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  • 1
    ISSN: 1432-5233
    Schlagwort(e): Insulin-dependent diabetes mellitus ; Hypoglycaemia ; Skin blood flow ; Reactive hyperaemia
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The aim of the present study was to compare the cutaneous postischaemic hyperaemic response in young insulin-dependent diabetic patients and healthy subjects during normoglycaemia, acute insulin-induced hypoglycaemia and in the posthypoglycaemic state. After a night of normoglycaemia the cutaneous postischaemic hyperaemic response in the forearm skin, measured by the transcutaneousPO 2 method, was the same in both groups. A reduction of the maximal postischaemic vasodilatory response was observed in diabetic patients from 2.4±0.3 to 2.0±0.2 kPa (P〈0.05) and in control subjects from 2.7±0.3 to 1.8±0.2 kPa (P〈0.02) during insulin-induced hypoglycaemia (plasma glucose〈2 mmol/l). Complete recovery of the vasodilatory response occurred in subjects in the posthypoglycaemic state. We conclude that hypoglycaemia induced a transient reduction of the vasodilatory response, which was rapidly reversed after glucose counter-regulation, in both diabetic patients and healthy controls. Thus, the prevailing blood glucose concentration must be taken into account when the postischaemic vasodilatory response is investigated in diabetic patients.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    Diabetologia 29 (1986), S. 855-860 
    ISSN: 1432-0428
    Schlagwort(e): Hypoglycaemia ; sympathetic nervous system ; skin nerve sympathetic activity ; microelectrode recording ; thermoregulation
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Microclectrode recordings of skin nerve sympathetic activity, consisting of sudomotor and vasoconstrictor signals, were performed in the peroneal nerve in seven healthy subjects during insulin-induced hypoglycaemia. The nerve activity was recorded at rest and for 90 min after intravenous injection of 0.15 IIJ insulin/kg body weight. The net outflow of skin nerve sympathetic activity was increased during hypoglycaemia, with the exception of one subject who exhibited a high initial level of activity. In all subjects a change of the temporal pattern of the outflow was found, suggesting a shift from mixed (sudomotor and vasoconstrictor) to pure sudomotor activity. This change coincided with a sensation of warmth, sweating and varying degrees of cutaneous vasodilatation, and was followed by a fall in body temperature. It is concluded that hypoglycaemia has a differential effect on sympathetic activity in skin nerves, with a strong increase of sudomotor impulses and simultaneous inhibition of vasoconstrictor signals. Thus, neurally mediated thermoregulatory adjustment contributes to heat loss during hypoglycaemia.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    Digitale Medien
    Digitale Medien
    Springer
    Diabetologia 35 (1992), S. 873-879 
    ISSN: 1432-0428
    Schlagwort(e): Sympathetic nervous system ; catecholamines ; insulin ; blood pressure ; glucose metabolism ; hypertension ; insulin resistance
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Sympathetic nervous system activation by insulin has been suggested as a mechanism explaining the association between insulin resistance and hypertension. We further examined the effect of insulin by direct microneurographic muscle and skin nerve sympathetic activity recordings during euglycaemic insulin clamps in healthy subjects. The mean plasma insulin level was elevated from 5.3±0.7 to 92.2±2.2 mU/l in seven subjects during a 90-min one-step clamp. In six other subjects plasma insulin was further raised from 85.7±4.0 mU/l to 747±53 mU/l between 45–90 min (two-step clamp). Four of the latter subjects received a sham clamp with NaCl infusions only on a second recording session. At the low dose of insulin muscle nerve sympathetic activity increased from a resting level of 22.7±5.0 bursts per min to 27.7±5.0 bursts per min at 15 min (p〈0.05). The increases in muscle nerve sympathetic activity were significant (p〈0.001; ANOVA) throughout insulin infusion, with a slight further increase (from 29.2±1.6 to 32.3±1.9 bursts per min) at the supraphysiological insulin concentration. During sham clamps muscle nerve sympathetic activity did not increase. Both insulin clamps induced minor, but significant, increases in forearm venous plasma noradrenaline concentrations. Skin nerve sympathetic activity (n=3) did not change during insulin infusions. Heart rate increased slightly but significantly (p〈0.005), during the insulin clamps. Blood pressure was not notably affected. In conclusion, hyperinsulinaemia was associated with increased vasoconstrictor nerve activity to skeletal muscle and with no change of sympathetic outflow to skin.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    ISSN: 1432-0428
    Schlagwort(e): Amylin ; endocrine pancreatic tumour ; glucose tolerance ; insulin resistance ; islet amyloid polypeptide ; pancreatic islets
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Islet amyloid polypeptide or amylin is a polypeptide secreted mainly from the pancreatic beta cells together with insulin upon stimulation. High levels of islet amyloid polypeptide have also been shown to increase the peripheral insulin resistance and consequently a role for islet amyloid polypeptide in the glucose homeostasis has been suggested. We have studied the glucose homeostasis in a patient with a malignant endocrine pancreatic tumour producing large amounts of an islet amyloid polypeptide-like molecule (about 400 times the upper reference level for islet amyloid polypeptide). This patient developed insulin-requiring diabetes mellitus shortly after the tumour diagnosis. Both intravenous and oral glucose tolerance tests revealed inhibited early responses in insulin and C-peptide release, but the insulin and C-peptide response to glucagon stimulation was less affected. Aneuglycaemic insulin clamp showed normal insulin-mediated glucose disposal. In vitro experiments, where isolated rat pancreatic islets were cultured with serum from the patient, showed a moderately decreased islet glucose oxidation rate and glucose-stimulated insulin release compared to islets cultured with serum from healthy subjects. However, culture of rat islets with normal human serum supplemented with synthetic rat islet amyloid polypeptide did not affect the glucose-stimulated insulin release. In conclusion, the observed effects show that the diabetic state in this patient was associated with an impaired glucose-stimulated insulin release but not with an increased peripheral insulin resistance. Thus, the results suggest that if islet amyloid polypeptide has diabetogenic effects they are more likely to be exerted at the level of insulin secretion than at the level of peripheral insulin sensitivity.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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