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  • 1
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; cerebrovascular disorders ; mortality ; recurrent stroke ; myocardial infarction ; causes of death
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cohorts of diabetic (n=121) and non-diabetic (n=584) patients were prospectively followed for up to ten years after having suffered from a stroke. All but six of the diabetic patients had Type 2 (non-insulin-dependent) diabetes mellitus. The diabetic patients had more risk factors associated with stroke: heart failure (p〈0.001) and angina pectoris (p〈0.001), than the non-diabetic patients. Neither body mass index nor blood pressure levels differed between the groups at admission. Haematocrit levels were higher in the diabetic group (p〈0.01). The diabetic patients were more commonly afflicted by cerebral embolism and to a lesser extent by transient ischaemic attacks than the nondiabetic patients. When calculated by log-rank tests, the diabetic group had an increased risk of death (p〈0.001), recurrent stroke (p=0.001), and of myocardial infarction (p=0.001) after the initial stroke. Autopsy-verified causes of death between the groups did not differ significantly, although half of all deaths during the period one to six months after stroke were caused by pulmonary embolism in the diabetic group. Thus, diabetes increases the risk of death after a stroke, and it also increases among stroke survivors the risk of recurrent stroke and myocardial infarction.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 38 (1995), S. 1061-1068 
    ISSN: 1432-0428
    Keywords: Key words Diabetes mellitus ; cerebrovascular disorders ; case fatality ; stroke mortality ; stroke incidence ; epidemiology ; WHO MONICA ; population attributable risk ; Sweden.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Stroke incidence, case fatality and mortality in diabetic patients were compared to non-diabetic subjects in a 35–74-year-old population in northern Sweden (target population 241,000). During an 8-year period, 1,544 stroke events in diabetic patients and 4,826 events in non-diabetic subjects were recorded. The crude incidence of stroke was 1,000 per 100,000 in the diabetic men vs 247 in the non-diabetic men (relative risk 4.1; 95 % confidence interval 3.2–5.2). Among diabetic women, the crude incidence was 757 per 100,000 and 152 in non-diabetic women (relative risk 5.8; 95 % confidence interval 3.7–6.9). The 28-day case fatality among men was similar in the diabetic and non-diabetic stroke patients (18.6 vs 17.1 %; p = 0.311), but significantly higher in diabetic women compared with non-diabetic women (22.2 vs 17.9 %; p = 0.02). When compared with the non-diabetic population, the overall mortality from stroke in the diabetic population (first and recurrent) was 4.4-times higher in male and 5.1-times higher in the female patients. Hypertension, atrial fibrillation, heart failure or myocardial infarction were all significantly more common in diabetic than in non-diabetic stroke patients. The population attributable risk, a crude estimate of all strokes ascribed to diabetes mellitus, was 18 % in men and 22 % in women. In Sweden, about 50 strokes are annually directly attributed to diabetes in a population of 100,000 in this age group. [Diabetologia (1995) 38: 1061–1068]
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 8 (1972), S. 153-159 
    ISSN: 1432-0428
    Keywords: Insulin content ; pancreatic weight ; glucose load ; serum insulin ; insulin release in vitro ; neonatal period ; postnatal feeding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé La réponse de l'insuline à une stimulation par le glucose a été étudiéein vivo etin vitro chez des rats nouveau-nés de petites ou de grandes portées. Chez les animaux des petites portées, âgés de deux jours, il y avait une nette augmentation des taux de l'insuline du sérum après une injection de glucose intrapéritonéale, tandis que la réponse de l'insuline au glucose était faible et lente chez les animaux des grandes portées, âgés de deux jours. La faible réponse de l'insuline au glucose chez les animaux des grandes portées, âgés de deux jours, a été confirmée par l'étudein vitro dans laquelle a été mesurée la sécrétion d'insuline par les glandes pancréatiques isolées après incubation dans une concentration faible ou forte de glucose. Le 3e ou le 4e jour après la naissance, il y a une augmentation de la sécrétion d'insuline en réponse à une charge de glucosein vivo etin vitro dans les deux groupes d'animaux. — Les résultats indiquent que la nutrition post-natale influence le développement de la sécrétion d'insuline provoquée par le glucose. La possibilité d'une influence des facteurs extra-pancréatiques sur le procédé de maturation est discutée.
    Abstract: Zusammenfassung Die Insulinsekretion nach Glucosestimulation wurdein vivo undin vitro an kleinen und großen Würfen säugender Ratten untersucht. Bei 2 Tage alten Tieren aus kleinen Würfen war ein starker Anstieg des Seruminsulinspiegels nach intraperitonealer Glucoseinjektion festzustellen, während die Insulinantwort auf Glucose bei Tieren eines großen Wurfs langsam und gering war. Die schwache Insulinsekretion nach Glucose bei 2 Tage alten Ratten eines großen Wurfs wurdein vitro weiter untersucht und die Insulinsekretion in geringer und hoher Glucosekonzentration gemessen. Am dritten und vierten postnatalen Tag wurde eine erhöhte Insulinsekretionin vivo undin vitro bei beiden Tiergruppen beobachtet. Die Ergebnisse deuten darauf hin, daß die Entwicklung der glucoseinduzierten Insulinsekretion von der postnatalen Fütterung beeinflußt ist.
