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  • Alzheimer's disease  (4)
  • severe hypoglycaemia  (4)
  • Diabetes mellitus  (3)
  • 1
    Electronic Resource
    Electronic Resource
    Interleukin-6 and α-2-macroglobulin indicate an acute-phase state in Alzheimer's disease cortices
    Amsterdam : Elsevier
    FEBS Letters 285 (1991), S. 111-114 
    Details
    ISSN: 0014-5793
    Keywords: Acute phase ; Alzheimer's disease ; Interleukin-6 ; Protease inhibitor ; α-2-Macroglobulin
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0014-5793(91)80737-N
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  • 2
    Electronic Resource
    Electronic Resource
    Alpha 2-macroglobulin synthesis in interleukin-6-stimulated human neuronal (SH-SY5Y neuroblastoma) cells Potential significance for the processing of Alzheimer β-amyloid precursor protein
    Amsterdam : Elsevier
    FEBS Letters 282 (1991), S. 127-131 
    Details
    ISSN: 0014-5793
    Keywords: Alpha 2-macroglobulin ; Alzheimer's disease ; Amyloid precursor protein ; Interleukin-6 ; Neuron
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0014-5793(91)80460-K
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  • 3
    Electronic Resource
    Electronic Resource
    In-vitro matured human macrophages express Alzheimer's βA4-amyloid precursor protein indicating synthesis in microglial cells
    Amsterdam : Elsevier
    FEBS Letters 282 (1991), S. 335-340 
    Details
    ISSN: 0014-5793
    Keywords: Alzheimer's disease ; Amyloid precursor protein ; Macrophage ; Microglia
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0014-5793(91)80508-Z
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  • 4
    Electronic Resource
    Electronic Resource
    Effect of insulin concentration, subcutaneous fat thickness and skin temperature on subcutaneous insulin absorption in healthy subjects (1994)
    Springer
    Diabetologia 37 (1994), S. 377-380 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; pharmacokinetics ; insulin absorption ; metabolic control ; skin temperature
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Subcutaneous insulin absorption kinetics were assessed in 50 healthy study subjects (21 female, 29 male; age 26±3 years, BMI 22.5±1.8 kg/m2; mean±SD) during 45 min after periumbilical injection of soluble human U40- or U100-insulin (0.15 IU/kg). Subcutaneous fat thickness was measured by ultrasound, and skin temperature at the injection site was registered. Serum insulin concentrations increased within 30 min from basal values of 37±15 to 140±46 pmol/l after U40-insulin and from 36±10 to 116±37 pmol/l after U100-insulin (p〈0.001). After 45 min serum insulin concentrations were 164±43 pmol/l with U40-insulin and 128±35 pmol/l with U100-insulin (p〈0.001). Decline in blood glucose levels and suppression of C-peptide were comparable. The serum insulin levels reached 30 and 45 min after U40- and U100-insulin injection were positively correlated with skin temperature (p〈0.0008), and negatively correlated with subcutaneous fat thickness (p〈0.009). In conclusion, the lower insulin concentration of U40-insulin, higher skin temperature, and a thinner subcutaneous fat tissue at the injection site are associated with accelerated and enhanced subcutaneous insulin absorption.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00408474
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  • 5
    Electronic Resource
    Electronic Resource
    Pregnancies in women with diabetic nephropathy: long-term outcome for mother and child (1995)
    Springer
    Diabetologia 38 (1995), S. 227-235 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; nephropathy ; pregnancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to improve the basis upon which to advise women with diabetic nephropathy about pregnancy, we studied the effect of diabetic nephropathy on the course of pregnancy, perinatal out-come, infant development and long-term outcome of the mothers. All pregnancies of women with diabetic nephropathy (defined as proteinuria 〉400 mg/day (n=26), creatinine clearance 〈80 ml/min and hypertension in the first trimester (n=10)) followed at our centre from 1982 to 1992 were identified (34 White class F and 2 White class T) and the women and their children re-examined in the spring 1993. From the first to the third trimester the percentage of women with proteinuria over 3 g/day increased from 14 to 53% and those treated with anti-hypertensive medication from 53 to 97%. There were no intrauterine or perinatal deaths, but one child died suddenly 4 weeks postpartum. Of 36 new-borns (gestational week at birth 36(3), birth weight 2384(834) g)), 11 were born before week 34 and 8 had respiratory distress syndrome. Renal function in the first trimester, diastolic blood pressure in the third trimester and an HbA1c above normal were predictive of gestational age at delivery and low birth weight (stepwise regression analysis). At follow-up of the children (n=35, age 4.5 (0.4–10) years) the majority (n=27) were normally developed but seven had psychomotor retardation (four of them major). One child had a severe motor retardation due to a congenital anomaly. At follow up, 21 of the 29 mothers had preserved renal function (creatinine 1.3 (0.8–4.3) mg/dl and 8 had developed end stage renal disease and required dialysis (2 of whom were White class T) within 3 (1–9) years postpartum. Of those, 4 women (3 White F and 1 White T) had died. Pregnancy did not seem to specifically accelerate the rate of decline of renal function. In women with diabetic nephropathy perinatal mortality can be prevented but perinatal and long-term infant morbidity remains elevated. Women with severely impaired renal function before pregnancy are at risk for serious morbidity when their children are still young. Improvement might be made if all women were to receive specialized care and counselling before, throughout and after pregnancy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400099
