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  • 1
    Electronic Resource
    Electronic Resource
    Safety of continuous subcutaneous insulin infusion: Metabolic deterioration and glycaemic autoregulation after deliberate cessation of infusion (1982)
    Springer
    Diabetologia 22 (1982), S. 175-179 
    Details
    ISSN: 1432-0428
    Keywords: Continuous subcutaneous insulin infusion ; insulin withdrawal ; ketoacidosis ; glucose regulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To assess the rate of metabolic deterioration and potential risks of failure of continuous subcutaneous insulin infusion during basal insulin delivery, we deliberately stopped infusion in nine insulin dependent diabetics. Plasma glucose, blood 3-hydroxybutyrate and plasma free insulin were measured for 9 h whilst the patients remained supine and fasting. Mean plasma glucose remained unchanged at normal fasting levels for the first hour, then rose to plateau at about 10 mmol/l until the end of the experiment. The final plateau level of glucose varied from patient to patient; two C-peptide secreting diabetics plateaued at low glucose levels. In contrast, blood 3-hydroxybutyrate rose progressively, without plateauing. Plasma free insulin concentrations fell during the withdrawal period and there was a highly significant negative correlation between free insulin and 3-hydroxybutyrate. No patient was more than mildly unwell after 9 h of insulin deprivation. We conclude that under these experimental conditions there is glycaemic autoregulation and that ketones may sometimes be a more appropriate monitor of insulin deficiency or loss of diabetic control than is glucose. Accidental failure of continuous subcutaneous insulin infusion and interruption of basal delivery in resting and fasting diabetics will probably not cause dangerous metabolic or clinical deterioration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00283748
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Renal autoregulation is normal in newly diagnosed, normotensive, NIDDM patients (1998)
    Springer
    Diabetologia 41 (1998), S. 206-211 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Renal autoregulation ; angiotensin converting enzyme inhibitor ; normotension ; nephropathy ; non-insulin-dependent diabetes mellitus.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Abnormalities of renal autoregulation with glomerular hyperfiltration and raised intraglomerular pressure have been suggested as important factors in the initiation and development of diabetic nephropathy. Angiotensin converting enzyme (ACE) inhibition appears to have a specific reno-protective role in diabetic nephropathy, possibly by reducing intraglomerular pressure. The acute effects of ACE inhibition on renal haemodynamics in normotensive, non-insulin-dependent diabetes mellitus (NIDDM) have not been previously reported. We measured simultaneous glomerular filtration rate (GFR) and renal plasma flow (RPF) in 29 (4 female) subjects, mean age 52 years (range 27–70), using 51Cr EDTA and 125I Hippuran. Clearances were corrected to 1.73 m–2. All patients were normotensive (blood pressure 〈 75th centile for age and sex), newly diagnosed ( 〈 30 days), taking no antihypertensive or hypoglycaemic medication. Subjects were randomly allocated (double blind) to receive the ACE inhibitor trandolapril 4 mg day–1 (H) (hypotensive dose), trandolapril 0.5 mg day–1 (L) (non-hypotensive dose) or placebo (P) for 10 days after which renal haemodynamics were remeasured. For all subjects baseline GFR, RPF and filtration fraction (FF) were 97 ± 21 ml min–1 mean ± SD, 439 ± 120 ml min–1 and 22.3 ± 2.9 % respectively. Glomerular hyperfiltration (GFR 〉 120 ml min–1) was only demonstrated in 3 subjects (10.3 %). In group H mean arterial pressure (103 ± 8 vs 93 ± 9 mmHg, p 〈 0.001) and FF (23.8 ± 2.3 vs 20.0 ± 4.0 %, p = 0.03) fell while RPF increased (376 ± 111 vs 426 ± 60 ml min–1, p = 0.02), there was no significant change in GFR. No significant change in mean arterial pressure, GFR, RPF or FF occurred in groups P and L. These studies suggest that in newly diagnosed normotensive NIDDM subjects normal renal autoregulation occurs and glomerular hyperfiltration is uncommon. [Diabetologia (1998) 41: 206–211]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050891
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  • 3
    Electronic Resource
    Electronic Resource
    End-stage renal disease in NIDDM: a consequence of microangiopathy alone? (1996)
    Springer
    Diabetologia 39 (1996), S. 1673-1675 
    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/s001250050633
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Renal enlargement and insulin-like growth factor-1 accumulation in the Wistar rat model of experimental diabetes is not prevented by angiotensin converting enzyme inhibition (1996)
    Springer
    Diabetologia 39 (1996), S. 166-171 
    Details
    ISSN: 1432-0428
    Keywords: Renal enlargement ; renal haemodynamics ; angiotensin II ; insulin-like growth factor-1 ; angiotensin converting enzyme inhibition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Experimental diabetes is associated with renal enlargement and glomerular hyperfiltration. Possible mechanisms for these changes could be the direct effects of growth factors such as insulin-like growth factor-1 and angiotensin II. We investigated whether treatment with trandolapril, an angiotensin converting enzyme inhibitor, prevented renal enlargement in streptozotocin-diabetic rats. Seven groups of male Wistar rats were studied: C (control+placebo); CL (control+low-dose trandolapril, 0.01 mg · kg−1 · day−1); CH (control + high-dose trandolapril, 0.5 mg · kg−1 · day−1); DP (diabetic + placebo); DI (diabetic, insulin-treated); DL (diabetic + low-dose trandolapril); DH (diabetic + high-dose trandolapril) and DI (diabetic + insulin). From day 2 glucose concentrations and body weight were similar in the non-diabetic and diabetic animals treated with insulin. Diabetic animals treated with placebo and low-dose trandolapril weighed significantly less compared to the control group. The diabetic groups, not treated with insulin, showed marked hyperglycaemia throughout the study. Kidney weight was greater in the diabetic, non insulin-treated groups compared with the control and insulin-treated groups. After 24 h of diabetes, kidney insulin-like growth factor-1 content was significantly increased from baseline levels in groups DP, DL and DH but by 48 h these levels had returned to normal. Renal tissue angiotensin converting enzyme activity was similar in groups C and DI but significantly reduced in all trandolapril-treated animals. Despite inhibiting renal angiotensin converting enzyme activity renal enlargement with increased tissue insulin-like growth factor-1 still occurred. This suggests that neither angiotensin II nor glomerular hyperfiltration, with raised intraglomerular pressure, play a role in the initial renal enlargement seen in experimental diabetes. Renal accumulation of insulin-like growth factor-1 appears to be an important factor in early renal hypertrophy and its effects are not modulated by angiotensin converting enzyme or angiotensin II.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403959
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  • 5
    Electronic Resource
    Electronic Resource
    Growth factors and diabetic nephropathy: kidney structure and therapeutic interventions (1997)
    Springer
    Diabetologia 40 (1997), S. B68 
    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/s001250051407
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  • 6
    Electronic Resource
    Electronic Resource
    Capillary tubes for blood glucose sampling (1982)
    Springer
    Diabetologia 23 (1982), S. 539-540 
    Details
    ISSN: 1432-0428
    Keywords: Home glucose monitoring ; capillary tubes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A formal evaluation of the Sarstedt capillary tube system for blood glucose sampling was undertaken. Results obtained with the method were found to be highly reproducible (coefficient of variation = 4.7%) and accurate (mean±SD difference between this system and a reference system =-0.14±0.45 mmol/l). A decline in glucose values by 10% occurred when they were stored for 48 h before analysis, and this decline persisted in samples kept at room temperature, but was abolished by storage at 4 °C.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00254307
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