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  • 1
    ISSN: 1432-5233
    Keywords: Hypertension ; Non-insulin-dependent diabetes ; Microalbuminuria ; Lisinopril ; Nifedipine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of the angiotensin-converting enzyme lisinopril were compared with those of the calcium antagonist nifedipine in 162 non-insulin-dependent diabetic hypertensive patients for a 24-week period. In 83 and 79 patients, respectively, lisinopril and slow-release nifedipine produced similar reductions in blood pressure (systolic/diastolic: −16/−13 mmHg supine and −14/−11 mmHg standing after lisinopril; −15/−12 mmHg supine and −14/−11 mmHg standing after nifedipine). Fasting and post-prandial plasma glucose, glycosylated haemoglobin and plasma lipids appeared to be unaffected by either agent. Also, 28% of the patients on lisinopril and 30% of those on nifedipine presented microalbuminuria. Both drugs induced a reduction in the albumin excretion rate (AER). The geometric meanxx: tolerance factor of the reduction in AER among the 23 microalbuminuric patients on lisinopril (−10.0xx:1.3 μg/min) was greater, though not significantly so, than that observed in the 26 on nifedipine (−0.9x:1.2 μg/min). Moreover, lisinopril appeared to be better tolerated than nifedipine in our study population. Microalbuminuria is an important risk factor for cardiovascular mortality in non-insulin-dependent diabetic patients as well as in the general population. To what extent a reduction in the AER could ameliorate the cardiovascular prognosis in non-insulin-dependent diabetic patients is, at present, unknown. Finally, both lisinopril and nifedipine showed a similar antihypertensive effect in these patients which was not associated with significant differences in plasma glucose, insulin or lipid concentrations. The clinical consequences of the insignificant differences in AER remain unclear.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Primary adult myxoedema ; oral glucose tolerance test ; arginine test ; insulin tolerance test ; plasma insulin ; pancreatic glucagon (nesidioglucagon) ; gut glucagon (enteroglucagon) ; growth hormone ; hypoglycemia ; insulin resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Previous studies have shown that in patients with primary adult myxoedema (PAM) the rise in blood glucose (BG) and plasma insulin (IRI) after various stimuli is higher and more sustained than in normals, so that in this condition insulin resistance may be hypothesized. In the search for factors involved glucose (BG), insulin (IRI), glucagon (IRG), (assayed with an antiserum which is not specific for pancreatic glucagon) and growth hormone (GH), have been determined in blood during the oral glucose tolerance test, OGTT, (100 g), arginine intravenous infusion, ATT (30 g/30 min), and insulin-induced hypoglycemia, ITT (0.1 kg), in patients with PAM, without clinical diabetes, and in normal control subjects. During OGTT, glucose and IRI levels were higher than normal; on the other hand, IRG (probably gut glucagon, or enteroglucagon) levels were lower than in normals. During ATT blood glucose in PAM was slightly higher than normal at 30′ and lower at 90′ and 120′; insulin levels were higher than normal at any time; GH and IRG (very likely pancreatic glucagon, or nesidioglucagon) responses were lower than normal. During ITT, blood glucose levels dropped slowly but progressively and GH levels were lower than normal. It is concluded that in primary adult myxoedema glucagon, both enteric and pancreatic, and growth hormone secretions are impaired. The resistance to insulin action observed in PAM does not seem to be due to an excess of growth hormone or (nesidioglucagon).
    Type of Medium: Electronic Resource
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