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  • 1
    Electronic Resource
    Electronic Resource
    Plasma C-peptide and serum insulin antibodies in diabetic patients receiving pancreatic transplants (1980)
    Springer
    Diabetologia 19 (1980), S. 25-30 
    Details
    ISSN: 1432-0428
    Keywords: C-peptide ; insulin antibodies ; glucose tolerance ; segmental pancreatic transplantation ; pancreatic transplant rejection ; brittle diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Plasma C-peptide and serum insulin antibody levels were determined in 5 diabetic patients undergoing vascularized pancreatic transplantation. The grafts functioned well at first and exogenous insulin could be withdrawn, but one to 7 weeks later the grafts were rejected. After the transplantation there was an increase in the fasting plasma C-peptide level, and B-cell stimulation with glucose or glucagon evoked a C-peptide response. Healing of ischaemic damage was reflected in an increase in the C-peptide level. During graft rejection the C-peptide level fell. Measurement of plasma C-peptide levels provides a direct index of the B-cell function of the pancreatic graft. After transplantation the insulin antibody level fell exponentially, with an apparent half life of 10–11 days, whereas the level of total IgG was variable. The results indicate that formation of insulin antibodies ceases immediately on removal of the immunogenic stimulus, that is, on withdrawal of xenogeneic insulin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00258306
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  • 2
    Electronic Resource
    Electronic Resource
    Influence of phenformin and metformin on exercise induced lactataemia in patients with diabetes mellitus (1978)
    Springer
    Diabetologia 15 (1978), S. 95-98 
    Details
    ISSN: 1432-0428
    Keywords: Phenformin ; metformin ; exercise ; lactataemia ; diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of long-term treatment with phenformin and metformin respectively on blood lactate concentrations in relation to submaximal muscular exercise has been examined in 21 maturity-onset diabetics, using a cross-over method. At similar degrees of diabetic control the mean blood lactate concentration during exercise and shortly thereafter was significantly higher when the patients had received phenformin. The mean fasting lactate concentration was 1.07 mmol/l with phenformin and 1.03 mmol/l with metformin and the peak concentration was 2.56 mmol/l and 2.19 mmol/l respectively. The mean fasting blood glucose concentration before the exercise was 11.2 mmol/l with phenformin and 11.3 mmol/l with metformin; the glucose output in the urine during the preceding 24 hours was 93 mmol and 105 mmol respectively. The mean work load during exercise was 60 watts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00422252
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  • 3
    Electronic Resource
    Electronic Resource
    Renal and splanchnic exchange of human biosynthetic C-peptide in Type 1 (insulin-dependent) diabetes mellitus (1991)
    Springer
    Diabetologia 34 (1991), S. 423-428 
    Details
    ISSN: 1432-0428
    Keywords: Glucose utilization ; Type 1 (insulin-dependent) diabetes mellitus ; human C-peptide ; glucagon ; renal uptake ; hepatic uptake
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Biosynthetic human C-peptide or NaCl (154 mmol·l−1) was given intravenously to 13 Type 1 (insulin-dependent) diabetic patients to determine the renal and splanchnic exchange of C-peptide. Catheters were inserted percutaneously into an artery and a renal and hepatic vein. Infusions of C-peptide were given for 60 min at two dose levels (5 and 30 pmol·kg−1·min−1). Insulin was infused throughout the study (0.5 mU·kg−1·min−1) and plasma glucose was kept constant by a variable glucose infusion. The regional blood flows were measured by indicator dilution techniques. In 11 of the 13 patients basal C-peptide levels were not detectable. The arterial steady-state C-peptide concentration was 0.81±0.10 nmol·l−1 and 2.33±0.30 nmol·l−1 at the low and high rate infusions, respectively. Renal uptake was 124±18 pmol·min−1 at the low infusion corresponding to 39% of the infused amount. At the higher dose C-peptide infusion renal uptake increased to 155±21 pmol·min−1 (p〈0.05). Urinary excretion of C-peptide was 7±2 pmol·min−1 at the low dose infusion and increased to 34±6 pmol·min−1 at the high dose infusion (p〈0.01). The