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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 19 (1980), S. 484-484 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Insulin-dependent diabetes ; autonomic neuropathy ; graded exercise ; heart rate ; blood pressure ; cardiac output ; cardiac stroke volume ; plasma volume ; hepato-splanchnic blood flow ; body temperature ; plasma catecholamines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Haemodynamic variables were measured during supine rest and during ergometer cycle exercise at two work loads (50 W and 100 W) in normal subjects (n = 7), in insulin-dependent diabetic subjects without neuropathy (n = 8), in insulin-dependent diabetic subjects with slight autonomic neuropathy (decreased beat-to-beat variation in heart rate, which is considered due to a cardiac parasympathetic defect; n = 8), and in insulin-dependent diabetic subjects with severe autonomic neuropathy, including orthostatic hypotension (n = 7). Compared with normal subjects, cardiac stroke volume was lower in the diabetic subjects with autonomic neuropathy, both at rest and during exercise (p 〈 0.025), whereas intermediate values were found in the diabetic subjects without neuropathy. The increase in cardiac output in response to exercise was smaller (p 〈 0.05) in both diabetic groups with autonomic neuropathy compared with the normal and diabetic subjects without autonomic neuropathy. The increase in hepato-splanchnic vascular resistance was smaller in the diabetic subjects with severe autonomic neuropathy than in the normal subjects and the diabetic subjects without autonomic neuropathy (p 〈 0.025), whereas intermediate values were found in the diabetic subjects with slight autonomic neuropathy. We conclude that, in diabetic patients with severe autonomic neuropathy, the responses of the heart and the splanchnic resistance vessels to exercise are impaired. While sympathetic neuropathy may be responsible for impaired function of splanchnic resistance vessels, both cardiac sympathetic neuropathy and diabetic cardiomyopathy may be involved in the impaired cardiac response to exercise in diabetic subjects with autonomic neuropathy.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Arterial blood pressure ; blood glucose ; cardiovascular ; heart rate ; insulin ; long-term diabetes ; nephropathy ; neuropathy ; noradrenaline ; proteinuria ; urinary albumin excretion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of intravenous injection of insulin on heart rate, plasma noradrenaline and urinary excretion rates of albumin and beta-2-microglobulin was examined in 10 long-term diabetics, 5 of whom had albuminuria. — In patients without albuminuria intravenous injection of insulin resulted in changes similar to but less pronounced than those previously observed in short-term diabetics: albumin excretion, plasma noradrenaline and heart rate increased, creatinine excretion decreased significantly. —Intravenous injection of insulin increased heart rate but not plasma noradrenaline in long-term diabetics with albuminuria. Arterial blood pressure did not change after insulin. Contrary to expectation insulin decreased urinary albumin excretion (from 418 to 312 μg/min, 27 per cent) in these patients. There was a marked decrease in urinary excretion rates of beta-2-microglobulin and creatinine (55 and 17 per cent, respectively) after insulin. — The decrease in albumin excretion after insulin in diabetics with albuminuria is most likely due to renal vasoconstriction. The absence of a rise in albumin excretion after insulin may be due to severe morphological changes in glomeruli in these patients.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; hypoglycaemia ; B cell function ; glucagon ; glucose recovery ; lipolysis ; ketogenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Hormonal, metabolic and cardiovascular responses to insulin induced hypoglycaemia were investigated in seven Type 1 (insulin-dependent) diabetic patients with residual B cell function, eight Type 1 diabetic patients without B cell function and six healthy subjects. No differences were found between the diabetic groups regarding nadir of glucose and rate of recovery to normoglycaemia. The patients with residual B cell function had a glucagon response to hypoglycaemia which was close to that of normal subjects. In patients without B cell function, the glucagon response to hypoglycaemia was present, albeit significantly smaller than in the patients with preserved B cell function (0.025 ng/ml, range 0.007–0.042 versus 0.054 ng/ml, range 0.029–0.087). The group without B cell function had signs of an exaggerated rate of lipolysis and ketogenesis compared with the patients with B cell function and the normal subjects.
