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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 28 (1985), S. 59-59 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 13 (1977), S. 345-350 
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; mortality ; coronary heart disease ; cerebrovascular disease ; hypoglycaemic therapy ; cohort studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A retrospective analysis of a cohort of 5210 diabetic patients revealed a mortality rate 1.3 times higher than in the general population of Warsaw. The higher death rate in the cohort under study was mainly due to an excess mortality from coronary heart disease and cerebrovascular disease. The excess mortality was greater in men than in women. The risk of death from cardiovascular diseases was higher among the patients with early onset diabetes. Mortality from cerebrovascular disease was highest in patients treated with insulin, intermediate in the group treated with oral drugs, and lowest in the group treated only with diet. The mortality ratio from coronary heart disease in men was not related to the method of hypoglycaemic therapy given at the onset or during the course of the diabetes. In women, the highest mortality was in the group treated with insulin, intermediate in the group treated with oral agents, and lowest in the group treated with diet only.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Insulin antibodies ; insulin therapy ; mono-component insulin ; immunoelectrophoresis ; diabetes ; virus hepatitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Levels of insulin binding immunoglobulin G (IgG) were determined by the method of Christiansen in diabetic patients divided into the following groups: 1. recently diagnosed diabetics, treated from the beginning with monocomponent (MC) pork insulin (12 patients); 2. diabetics treated from the beginning with several times recrystallized monospecies (MS) pork insulin (6 patients), and 3. diabetics previously treated for long periods with commercial insulin and changed to MC pork insulin (11 patients). The patients were observed for periods of from several months to two years. In patients treated with MC insulin, levels of insulin antibodies in the serum were not significantly increased, except in 3 patients who had viral hepatitis before or during insulin therapy and in an other patient immediately after an attack of influenza. In a majority of the patients treated with MS insulin, an increase in levels of insulin antibodies in the serum was observed. Patients previously treated with commercial insulin had very high titers of insulin antibodies in their serum, which decreased after changing over to MC insulin. In this group, some patients, in spite of continuation of treatment with MC insulin, developed increasing levels of insulin-binding antibodies in the serum during a later period of observation. The results indicate that during treatment of diabetes with insulin, contaminating pancreatic proteins due to shortcomings in production technology are responsible for immunogenicity of the insulin preparations. However, immunogenic properties of pure insulin may become manifest under clinical conditions in patients whose immune system has been sensitized by different factors.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Diabetes ; antidiabetic biguanides ; blood glucose ; plasma pancreatic GLI ; plasma gut GLI ; intraduodenal glucose administration ; intraduodenal amino acid administration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Five patients with mild maturity-onset diabetes were given 250 ml of a 20% glucose solution by intraduodenal infusion and eight other patients similarly received an amino acid solution in a dose of 0.5 g amino acids per kg body weight. The pancreatic and gut glucagon-like immunoreactivity (pancreatic GLI and gut GLI) in plasma were measured before and after the application of the two stimuli. Each person was tested twice; the first (control) test was followed by a second test after three days of treatment with phenformin 150 mg daily, plus the same 150 mg dose taken 60 min before the intubation. The plasma pancreatic GLI increased slightly during both infusions, but was not affected by phenformin. Intraduodenal infusion of both glucose and the amino acid solution induced a greater rise in plasma gut GLI. After treatment with phenformin, the fasting plasma gut GLI was higher than the control value in eleven of thirteen patients. In most cases higher gut GLI plasma levels were also found after duodenal administration of glucose and amino acids. These data furnish further evidence of the local action of antidiabetic biguanides on the intestinal wall, including its hormonal activity. The hypothesis is advanced that the phenformin-induced increase in gut GLI secretion may bring about competition of the latter with pancreatic glucagon for receptors in liver cell membranes, reducing the effect of glucagon on the liver, and thus contributing to a decrease in glycaemia.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0428