    Notes: Summary The insulin response to glucose stimulation has been investigatedin vivo andin vitro in suckling rats from small or large litters. In two day old animals from small litters there was a marked increase in serum insulin levels after an intraperitoneal glucose injection, while the insulin response to glucose in animals from large litters was low and sluggish. The weak insulin response to glucose in the two day old rats from large litters was further substantiated in studiesin vitro in which the insulin release of isolated pancreatic glands was measured after incubation in a low or a high glucose concentration. On the third and fourth postnatal days there was an increased insulin secretion in response to the glucose challenge bothin vivo andin vitro in the two groups of animals. The results indicate that postnatal feeding modulates the development of the glucose-mediated insulin release.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 38 (1995), S. 1061-1068 
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; cerebrovascular disorders ; case fatality ; stroke mortality ; stroke incidence ; epidemiology ; WHO MONICA ; population attributable risk ; Sweden
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Stroke incidence, case fatality and mortality in diabetic patients were compared to non-diabetic subjects in a 35–74-year-old population in northern Sweden (target population 241,000). During an 8-year period, 1,544 stroke events in diabetic patients and 4,826 events in non-diabetic subjects were recorded. The crude incidence of stroke was 1,000 per 100,000 in the diabetic men vs 247 in the non-diabetic men (relative risk 4.1; 95% confidence interval 3.2–5.2). Among diabetic women, the crude incidence was 757 per 100,000 and 152 in non-diabetic women (relative risk 5.8; 95% confidence interval 3.7–6.9). The 28-day case fatality among men was similar in the diabetic and non-diabetic stroke patients (18.6 vs 17.1%; p=0.311), but significantly higher in diabetic women compared with non-diabetic women (22.2 vs 17.9%; p=0.02). When compared with the non-diabetic population, the overall mortality from stroke in the diabetic population (first and recurrent) was 4.4-times higher in male and 5.1-times higher in the female patients. Hypertension, atrial fibrillation, heart failure or myocardial infarction were all significantly more common in diabetic than in non-diabetic stroke patients. The population attributable risk, a crude estimate of all strokes ascribed to diabetes mellitus, was 18% in men and 22% in women. In Sweden, about 50 strokes are annually directly attributed to diabetes in a population of 100,000 in this age group.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Biochimica et Biophysica Acta (BBA)/General Subjects 588 (1979), S. 232-240 
    ISSN: 0304-4165
    Keywords: (Islets of Langerhans) ; Chloromercuribenzene p-sulphonic acid ; D-Glucose ; Phosphate efflux ; Phosphate flush
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Medicine , Physics
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1238
    Keywords: Key words Intensive care ; Sepsis ; Surgery ; Corticosteroid ; Adrenal hypofunction ; Cortisol ; Trauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To investigate the prevalence of adrenal hypofunction, as assessed by plasma cortisol (p-cortisol) and its relationship to clinical events. Design: Prospective, consecutive. Setting: General intensive care unit in a university hospital. Patients: Fifty-five patients (34 men and 21 women) were studied (surgery 40 patients, hemodialysis 5, ventilator treatment 45, sepsis 21). Methods: Morning basal levels of p-cortisol were determined. Previous reports define adrenal insufficiency to be present if p-cortisol under stressful conditions is lower than either 400 or 500 nmol/l. The tetracosactoid test (250 μg Synacthen) was performed in 16 patients and urinary 24-h excretion of cortisol in 24 (none on corticosteroid treatment). Results: Median p-cortisol was 550 nmol/l (range 20–1764). In 36 % of patients p-cortisol was lower than 400 nmol/l and in 47 % lower than 500 nmol/l. There was a significantly increased probability (P 〈 0.05) of p-cortisol being below 400 nmol/l in patients admitted due to trauma or cerebral disorder and in patients on ventilator therapy or on mannitol. Thirty minutes after tetracosactoid administration p-cortisol response was lower than 200 nmol/l in 56 % of the patients. Conclusions: Several patients had low p-cortisol and attenuated responses to tetracosactoid, indicative of adrenal insufficiency. There seem to be certain risk factors for adrenal hypofunction which may justify more frequent use of physiological doses of corticosteroid in selected patients
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 24 (1983), S. 412-417 
    ISSN: 1432-0428
    Keywords: Sulphonylurea ; glibenclamide ; drug-induced hypoglycaemia ; hypoglycaemic coma ; drug-related death ; drug interactions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the largest series of patients with glibenclamide-associated hypoglycaemia reported so far, 51 cases reported to the Swedish Adverse Drug Reactions Advisory Committee and six additional cases are reviewed and related to sales and prescription data of glibenclamide. Median age of the patients with hypoglycaemia was 75 years and 21% were 85 years or above. For comparison, the median age of a random sample (1 in 288 of all patients prescribed glibenclamide) was 70 years and only 5% were 85 years or older. In eight out of 40 cases where duration of glibenclamide treatment was recorded, the hypoglycaemic event occurred during the first month of treatment. The median daily dose of glibenclamide prescribed was 10 mg both in the hypoglycaemic cases and in the prescription sample. Coma or disturbed consciousness was the most common clinical presentation in this series and the minimum blood glucose value was 1.3 mmol/l (median). Twenty-two patients responded immediately to treatment, 24 had protracted hypoglycaemia of 12–72 h duration and 10 died. Fatal outcome was observed even with small doses of glibenclamide (2.5–5 mg/day). Previous strokes and cardiac disorders were isolated as two independent determinants of a serious course of the hypoglycaemia. Other contributing factors included impaired renal function, low food intake, diarrhoea, alcohol intake and interaction with other drugs. Thus, it is not uncommon for glibenclamide, like the first-generation sulphonylureas, to cause serious, protracted and even fatal hypoglycaemic events.
    Type of Medium: Electronic Resource
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