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  • 1
    Electronic Resource
    Electronic Resource
    Quality of centralized diabetes care: a population-based study in the German Democratic Republic 1989–1990 (1993)
    Springer
    Acta diabetologica 30 (1993), S. 166-172 
    Details
    ISSN: 1432-5233
    Keywords: Diabetes ; Hypertension ; Nephropathy ; Retinopathy ; Severe hypoglycaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The efficacy of care in the centralized diabetes care system in the former German Democratic Republic was evaluated on the basis of the recommendations of the St. Vincent Declaration. Eighty-three per cent (n=190, 46% women) of all insulin-treated diabetic patients aged 16–60 years who were registered in one district diabetes care unit were examined. Of these, 131 patients had type 1 (insulin-dependent) diabetes (69%) and 59 type 2 (noninsulin-dependent) diabetes (31%). All patients were on animal insulin and 96% (n=187) had conventional therapy consisting of fixed insulin dose and a fixed diet. Levels of glycosylated haemoglobin (normal 4.15%, SD 0.54) were 6.3±1.3% in type 1 and 7.4±1.7% in type 2 diabetics. Retinopathy was found in 35% of type 1 (proliferative 3.8%) and 23% of type 2 patients (proliferative 3.4%). No patient was blind. Screening for nephropathy identified 29% of type 1 and 47% of type 2 diabetics as having albuminuria 〉20 mg/l in early-morning urine. The prevalence of hypertension was 31% and 69% for type 1 and type 2 patients respectively. Foot ulcers were found in 2.1% and lower limb amputations in 2.1%. The incidence of severe hypoglycaemia (except in pregnancy) was 0.07 per patient per year. This study shows that the diabetes care system was effective and the winding up of this system with the reunification of Germany was not a medical necessity. However, the system failed to establish an integrated regime with regional general practitioners for the effective treatment of hypertension.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00572862
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  • 2
    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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  • 3
    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: Key words 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. [Diabetologia (1994) 37: 377–380]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00408474
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  • 4
    Electronic Resource
    Electronic Resource
    Self-selected unrefined and refined carbohydrate diets do not affect metabolic control in pump-treated diabetic patients (1988)
    Springer
    Diabetologia 31 (1988), S. 153-157 
    Details
    ISSN: 1432-0428
    Keywords: Unrefined diet ; Type 1 (insulin-dependent) diabetes ; intensive insulin therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This study investigated whether unrefined or refined carbohydrate diets have any effect on metabolic control and on insulin requirement in near-normoglycaemic Type 1 (insulin-dependent) diabetic out-patients on continuous subcutaneous insulin infusion therapy. Two females and 8 males (aged 27±9 years; diabetes duration 13±8 years; duration of insulin pump therapy 22±5 months; means±SD) participated in a randomised cross-over study with two 6-week periods on self-selected refined and unrefined carbohydrate diets respectively. As a result, energy intake differed between the experimental diets (2372±669 kcal/day on unrefined diet vs 2757±654 kcal/day on refined diet, p= 0.04), as did the fibre intake (18±5 g/day with the refined carbohydrate diet vs 35±13 g/day with the unrefined carbohy drate diet, p = 0.02). The composition of nutrients was approximately 40% carbohydrate, 45% fat, and 13% protein with both diets. Body weight, HbA1c, daily mean blood glucose (7.2±0.6 mmol/l) and serum lipids remained virtually unchanged during the entire study. Insulin requirement varied between 40.1±7.9 U/day with the unrefined carbohydrate diet, and 42.5±10.1 U/day with the refined carbohydrate diet (NS). Thus, neither the refined nor the unrefined carbohydrate diet affected insulin requirement and metabolic control in these near-normoglycaemic, normolipaemic, nonobese, insulin-pump-treated Type 1 diabetic patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00276848
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  • 5