    Keywords: Biguanides ; blood lactate ; ethanol ; fructose ; exercise
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In three groups of healthy subjects (n = 56) changes in blood lactate, pyruvate and bicarbonate concentrations and pH were determined during three different loading tests. These were an oral ethanol load (0.5 g/kg body wt), an IV fructose load (1 g/kg body wt over 60 min), and a 15 min submaximal exercise load. The same tests were repeated after administration of biguanides for 3 days in the following doses: phenformin 150 mg, buformin 300 mg and metformin 2.55 g daily. All three derivatives induced a significant rise in blood lactate level as well as a significant increase in blood [lactate]/[pyruvate] ratio in relation to control tests. The differences in the effect of individual biguanides were minimal. It was observed, on the other hand, that increments in blood lactate concentrations depended markedly on the type of load given. The highest rise in blood lactate level was found after fructose loading; in the 60th minute of the test after phenformin it was 1.60±1.29 (SD), after buformin 1.32±0.79, and after metformin 1.31±0.64 mmol/1. The smallest rise of lactate was observed after oral ethanol loading: in the 1st hour of the test the respective values were 0.41±0.24, 0.52 ±0.18, and 0.91±0.86 mmol/1. In the exercise test the highest increment of the blood lactate level was observed 15 min after the end of the exercise, being 1.06±0.37, 1.21±0.25 and 1.26±0.33 mmol/1, respectively. The results of these investigations show that all three biguanide derivatives used in treatment of diabetes — phenformin, buformin and metformin — are risk factors which may induce lactic acidosis under suitable conditions.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-0428
    Keywords: Insulin dependent diabetes ; insulin independent diabetes ; familial occurrence of diabetes mellitus ; familial occurrence of coronary heart disease ; familial occurrence of hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary During an epidemiological study concerning the fate of diabetics in Warsaw, 2,356 subjects (aged 35–68 years with duration of diabetes mellitus of 3–11 years) were investigated with particular relevance to the presence of diabetes mellitus, coronary heart disease, and hypertension in their parents and siblings. Diabetics were classified into the following groups: insulin dependent, insulin independent nonobese, insulin independent obese, and a group in whom the distinction between insulin dependence and insulin independence was unclear. The findings in these groups were compared with the frequencies of these diseases in a random sample of the general population. There was an excess of diabetes in close relatives of all the diabetic groups. This was highest for insulin independent non-obese diabetics. There was no difference in the prevalence of coronary heart disease and hypertension in close relatives of insulin dependent diabetics when compared with the general population, but these were twice as prevalent in close relatives of the insulin independent non-obese group. Obese insulin independent diabetics reported a similar excess of coronary heart disease and hypertension in siblings, but the excess was less marked in parents. The prevalence of these diseases in families of probands with unclassified diabetes was intermediate between the other two groups. These results demonstrate an aggregation of diabetes mellitus with coronary heart disease and hypertension in families of insulin independent non-obese diabetics. This provides further evidence for heterogeneity in diabetes mellitus.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-0428