proportions of infused amount excreted were fairly constant and between 2% and 3%. No net exchange of C-peptide was found across the splanchnic vascular bed. The rate of glucose infusion had to be increased by 35% during the low dose C-peptide, but not during NaCl infusion in order to maintain a constant plasma glucose concentration. Arterial plasma concentrations of noradrenaline increased by 15–25% during both C-peptide and NaCl infusions. It is concluded that in patients with Type 1 diabetes (a) the kidney is the primary site of C-peptide removal, (b) renal metabolism rather than urinary excretion is the dominating process for C-peptide elimination (c) the excreted proportions of an infused amount of C-peptide were fairly constant between 2% and 3% and (d) no hepatic C-peptide catabolism could be detected.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403181
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  • 4
    Electronic Resource
    Electronic Resource
    Long-term metabolic control after pancreas transplantation with enteric exocrine diversion (1991)
    Springer
    Diabetologia 34 (1991), S. S76 
    Details
    ISSN: 1432-0428
    Keywords: Glucose ; Lipids ; Lipoproteins ; Pancreatic graft rejection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Long-term metabolic control after pancreatic transplantation with enteric exocrine diversion was evaluated in 42 Type I (insulin-dependent) diabetic pancreas recipients with functioning grafts for 1 to 7 years. Glycaemic control (fasting blood glucose, glycosylated haemoglobin A1c, oral and intravenous glucose tolerance tests) was normal or near-normal in most patients, and showed no deterioration with time. In ten patients with functioning grafts for 5 years there was a small, but significant, improvement in the glucose control at 3 to 5 years as compared with that at 6 months post-operatively. In the latter recipients the number of acute rejection episodes correlated negatively with the intravenous glucose tolerance at 6 months (r=−0.64, p〈0.01) and at 5 years (r=−0.60, p〈0.01) after transplantation, respectively. The glycaemic control at 6 and 12 months after transplantation was similar whether segmental (n=35) or whole-organ (n=7) pancreatic grafts had been used. In six non-uraemic recipients who had received a pancreas transplant alone the serum cholesterol increased in all but one patient (0.05〈p〈0.1), and the LDL/HDL-cholesterol ratio was significantly higher (p〈0.005) one year after transplantation than before. Conversely, in six diabetic patients who had lost the function of their single pancreatic grafts the lipid and lipoprotein profiles remained unaltered. It is concluded that the long-term glycaemic control after segmental or whole-organ pancreatic transplantation with enteric exocrine diversion remains essentially normal in most recipients, and it may even improve with time. The short- and long-term glucose control seems to be adversely influenced by the number of acute rejections. Moreover, in non-uraemic pancreas transplant recipients the lipoprotein profile changed towards a more atherogenic pattern. The latter findings are probably attributable to the immunosuppressive therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00587625
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  • 5
    Electronic Resource
    Electronic Resource
    The Stockholm experience with pancreatic transplantation using enteric exocrine diversion (1991)
    Springer
    Diabetologia 34 (1991), S. S21 
    Details
    ISSN: 1432-0428
    Keywords: Pancreatic transplantation ; Human ; Enteric diversion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Between April 1974 and June 1990, 128 pancreatic transplantations were performed. Of these 117 were with pancreatico-enterostomy. In four consecutive series of combined transplantations in uraemic diabetic patients the 1-year graft survival rate have successively improved (27%, 65%, 68% and 73%). In three similar series of single pancreatic transplantations the results also improved but still remained inferior (0%, 33% and 33%). In a series of combined transplantations performed in preuraemic diabetic patients the 1-year actuarial graft survival rate was only 25%. The results with pancreatic transplantation with pancreatico-enterostomy are now satisfactory. However, immunological loss graft function still constitute a major problem in the non- or preuraemic recipients. The metabolic control in patients with functioning grafts is normal or near-normal in the majority of patients followed for at least 1 year.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00587613