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  • 6
    Electronic Resource
    Electronic Resource
    Quality assessment of diabetes care according to the recommendations of the St. Vincent Declaration: A population-based study in a rural area of Austria (1992)
    Springer
    Diabetologia 35 (1992), S. 429-435 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes ; eye complications ; foot complications ; neuropathy ; hypertension ; quality of care ; patient education ; general practice ; hospitalisation ; severe hypoglycaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Using a mobile ambulance the quality of diabetes care was evaluated, according to the recommendations of the St. Vincent Declaration, in 95 % of all known diabetic patients (n = 395) in a geographically defined rural area of Austria with 7871 inhabitants. Fourteen of the 395 patients had Type 1 (insulin-dependent) diabetes with age at onset of diabetes below 30 years. Of the 375 patients examined (women 61%, age 66 ± 13 years, median diabetes duration 6 years) 16 % were treated with insulin and 47 % with oral agents; HbA1c levels were 7.3 ± 1.7 %. Prevalence of known hypertension was 54%; 68% of these patients had their blood pressure uncontrolled (systolic ≥ 160 and/or diastolic ≥ 95 mmHg); a further 15% of patients with previously unknown hypertension had blood pressure values of ≥ 160 and/or ≥ 95 mmHg. Urinary albumin concentrations of 〉 200 mg/l were found in 15% of patients, 2% had a serum creatinine level of 〉 177 μmol/l, no patient had renal replacement therapy. Six patients (1.5%) were blind. Screening for retinopathy identified six patients (out of 317 in whom the retina could be evaluated) for whom consultation with an ophthalmologist as soon as possible was recommended. Of the total patient group (n = 395) 20 patients (5%) had foot complications (amputations and/or ulcers): 14 patients had a total of 21 lower limb amputations (eight above knee, six below knee, seven below ankle); eight of these 14 patients lived in a nursing home; 11 patients had a total of 13 foot ulcers. In conclusion, in this diabetic population quality of diabetes care was satisfactory with respect to glycaemic control, whereas the high rates of uncontrolled hypertension and above ankle amputations appear amenable to improvement. This study shows that through systematic assessment of the quality of diabetes care specific local needs and deficiencies can be identified in order to propose respective interventions in health care practices.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02342439
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  • 7
    Electronic Resource
    Electronic Resource
    Risk factors of severe hypoglycaemia in adult patients with Type I diabetes – a prospective population based study (1998)
    Springer
    Diabetologia 41 (1998), S. 1274-1282 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Type I diabetes ; severe hypoglycaemia ; risk factors ; hypoglycaemia awareness ; patient education ; social class ; behaviour ; attitude ; C-peptide.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The objective of this study was to identify possible risk factors of severe hypoglycaemia (SH) in a prospective population based study of adult Type I (insulin-dependent) diabetic patients. A representative sample of 684 patients (41 % women, mean ± SD age 36 ± 11, diabetes duration 18 ± 11 years), living in the district of Northrhine (9.5 million inhabitants), Germany, were examined in their homes using a mobile ambulance. A comprehensive baseline assessment of possible predictors of SH included sociodemographic and disease related variables, hypoglycaemia awareness, diabetes management, and attitudes and behavioural aspects as expressed by the patients. After a mean of 19 ± 6 months 669 (98 %) patients were interviewed about events of SH since the baseline examination. Using the multiple Cox proportional hazards model, five risk factors of SH were identified: SH during the preceding year [hazard ratio (HR) 2.7, 95 % confidence intervals (CI) 1.8–4.2], any history of SH (HR 1.9, CI 1.1–3.4), C-peptide negativity (HR 4.0, CI 1.2–12.7), social status (HR 0.8 for a difference of 5 units for a value range of 0–24, CI 0.6–0.9), and patients' determination to reach normoglycaemia (HR 0.7 for a difference of 1 unit for a value range of 1–6, CI 0.5–0.9), indicating that the lower the social status and the higher the patients' determination to reach normoglycaemia, the higher the risk of SH. After eliminating the history of hypoglycaemia from the model, impaired hypoglycaemia awareness and patients' inappropriate denial of SH as their particular problem became additional significant risk factors of SH. In conclusion, in this population based study of adult Type I diabetic patients, C-peptide negativity, a previous event of SH, patients' determination to reach normoglycaemia and social class were risk factors of SH. [Diabetologia (1998) 41: 1274–1282]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250051065
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  • 8
    Electronic Resource
    Electronic Resource
    Bicentric evaluation of a teaching and treatment programme for Type 1 (insulin-dependent) diabetic patients: improvement of metabolic control and other measures of diabetes care for up to 22 months (1983)