    Keywords: Keywords Maternal NIDDM ; paternal NIDDM ; C-peptide ; proinsulin ; lipids.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The 75-g oral glucose tolerance test was performed in 38 normoglycaemic (World Health Organization criteria) non-diabetic volunteers, aged 31–40 years, of whom 20 had a non-insulin-dependent diabetic (NIDDM) mother and 18 had an NIDDM father. At the time of the study the offspring of NIDDM mothers had a somewhat higher body mass index (BMI) (males: 26.5 ± 1.0 (mean ± SEM), females: 27.5 ± 1.5 kg/m2) than the offspring of NIDDM fathers (males: 23.4 ± 0.9, females: 24.2 ± 1.2 kg/m2). There was no difference in the time-course of glycaemia; however the serum concentrations of immunoreactive insulin (IRI), C-peptide and proinsulin were significantly higher in offspring of NIDDM mothers than in offspring of NIDDM fathers: area under the curve (AUC) serum IRI: 0.928 ± 0.091 vs 0.757 ± 0.056 nmol · l–1· h–1, p = 0.019; serum C-peptide: 6.379 ± 0.450 vs 4.753 ± 0.242 nmol · l–1· h–1, p = 0.004; serum proinsulin: 172 ± 40 vs 51 ± 7 pmol · l–1· h–1, p = 0.008). Serum IRI correlated with BMI, but C-peptide and proinsulin did not, and after accounting for BMI by covariance analysis they remained significantly higher in offspring of NIDDM mothers. In this group serum proinsulin was significantly higher in male than in female offspring (AUC serum proinsulin: 289 ± 68 vs 77 ± 27 pmol · l–1· h–1, P = 0.015). Male offspring of NIDDM mothers also had significantly higher serum triglyceride levels than females of the same group and than offspring of NIDDM fathers. The offspring (male and female) of NIDDM mothers had slightly lower serum apolipoprotein A-I levels than the offspring of NIDDM fathers. Significant correlations were found between serum triglycerides, HDL-cholesterol and apolipoprotein B, and serum concentrations of pancreatic beta-cell peptides, mostly in the offspring of NIDDM mothers; however, they did not display unequivocal association with gender within this group. The data are consistent with clinical observations of a greater risk of NIDDM transmission from the mother than from the father, and may suggest that male offspring are more exposed to this risk than female offspring. [Diabetologia (1996) 39: 831–837]
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 4 (1968), S. 345-348 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Dans un groupe de malades atteints de diabète juvénile, évoluant depuis plus de 10 ans, sans affections manifestes du foie ou des voies biliaires, on a effectué les recherches suivantes: 1. cholécystographie, 2. détermination du temps de contraction du sphincter de Lütkens et du sphincter d'Oddi, 3. détermination du temps de contraction de la vésicule biliaire, 4. détermination du temps d'apparition de BSP dans la bile C. En comparaison avec le groupe témoin (groupe de contrôle), on a constaté: un défaut beaucoup plus fréquent de la contraction de la vésicule biliaire (47% des cas), l'allongement du temps de la contraction du sphincter deLutkens (82.5%), l'allongement du temps d'écoulement de la bile vésiculaire (70.6%), ainsi que l'allongement de l'apparition de BSP dans la bile C (58.8%). La confrontation des valeurs moyennes montre chez les malades atteints de diabète, un allongement marqué: du temps de contraction du sphincter deLütkens (8 min ∶ 4 min), du temps d'écoulement de la bile vésiculaire (28 ∶ 18), ainsi que du temps de l'apparition de BSP dans la bile C (24 ∶ 19). Les résultats obtenus permettent de constater l'apparition plus fréquente de l'hypotonie de la vésicule biliaire chez les malades avec un diabète de longue durée. Cette perturbation du fonctionnement de la vésicule biliaire semble être une complication spécifique du diabète, semblable à d'autres troubles fonctionnels du tube digestif, constatés au cours du diabète.
    Abstract: Zusammenfassung Bei einer Gruppe von Patienten mit juvenilem Diabetes mellitus, der mehr als 10 Jahre andauerte und ohne manifeste Erkrankungen der Leber bzw. der Gallenwege verlief, wurden folgende Untersuchungen durchgeführt: — 1. Cholezystographie, 2. Bestimmung der Kontraktionszeit des Lütkens- und des Oddi-Sphinkters, 3. Bestimmung der Kontraktionszeit der Gallenblase, 4. Bestimmung der Erscheinungszeit des Bromsulphalein in der C-Galle. Der Vergleich mit der Kontrollgruppe ergab: eine bedeutend häufigere Verlängerung der Kontraktionszeit der Gallenblase bei 47% der Fälle, eine Verlängerung der Ausflußzeit der B-Galle bei 70.6%, eine Verlängerung der Kontraktionszeit des Lütkens-Sphinkters bei 82.5%, sowie eine Verlängerung der Erscheinungszeit von BSP in der C-Galle bei 58.8%. Die Zusammenstellung der Mittelwerte weist bei Diabetikern eine signifikante Verlängerung auf: der Kontraktionszeit des Lütkens-Sphinkters auf 8 Min. zu 4 Min., der Ausflußzeit der B-Galle auf 28 zu 18, sowie der Erscheinungszeit von BSP in der C-Galle auf 24 zu 19. — Die erhaltenen Resultate gestatten die Feststellung, daß bei Kranken mit langdauerndem Diabetes mellitus eine Hypotonie der Gallenblase auftritt. Diese Funktionsstörung der Gallenblase scheint eine ähnliche spezifische Komplikation des Diabetes zu sein, wie es auch andere Funktionsstörungen der Verdauungsorgane sind, die im Gefolge der Zukkerkrankheit beobachtet werden.