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  • 6
    Electronic Resource
    Electronic Resource
    Normalization of hepatic glucose regulation despite systemic insulin delivery. Studies in patients with pancreatic transplantation for Type 1 (insulin-dependent) diabetes mellitus (1991)
    Springer
    Diabetologia 34 (1991), S. 345-349 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; pancreatic transplantation ; hepatic glucose regulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary With current surgical techniques for pancreatic transplantation, the graft is anastomosed to the iliac vessels, resulting in delivery of insulin to the systemic circulation rather than to the portal vein as in healthy man. The possible influence of the altered route of insulin delivery on the regulation of splanchnic glucose metabolism was studied in four patients with Type 1 (insulin-dependent) diabetes mellitus at 6–19 months after combined pancreatic and kidney transplantation. Four non-diabetic, age-matched renal transplant recipients and two groups of age-matched healthy subjects served as controls. The studies were carried out in the basal state and during two rates of intravenous glucose infusion (2 and 4 mg · kg−1 · min−1). Fasting arterial glucose and splanchnic glucose output was similar in all groups. Basal hyperinsulinaemia was present in pancreatic graft recipients compared to healthy subjects. During low rate intravenous glucose infusion splanchnic glucose output decreased to a similar extent in all groups. With the higher glucose infusion rate (4 mg · kg−1 · min−1) a net glucose uptake was observed which was similar in all three groups. Peripheral glucose uptake was unchanged at the lower glucose infusion rate but increased by 45–55% at the higher rate. It is concluded that despite systemic insulin delivery from a heterotopic pancreatic graft, hepatic glucose metabolism appears normal both in the post-absorptive state and in response to glucose-stimulated endogenous insulin secretion. Portal insulin delivery is thus not necessary for normal hepatic glucose metabolism in the Type 1 diabetic patient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00405007
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  • 7
    Electronic Resource
    Electronic Resource
    Male predominance of Type 1 (insulin-dependent) diabetes mellitus in young adults: results from a 5-year prospective nationwide study of the 15–34-year age group in Sweden (1992)
    Springer
    Diabetologia 35 (1992), S. 56-62 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; Type 2 (non-insulin-dependent) diabetes mellitus ; incidence ; blood glucose ; body mass index ; percent desirable weight
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The incidence of diabetes mellitus in Sweden in the 15–34 year age group was prospectively studied on a nationwide basis, beginning 1 January 1983. A total of 1,214 male and 720 female cases of newly-diagnosed (excluding gestational) diabetes were reported over a 5-year period. This corresponds to an incidence of 20.5 per 100,000/year in male subjects and 12.7 per 100,000/year in female subjects. Most cases were classified as Type 1 (insulin-dependent) diabetes, with an incidence of 15.9 in males and 8.6 in females. The incidence of Type 1 diabetes decreased gradually with age, while the incidence of Type 2 (non-insulin-dependent) diabetes increased. A male predominance was found in all age groups, with a male-to-female ratio of 1.8∶1 for Type 1 diabetes and 1.3∶1 for Type 2 diabetes. Maximum blood glucose concentration at diagnosis was significantly higher in males than in females in both Type 1 and Type 2 diabetic subjects. In contrast, the percent desirable weight was significantly higher in females, both in Type 1 and Type 2 diabetic subjects. The difference in diabetes incidence therefore cannot be attributed to any methodological error. The present finding of a marked male predominance after puberty in Type 1 diabetes in an ethnically quite homogeneous population supports the hypothesis that environmental risk factors and life-style are important for the development of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400852
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  • 8
    Electronic Resource
    Electronic Resource