    Electronic Resource
    Electronic Resource
    Long-term safety, efficacy and side-effects of continuous subcutaneous insulin infusion treatment for Type 1 (insulin-dependent) diabetes mellitus: a one centre experience (1989)
    Springer
    Diabetologia 32 (1989), S. 421-426 
    Details
    ISSN: 1432-0428
    Keywords: Insulin therapy ; insulin pumps ; diabetes complications ; blood glucose self-monitoring ; diabetes diet
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A follow-up study of 116 Type 1 (insulin-dependent) diabetic patients on long-term continuous subcutaneous insulin infusion was conducted after 4.5±0.2 years. The average HbA1c-value of these patients decreased by 1% to 6.7±0.1% during this observation period. Typical side effects of continuous subcutaneous insulin infusion such as skin inflammation at the catheter insertion site occurred with similar frequency as has been reported previously by other authors. Diabetic ketoacidosis (0.14 per patient year) and disabling hypoglycaemia (0.1 per patient year, including 0.05 hypoglycaemic coma per patient-year) occurred at substantially lower rates than in other comparable studies with Type 1 diabetic patients at a similar degree of metabolic control. Subgroup evaluation suggested that a normal (〈5.6%) HbA1c-value at follow-up was associated with increased incidence of disabling hypoglycaemia, whereas poor metabolic control (HbA1c〉7.5%) was associated with increased rates of skin complications and hospital treatment for ketoacidosis. Thus, under the policies of this diabetes centre, continuous subcutaneous insulin infusion has proved to be beneficial to a large proportion of experienced adult Type 1 diabetic patients, who voluntarily had opted for, and continued with, this particular mode of insulin treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00271261
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  • 6
    Electronic Resource
    Electronic Resource
    Decay of haemoglobin a1c upon return to normoglycaemia (1992)
    Springer
    Diabetologia 35 (1992), S. 191-191 
    Details
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00402556
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  • 7
    Electronic Resource
    Electronic Resource
    Moderate intake of sucrose does not impair metabolic control in pump-treated diabetic out-patients (1985)
    Springer
    Diabetologia 28 (1985), S. 204-207 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; sucrose ; diet ; metabolic control
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of dietary intake of sucrose versus the use of sodium cyclamate were studied in 10 Type 1 (insulin-dependent) diabetic patients on continuous subcutaneous insulin infusion therapy. After a 4-week run-in period, the patients were randomly assigned to a cross-over protocol with two 4-week periods during which they used sucrose or sodium-cyclamate as sweetener. During the experimental periods, 24±13 g/day sucrose and 348±270 mg/day of sodium cyclamate were consumed, respectively. Metabolic control was monitored by the patients performing blood glucose self-monitoring several times daily. Bi-weekly, all patients were followed-up in our outpatient clinic. Mean daily blood glucose concentrations as well as the average daily insulin dose did not differ between the three experimental periods. HbAIc-levels, serum lipids and body weight remained unchanged and within the normal ranges throughout the study. Thus, moderate dietary intake of sucrose did not affect metabolic control in these normal weight, near-normoglycaemic, normolipidaemic, pump-treated Type 1 diabetic patients during a 1-month period. Whether similar conclusions apply to less well controlled diabetic patients remains to be seen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00282233
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  • 8
    Electronic Resource
    Electronic Resource
    Effects on parameters of glucose homeostasis in healthy humans from ingestion of leguminous versus maize starches (1999)
    Springer
    European journal of nutrition 38 (1999), S. 183-189 
    Details
    ISSN: 1436-6215
    Keywords: Key words Glycaemic index – insulin – diabetes mellitus – blood glucose – digestion – diet – prebiotics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition , Medicine
