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  • 1
    ISSN: 1432-0428
    Keywords: Type 2 (non-insulin-dependent) diabetes mellitus ; microalbuminuria ; glomerular filtration rate ; plasma lipoproteins ; insulin sensitivity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of simvastatin (10–20 mg/day) on kidney function, urinary albumin excretion rate and insulin sensitivity was evaluated in 18 Type 2 (non-insulin-dependent) diabetic patients with microalbuminuria and moderate hypercholesterolaemia (total cholesterol ≥5.5 mmol·l−1). In a double-blind, randomized and placebo-controlled design treatment with simvastatin (n=8) for 36 weeks significantly reduced total cholesterol (6.7±0.3 vs 5.1 mmol·l−1 (p〈0.01)), LDL-cholesterol (4.4±0.3 vs 2.9±0.2 mmol·l−1 (p〈0.001)) and apolipoprotein B (1.05±0.04 vs 0.77±0.02 mmol·l−1 (p〈0.01)) levels as compared to placebo (n=10). Both glomerular filtration rate (mean±SEM) (simvastatin: 96.6±8.0 vs 96.0±5.7 ml·min−1·1.73 m−2, placebo: 97.1±6.7 vs 88.8±6.0 ml·min−1·1.73 m−2) (NS) and urinary albumin excretion rate (geometric mean x/÷ antilog SEM) (simvastatin: 18.4x/÷1.3vs 16.2 x/÷1.2 μg·min−1, placebo 33.1 x/÷ 1.3 vs 42.7 x/÷ 1.3 μg·min−1)(NS) were unchanged during the study. A euglycaemic hyperinsulinaemic clamp was performed at baseline and after 18 weeks in seven simvastatin-and nine placebo-treated patients. Isotopically determined basal and insulin-stimulated glucose disposal was similarly reduced before and during therapy in both the simvastatin (2.0±0.1 vs 1.9±0.1 (NS) and 3.1±0.6 vs 3.1±0.7 mg·kg−1·min−1 (NS)) and the placebo group (1.9±0.1 vs 1.8±0.1 (NS) and 4.1±0.6 vs 3.8±0.2 mg·kg−1·min−1 (NS)). No different was observed in glucose storage or glucose and lipid oxidation before and after treatment. Further, the suppression of hepatic glucose production during hyperinsulinaemia was not influenced by simvastatin (−0.7±0.8 vs −0.7±0.5 mg·kg−1·min−1 (NS)). In conclusion, despite marked improvement in the dyslipidaemia simvastatin had no impact on kidney function or urinary albumin excretion rate and did not reduce insulin resistance in these microalbuminuric and moderately hypercholesterolaemic Type 2 diabetic patients.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Arterial blood pressure ; blood glucose ; cardiovascular system ; diabetes mellitus ; glomerular filtration rate ; heart rate ; insulin ; noradrenaline ; renal plasma flow ; urinary albumin excretion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of intravenous insulin (7–8 U as a bolus injection) on renal haemodynamics and urinary excretion of albumin and beta-2-microglobulin was examined in five recent onset juvenile diabetics. Blood glucose concentration was maintained after insulin at unchanged or slightly increased levels by continuous intravenous glucose infusion (50 g/100 ml, 1.2 ml/min). Mean arterial blood pressure increased slightly but significantly from 94±8 mmHg to 99±10 (mean ± SD) after insulin. The rise in heart rate (16 versus 29 beats/min) and in plasma noradrenaline (from 0.16 to 0.32 ng/ml versus 0.20 to 0.49 ng/ml) was significantly greater in the tilted position after insulin. There was no decrease in glomerular filtration rate or renal plasma flow after insulin, in contrast to the findings after intravenous injection of insulin without maintenance of plasma glucose. Urinary albumin excretion was approximately doubled after insulin, from 6.8 to 12.5 μg/min. Beta-2-microglobulin excretion decreased but this difference was not significant. — It is concluded that the rise in heart rate and plasma noradrenaline, and the increase in urinary albumin excretion, after insulin, are unrelated to changes in blood glucose concentration. It is suggested that increased albumin excretion after insulin is due to a direct effect of insulin on glomerular endothelial or epithelial cells.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Albumin ; beta-2-microglobulin ; blood glucose ; cardiovascular ; glomerular filtration rate ; insulin ; proteinuria ; pulse rate ; renal plasma flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of IV injection of 7 to 8 I. U. of insulin on renal haemodynamics and on urinary excretion of beta-2-microglobulin and of albumin was examined in 5 juvenile diabetics. Plasma glucose decreased from a mean value of 250 mg/100 ml to 117 mg/100 ml during the first 85 min after insulin. None of the patients had symptoms of hypoglycaemia and plasma adrenaline did not increase. There was no change in arterial blood pressure after insulin whereas pulse rate increased from 66/min to a maximum of 75/min. Glomerular filtration rate (GFR) and renal plasma flow (RPF) were decreased by 9 per cent and 13 per cent, respectively, during the first 90 min after insulin (2p 〈 0.01). There was also a statistically significant decrease in urine flow and urine secretion of several electrolytes, while filtration fraction remained almost constant. IV insulin decreased urinary excretion of beta-2-microglobulin and increased albumin excretion (2 p 〈 0.05). The albumin excretion induced by insulin is most likely due to increased amounts of filtered albumin, the mechanism of which remains unexplained.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; glomerular filtration rate ; microvascular permeability ; plasma volume ; proteinuria ; serum albumin ; transcapillary escape rate of albumin ; β2-microglobulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to examine the permeability of microvessels in diabetic children, the glomerular filtration rate, urinary excretion rates of albumin and β2-microglobulin, intravascular mass of albumin, and transcapillary escape rate of albumin were studied in 26 diabetic children without clinical signs of microangiopathy (age: 7–14 years; duration of disease: 3–14 years). Similar measurements were made in 28 healthy school children (age: 8–14 years). Mean glomerular filtration rate in the diabetic children was higher than in the normal children (138 versus 109 ml/min per 1.73 m2, p〈0.01). Urinary excretion rates of albumin and β2-microglobulin did not differ in diabetics. Mean intravascular albumin mass in the diabetic girls (1.64 g/kg body weight) was lower (p〈0.01) than in the diabetic boys (1.89 g/kg body weight) and also lower (p〈0.02) than in the normal girls (1.94 g/kg body weight). Mean transcapillary escape rate of albumin in the twenty diabetics with duration of diabetes less than 10 years (7.14%/h) was lower (p〈0.01) than that in normal children (8.90%/h); the escape rate showed a positive correlation with duration of diabetes (r=0.47; p〈0.02). Thus glomerular filtration rate in diabetic children is elevated to the same extent as in adult short-term juvenile diabetics while the permeability of the glomerular membrane to macromolecules is normal. Interpretation of the results on intravascular albumin mass and transcapillary escape rate of albumin requires further investigation.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 17 (1979), S. 71-76 
    ISSN: 1432-0428
    Keywords: Basement membrane ; diabetic nephropathy ; glomerular filtration rate ; glomerular hypertrophy ; glomerulus ; glucagon ; hypertension ; insulin ; kidney function ; proteinuria ; renal plasma flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Renal hyperfunction and hypertrophy are characteristic findings in the early diabetic state, both in diabetes mellitus and in experimental diabetes. A number of structure-function relationships and their likely mechanisms are discussed. The metabolically induced hypertrophy of glomerular capillaries possibly plays a central role. Its cause is not known, but recent results on its time-course emphasize the probable long-term consequences of the irreversibility of the accumulation of basement membrane material.
    Type of Medium: Electronic Resource
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