    Type of Medium: Electronic Resource
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  • 6
    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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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 32 (1989), S. 888-888 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 7 (1971), S. 113-117 
    ISSN: 1432-0428
    Keywords: Juvenile diabetics ; nervous abnormalities ; vibratory perception threshold ; ischaemia ; metabolic ; insulin treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Il est bien connu que les diabétiques conservent la perception vibratoire pendant une période d'ischémie plus prolongée que les non-diabétiques. Cette anomalie neurologique est présente au moment de l'apparition clinique du diabète et peut être normalisée par le traitement à l'insuline. — Dans le présent travail, le seuil de perception vibratoire a été étudié au cours de l'ischémie chez six diabétiques avant et après traitement par l'insuline et chez six non-diabétiques. Les valeurs de seuil ont été mesurées dans le gros orteil, et l'ischémie a été induite en gonflant un brassard de pression placé soit au-dessus du genoux, soit au niveau de la cheville. — Les résultats obtenus montrent qu'un fonctionnement normal d'une partie seulement de la longueur de la fibre nerveuse suffit pour obtenir une réponse ischémique normale tout au long du nerf, probablement parce que cette partie arrêtera la conduction comme si la fibre nerveuse toute entière était complètement réparée. — En outre, il est démontré qu'au cours du traitement par l'insuline, la normalisation survient plus fréquemment dans les parties proximales des nerfs par comparaison avec les parties plus distales. — On pense que les anomalies ischémiques sont dues à une gaine de myéline défectueuse.
    Abstract: Zusammenfassung Es ist hinreichend belegt, daß das Vibrationsempfinden bei Diabetikern während einer längeren Ischämie-Periode als bei Nichtdiabetikern erhalten bleibt. Diese neurologische Anomalie ist bereits bei der klinischen Manifestation des Diabetes nachweisbar und läßt sich durch Insulinbehandlung normalisieren. — In der vorliegenden Untersuchung wurde der Schwellenwert für das Vibrationsempfinden bei 6 Diabetikern vor und nach Insulinbehandlung und bei 6 Nichtdiabetikern untersucht. Die Schwellenwerte wurden am Großzeh gemessen und die Ischämie durch Anlegen einer Staubinde oberhalb des Knies oder in der Knöchelgegend ausgelöst. — Die erzielten Resultate zeigen, daß, um eine normale Ischämie-Reaktion für die Gesamtlage des Nerven zu erhalten, nur ein Teil der Länge der Nervenfaser normal funktionieren muß, wahrscheinlich weil dieser Teil aufhören wird zu leiten, als ob die ganze Nervenfaser völlig repariert sei. — Weiter konnte gezeigt werden, daß während der Insulinbehandlung die Normalisierung in den proximalen Vervenabschnitten schneller als in den distalen Bezirken eintritt. — Die unter Ischämie nachweisbaren Anomalien werden auf eine defekte Myelin-Scheide bezogen.
    Notes: Summary It has been well documented that diabetic patients retain vibratory perception during a longer period of ischaemia than non-diabetics. This neurological abnormality is present at the time of the clinical appearance of diabetes and can be normalized by treatment with insulin. — In the present study the vibratory perception threshold was studied during ischaemia in six diabetics before and after treatment with insulin and in six nondiabetics. Threshold values were measured in the big toe, and isehaemia induced by inflating a pressure cuff placed either above the knee or at the level of the ankle. — The results obtained show that a normal function of only a part of the length of the nerve fibre is required to obtain a normal ischaemic response throughout the length of the nerve, presumably because this part will stop conduction as if the whole nerve fibre were fully repaired. — Furthermore, it is demonstrated that during treatment with insulin, normalization occurs at a greater rate in the proximal parts of the nerves compared with the more distal parts. — The ischaemic abnormalities are believed to be due to a defective myelin sheath.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0428
    Keywords: Isolated perfused pancreas ; catecholamine release ; insulin release ; glucagon release ; glucose ; autonomic nervous system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Six fasting male mongrels served as pancreas donors. The pancreas was perfused without recirculation with a synthetic medium. The noradrenaline and adrenaline concentration in the efflux perfusate was determined by a double-isotope derivative technique. 1. The noradrenaline concentration in the efflux perfusate rose considerably (from 0.25 ng/ml to 10.0 ng/ml), when the pancreas was perfused with a glucose deprived perfusing medium. The concentration rose almost linearly with time. After the addition of very small amounts of glucose (2 mg/100 ml) to the perfusing medium there was a considerable decrease in catecholamine concentration and a further decrease with higher glucose concentrations. 2. No change in catecholamine concentration in the efflux perfusate was observed if the pancreas was perfused with a high glucose concentration during the whole experiment. 3. Glucagon release was also high during perfusion with a glucose deprived solution while insulin release was low. These experiments raise the question whether an increased catecholamine release may, at least partially, be responsible for the change in insulin and glucagon secretion during glucose deprivation.
    Type of Medium: Electronic Resource
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