    Notes: Summary Background: Due to their lower glycaemic index, leguminous seeds affect human carbohydrate metabolism lesser than do cereals. Problems, however, could arise from side effects, e.g., increasing flatulence. Aim of the study and methods: In 26 healthy subjects, metabolic and symptomatic responses following acute ingestion of equivalent amounts of pure pea starch (NASTAR (Cosucra BV, Rosendaal/The Netherlands), crude yellow pea flour (CPC Deutschland, Germany), and modified and unmodified cornstarches (SNOWFLAKE and SIRONA, Cerestar/Germany) were assessed, i.e., plasma glucose, serum insulin, C-peptide, hydrogen exhalation, and flatulence. Results: Pure pea starch elicited less hyperglycaemia (minus 47 %), hyperinsulinaemia (minus 54 %), and C-peptide secretion (minus 37 %) as compared to cornstarch (p〈0.05), while the responses to modified versus unmodified corn starch were similar (8 subjects, n.s.). Pure pea and corn starches were equally well tolerated, while flatulence and breath hydrogen concentration were increased only after the intake of crude pea flour. Maldigestion of pea flour was calculated to be around 10 % (reference lactulose). Conclusions: The well-known metabolic advantages of pea starch over cornstarch were confirmed. Tolerability of pure pea starch was excellent, but not of crude pea flour. Provided it has the same technical characteristics, pure pea starch as a “prebiotic” could replace cornstarch in industrial food production.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003940050060
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  • 9
    Electronic Resource
    Electronic Resource
    Target fasting glycaemia for pump-treated type-i diabetics (1984)
    Springer
    Journal of molecular medicine 62 (1984), S. 328-330 
    Details
    ISSN: 1432-1440
    Keywords: Continuous subcutaneous insulin infusion ; Free insulin concentration ; Fasting blood glucose ; Target values
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 17 type-I diabetic patients on continuous s.c. insulin infusion (CSII) therapy, potential interrelationships between fasting levels of blood glucose (BG), serum free insulin (free IRI), total (free and bound) insulin (total IRI) and insulinbinding immunglobulin G (IgGI) were evaluated. There was no consistent relationship between the basal s.c. infused insulin dosages and the associated insulinaemia or glycaemia. A significant inverse correlation was found between the fasting levels of serum free IRI and BG (P〈0.005). On the basis of this interrelationship, a target range of 90–110 mg/dl for fasting BG during CSII treatment is proposed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716450
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  • 10
    Electronic Resource
    Electronic Resource
    Zur Pathogenese der diabetischen Podopathie (1999)
    Springer
    Der Internist 40 (1999), S. 994-1001 
    Details
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Diabetes ; Komplikationen ; Polyneuropathie ; Diabetes ; Periphere arterielle Verschlußkrankheit ; Diabetischer Fuß ; Podopathie ; diabetische
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Polyneuropathie und periphere arterielle Verschlußkrankheit sind die wesentlichen pathogenetischen Voraussetzungen für das Entstehen der diabetischen Podopathie. Hinzu kommen dann Traumata durch Druckeinwirkung, Verletzungen, thermische Einwirkung oder Frakturen. In der Folge bilden sich häufig sekundäre Infektionen. Die erfolgversprechende Therapie der diabetischen Podopathie setzt klare Vorstellungen über die Pathogenese voraus. Manches spricht leider dafür, daß auf diesem Gebiet hierzulande ein gewisser Nachholbedarf besteht, die pathogenetischen Zusammenhänge nicht hinreichend bekannt sind und daher prophylaktische und therapeutische Maßnahmen nicht früh und effizient genug eingeleitet bzw. durchgeführt werden. Auch wenn nicht allerorts spezielle Fußambulanzen für Diabetiker eingerichtet werden können, sollte der diabetischen Podopathie, einer zumeist geriatrischen Diabeteskomplikation, größere Aufmerksamkeit gewidmet werden. Dazu soll diese Übersicht, die sich eingehend mit der Pathogenese, übrigens auch mit obsoleten Vorstellungen zur Pathogenese, der Therapie, Prophylaxe und Prognose der diabetischen Podopathie befaßt, einen Beitrag leisten.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050429
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