    Springer
    Diabetologia 25 (1983), S. 470-476 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes education ; Type 1 diabetes ; severe hypoglycaemia ; diabetes care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In two hospitals an identical diabetes teaching and treatment programme (in-patient, Monday to Friday, group teaching) was set up. Seventy-eight consecutive, conventionally treated Type 1 diabetic patients (duration of diabetes 10±6 years), referred during a certain period, were reinvestigated after 1 year, and again (for assessment of metabolic control only) 22 months after the teaching and treatment programme. Initially, mean glycosylated haemoglobin was 2.6%, after one year 1.0%, and after 22 months 1.5% above the upper limit of the normal range (p〈0.001). Hospital admissions were reduced from a mean of 10 to a median of 1 day per patient per year (p〈0.001). The long-term quality of diabetes care achieved by the diabetes teaching and treatment programme was unrelated to intelligence quotient, diabetes duration, or diabetes-related knowledge. Patients with normal levels of glycosylated haemoglobin on follow-up (33% of all patients) had particularly good compliance rates, and significantly lower initial values of glycosylated haemoglobin than patients with glycosylated haemoglobin levels ⩾10%. The data indicate that the diabetes teaching and treatment programme resulted in a substantial long-term improvement of metabolic control and a striking reduction of hospital admissions. The study substantiates the feasibility of applying this teaching and treatment programme on a large scale to other hospitals, so as to improve the quality of diabetes care and decrease health care costs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00284453
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  • 9
    Electronic Resource
    Electronic Resource
    Evaluation of an intensified insulin treatment and teaching programme as routine management of Type 1 (insulin-dependent) diabetes (1987)
    Springer
    Diabetologia 30 (1987), S. 681-690 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; insulin therapy ; severe hypoglycaemia ; ketoacidosis ; patient education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary It has been questioned whether aiming at near-normoglycaemia by intensified insulin treatment regimens is feasible and safe for the majority of patients with insulin-dependent diabetes. In this study, intensified insulin injection therapy (including blood glucose self-monitoring and multiple insulin injections) based upon a 5-day inpatient group teaching programme was evaluated in Type 1 (insulin-dependent) diabetes mellitus in the centralised health care system of Bucharest. One hundred patients (group A, initial HbA1 12.5%) were followed for 1 year on their standard therapy (individual teaching, no metabolic self-monitoring), and thereafter for 1 year on intensified therapy. Another 100 patients (group B, HbA1 12.3%) were followed for 2 years on intensified therapy. A third 100 patients (group C, HbA1 11.7%) were assigned to a basic 4-day inpatient group teaching programme with conventional insulin therapy (including self-monitoring of glucosuria and acetonuria) and followed for 1 year. Mean HbA1 remained unchanged after standard treatment (group A: 12.8% at 12 months), but decreased during intensified therapy (group A: 10.1% at 24 months; group B: 9.3% at 12 months, 9.5% at 24 months; p〈0.0001). In group C, no change was found compared to standard treatment (i.e. group A at 12 months). Incidence rates of ketoacidosis were 0.16 episodes per patient per year during standard treatment, 0.01 during intensified treatment (p〈0.01) and 0.04 in group C (p〈0.025). Hospitalisation rates were reduced by 60% during intensified therapy and by 40% in group C. Frequency of severe hypoglycaemia was not significantly different between the three treatment regimens. Thus, under the condition that insulin treatment is based upon a structured and comprehensive training of the patient, intensified insulin injection therapy performed as routine treatment of Type 1 diabetes significantly lowers HbA1 levels without increasing the risk of severe hypoglycaemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00296989
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  • 10
    Electronic Resource
    Electronic Resource
    Human insulin: much ado about hypoglycaemia (un)awareness (1987)
    Springer
    Diabetologia 30 (1987), S. 829-833 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; human insulin ; hypoglycaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The biological effects, hypoglycaemic symptoms, endocrine counterregulatory responses and glucose recovery following the injection of purified porcine and human insulin preparations were compared in a number of controlled clinical investigations and prospective clinical trials. In these studies involving healthy volunteers, Type 1 (insulin-dependent) diabetic patients on continuous subcutaneous insulin infusion or intensified conventional insulin therapy and insulin treated Type 2 (non-insulin-dependent) diabetic patients, no differences with regard to biological effects, counterregulatory responses, hypoglycaemic awareness or the long-term incidence of severe hypoglycaemia between porcine and human insulin preparations were identified. These data fail to confirm any specific risk of severe hypoglycaemia attributable to the use of human insulin preparations in the treatment of patients with diabetes mellitus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00274789
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