulating glycosylated hemoglobin (HbA1c), fructosamine, N-acetyl-beta-D-glucosaminidase (NAG), and fluorescent peroxides were evaluated. Within the first month of treatment, protection by the combination paralleled that elicited by vanadate alone. At subsequent steps, U-83836E significantly improved the protective effect of vanadate alone on polydipsia and polyuria, but especially on hyperglycemia and glycosuria. The further ameliorating effect of the lazaroid was also observed on HbA1c and NAG, and, most important, on the cataract. In conclusion, these findings demonstrate that the lazaroid U-83836E succeeds in further protecting the most important symptoms of diabetes treated with vanadate, and that this antioxidant acts effectively even when it is administered orally in food, in a non invasive manner.

Acetylglucosaminidase↗
PubMed1994

[Diabetes monitoring for the pregnant diabetic].

Diabetological care in pre-gestational (preGDM) and gestational (GDM) pregnant diabetic is an indispensable factor for the reduction of risk of mother, fetus and newborn complications. The adoption of an intensified therapy, aiming at maintaining almost normal glycemic values, and the improvement in fetal monitoring have led to a marked reduction, for instance, in fetal intrauterine death and in perinatal mortality rate in general. Furthermore, pregnancy programming allows good glycemic control since conception and a decrease in malformations. It is therefore, necessary to create interdisciplinary teams treating pregnant diabetics coordinately. Diabetological care involves the evaluation of risks from the first phases to the end of the pregnancy, therapeutical decisions on the basis of metabolic and non-metabolic parameters, the education of diabetic women, the coordination of the other specialized interventions and delivery programming together with the obstetrician and the neonatologist. The programs of checks to be executed on pregnant diabetics, during hospitalization and on outpatients, are here illustrated considering the meaning of: fasting glycemia and spontaneous glycemic curves, with goals both in preGDM and in GDM; HbA1c and fructosamine; glycosuria and ketonuria; plasmatic lipids and uricaemia; other non-metabolic checks, in particular blood pressure one.

Ambulatory Care↗
PubMedDate not supplied

Effects of nomegestrol acetate on carbohydrate metabolism.

The effects of nomegestrol acetate on carbohydrate metabolism were investigated in 20 premenopausal women presenting with menstrual disturbances. The progestogen was administered from day 5 to day 24 of the cycle, over six consecutive cycles, at a dosage (5 mg/d) known to inhibit ovulation. A 3 hour oral glucose tolerance test (OGTT) was performed prior to the hormonal intake and at 3 months and 6 months of therapy. Blood glucose and insulin were measured before and for 3 hours after a 75 g glucose load, and the glucose and insulin areas under the curves (AUC) were calculated. The fasting glycosylated hemoglobin and fructosamine were also determined. Treatment did not induce any significant changes in plasma glucose or insulin glucose values during the oral glucose tolerance test, in glucose and insulin areas under the curves or in glycosylated protein levels. Two women with impaired glucose tolerance were not worsened during therapy. These data suggest that nomegestrol acetate is free from adverse effects on glucose tolerance after 6 months treatment.

Adult↗
PubMed1994

The kinetics of the addition of glucose and acetaldehyde to histone proteins.

The time-course of the reaction of H1 and total histone with glucose, acetaldehyde or both has been studied using the NBT reduction test and fluorescence. With both methods, purified H1 histone gave higher absorbance with acetaldehyde than with a 1:1 combination of glucose and acetaldehyde. For total histone, the opposite was found; a 1:1 combination of the above two aldehydes had the higher absorbance. As an explanation, the possibility of different reactivity of the amino groups with glucose and acetaldehyde is proposed. A possible simultaneous interaction between glucose, acetaldehyde and serum protein, mainly albumin, may alter the results of the diagnostic protein glycation methods, e.g. of the fructosamine test, and, therefore, also the monitoring of diabetes.

Acetaldehyde↗
PubMed1994

[Detecting impaired glucose tolerance based on medical decision making].

Impaired glucose tolerance (IGT) is recognized as a preclinical state of diabetes mellitus (DM), and therefore its detection is important in terms of preventive medicine. It is, however, difficult to perform an oral glucose tolerance test (OGTT) during usual health examinations due to time constraints. This study aims to establish an appropriate procedure for detecting IGT without OGTT. Subjects were 422 males who had annual health examinations and who did not have DM. The measurement of serum fructosamine (FRA) and glycosylated hemoglobin (HbA1C), and a 75-gram oral glucose tolerance test were conducted simultaneously. IGT cases were determined as those subjects whose glucose value after two hours of oral glucose administration was 140 mg/dl or above. Ninety-four persons were classified as having IGT with this criterion. Receiver operating characteristics (ROC) analysis and logistic regression analysis were conducted to determine the most appropriate procedure for the detection of IGT. The following results were obtained: 1. ROC analysis indicated that suitable cut-off values for FPG, HbA1C, and FRA were 100 mg/dl, 5.3%, 240 mumol/l respectively. 2. The following logistic function showed suitable diagnostic capability among the several combinations of medical tests: Y = 1/(1 + e-R); R = 0.027 x age + 0.035 x (body index [%]) + 0.074 x FPG [mg/dl] + 0.198 x HbA1C [%] - 11.286. When IGT was defined as a level of logistic function equal to 0.2 or above, the logistic function showed a sensitivity value of 0.755 and specificity value of 0.753.

Adult↗
PubMed1993

Comparison of obese and non-obese patients with gestational diabetes.

The aim of this study was to assess the effect of obesity on the outcome of gestational diabetes (GD). The age of the subject (31 +/- 5 years) and duration of pregnancy (29 +/- 5 weeks) were similar at the time of diagnosis for the 19 obese (34 +/- 6 kg/m2) and 19 non-obese (23.0 +/- 2.1 kg/m2) subjects. Before treatment, the area under the curve of the glucose tolerance test and the mean capillary blood glucose levels were similar in both groups; however, the baseline blood glucose levels of the obese patients (6.0 +/- 0.8 mmol/l) were higher than those of the non-obese patients (5.3 +/- 0.8 mmol/l; P < 0.01). During pregnancy, the total weight gain of the obese patients was less (10.6 +/- 5.0 vs. 15.2 +/- 4.7 kg, P < 0.006). Fifteen of the obese patients required treatment with insulin, while only six of the non-obese women required insulin (P < 0.005). During insulin therapy, the mean capillary blood glucose, glycosylated haemoglobin and fructosamine levels were similar in both groups. In conclusion, our data suggest that GD in obese patients is characterized by lower weight gain and higher baseline glucose with the result that insulin therapy is more frequently instituted.

Adult↗