    Cell size and the antilipolytic effect of insulin in human subcutaneous adipose tissue (1975)
    Springer
    Diabetologia 11 (1975), S. 159-164 
    Details
    ISSN: 1432-0428
    Keywords: Release of glycerol ; adipose tissue ; cell size ; insulin ; isopropyl-noradrenaline ; noradrenaline ; obesity ; jejunoileostomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Lipolysis was studied in subcutaneous adipose tissue removed under local or general anaesthesia from subjects with marked difference in body weight and from obese subjects before and after intestinal shunt operations. The release of glycerol was measured in sections of adipose tissue incubated for two hours in bicarbonate buffer containing 4 per cent bovine albumin with no glucose added. The larger fat cells were more insulin sensitive than the smaller. A positive relationship was observed between the fat cell size and the antilipolytic effect of insulin (100 μU/ml). Insulin had no significant effect on the lipolytic effect of the catecholamines, when this is calculated as the increment in the glycerol release above the basal.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00429841
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  • 9
    Electronic Resource
    Electronic Resource
    Abnormalities in the adrenergic control and the rate of lipolysis in isolated human subcutaneous adipose tissue in diabetes mellitus (1976)
    Springer
    Diabetologia 12 (1976), S. 593-599 
    Details
    ISSN: 1432-0428
    Keywords: Adipose tissue ; diabetes mellitus ; isoprenaline ; noradrenaline ; glycerol release ; cyclic AMP
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Subcutaneous adipose tissue was obtained from 9 patients with untreated diabetes mellitus and from 13 obese nondiabetics. After incubation with isoprenaline or noradrenaline, glycerol release and tissue cyclic AMP (cAMP) were determined. Basal glycerol release was twice as rapid from the diabetic adipose tissue. With isoprenaline, the cAMP concentration and the glycerol production was significantly higher in the diabetic adipose tissue. Noradrenaline did not increase glycerol production or cAMP concentration in the diabetic adipose tissue. Subcutaneous adipose tissue was also removed from the diabetics after antidiabetic treatment. Basal lipolysis was significantly reduced and noradrenaline significantly increased both glycerol release and cAMP production. With isoprenaline, cAMP productjon and glycerol release were significantly less after antidiabetic treatment than in the untreated state. The data provide evidence for increased α- as well as β-adrenergic receptor sensitivity in human subcutaneous adipose tissue of untreated diabetic patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01220636
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  • 10
    Electronic Resource
    Electronic Resource
    Plasma β-hydroxybutyric acid response to nicotinic acid-induced plasma free fatty acid decrease in man (1966)
    Springer
    Diabetologia 2 (1966), S. 127-129 
    Details
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé 4 malades avec diabète juvénile non-traité et 4 personnes obèses à jeun ont reçu de l'acide nicotinique dans une étude aiguë. Dans tous les cas le taux des acides gras libres du plasma descendait, suivi par une chute de l'acide bêta-hydroxybutyrique dans le plasma. Les effets étaient moins prompts et moins prononcés chez les personnes obèses à jeun. Des modifications moindres du glucose sanguin ont été observées.
    Abstract: Zusammenfassung 4 Patienten mit unbehandeltem, jugendlichen Diabetes und 4 Adipöse im Hungerzustand erhielten im akuten Versuch Nikotinsäure. Bei allen Versuchspersonen trat ein Abfall der freien Fettsäuren im Plasma ein, an den sich ein Absinken des β-hydroxy-buttersäure-Spiegels im Plasma anschloß. Bei den übergewichtigen Personenim Hungerzustand setzten diese Wirkungen langsamer ein und waren schwächer ausgeprägt. Die Blutzuckerspiegel änderten sich in geringerem Ausmaße.
    Notes: Summary Nicotinic acid was in acute studies administered to 4 patients with untreated juvenile diabetes and to 4 obese fasting patients. In all cases the plasma level of FFA decreased. This was soon followed by a decrease in plasma β-hydroxybutyric acid. The effects were less prompt and pronounced in the obese fasting subjects. There were lesser changes in the concentration of blood glucose.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00423022
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