    Notes: Summary In a group of patients with juvenile-onset diabetes of over 10 years duration without known liver and bile duct diseases the following examinations were performed: 1. cholecystography; 2. measurement of the time of contractation of the Lütkens' and Oddi's sphincters; 3. measurement of the time of gall-bladder contraction; 4. measurement of the time of BSP appearing in the bile. Compared with the control group, there was a markedly more frequent impairment of gall-bladder contraction (in 47 percent of cases), as well as prolongation of the time ofLütkens' sphincter contraction (82.5 percent), prolongation of the time of the efflux of bile from the gall-bladder (70.6 percent) and prolongation of the bile BSP time (58.8 percent). The calculated means have shown in diabetic patients a significant prolongation of the Lütkens' sphincter contraction (8 min ∶ 4 min), of the time of the efflux of bile from the gall-bladder (28 ∶ 18) and of the bile-BSP time (24 ∶ 19). The results obtained prove a greater incidence of gall-bladder hypotony in patients with long-lasting diabetes. That dysfunction of the gall-bladder seems to be a specific complication of diabetes, similar to others found in the gastrointestinal tract of diabetic patients.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 7 (1971), S. 152-155 
    ISSN: 1432-0428
    Keywords: 5-aminolevulinic acid ; porphobilinogen ; diabetic ketosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Chez 56 malades atteints de diabète, on a déterminé selon la méthode de Mauzerall et Granick l'excrétion dans les urines de 24 h de l'acide 5-amino-lévulinique (AAL), et du porphobilinogène (PBG). On n'a pas constaté de différence marquée entre les valeurs moyennes, calculées pour ces patients, en les comparant au groupe de contrôle (40 personnes). On n'a pas constaté non plus de corrélation entre l'excrétion urinaire de l'AAL et de PBG avec le poids corporel, la durée du diabète et la méthode de traitement. Par contre, on a noté un degré élevé de corrélation entre l'excrétion de l'AAL et la diurèse (r xz =+0.75) ainsi que la glycosurie (r yz =+ 0.66). La corrélation entre l'excrétion de PBG et la diurèse et la glycosurie était au contraire faible. Dans le diabète non-contrôlé avec cétonurie (10 personnes), on a constaté un accroissement notable de i'excrétion d'AAL tandis que l'excrétion de PBG demeurait inchangée. — Chez les personnes saines il n'y avait pas de corrélation entre l'excrétion de l'AAL, aussi bien que de PBG, et la diurèse. Les investigations sur l'excrétion urinaire de T'A AL, et de PBG durant la diurèse hydrique et osmotique, provoquée par la perfusion intraveineuse de solution hypertonique de glucose chez des individus sains, ont fourni des données témoignant contre l'influence du glucose sur la réabsorption de l'AAL dans les tubules rénaux. — Les auteurs interprètent ces données comme un résultat de l'accroissement de l'activité de l'AAL-synthétase et de l'inhibition de l'activité de l'AAL-déshydrase au cours du diabète non-contrôlé, à la suite du métabolisme intracellulaire perturbé du glucose et de la production diminuée de l'ATP.
    Abstract: Zusammenfassung Bei 56 Diabetikern wurde die 24 Std. Urinausscheidung von 5-Aminolaevulinsäure (ALA) und Porphobilinogen (PBG) nach der Methode von Mauzerall und Granick bestimmt. Die bei diesen Patienten erhobenen Mittelwerte zeigten keine signifikanten Unterschiede zu den Ergebnissen bei einer Vergleichsgruppe von 40 Normalpersonen. Weder für die ALA-, noch für die PBG-Ausscheidung konnte eine Korrelation zum Körpergewicht, der Diabetesdauer und der Therapieform nachgewiesen werden. Hingegen korrelierten ALA-Ausscheidung und Diurèse (r xz =+0,75) und Glycosurie (r xz =+0,66) hoch, während die Korrelation zwischen PBG-Ausscheidung und Diurese, sowie Glycosurie nur locker war. Bei 10 schlecht eingestellten, azetonurischen Diabetikern wurde ein signifikanter Anstieg der ALA-Ausscheidung bei unveränderter PBG-Excretion beobachtet. — Bei Stoffwechselgesunden fanden sich keine signifikanten Beziehungen zwischen ALA- und PBG-Ausscheidung, sowie der Diurèse. Die Bestimmung der ALA- und PBG-Ausscheidung während eines Wasserstoßes und osmotischer Diurèse nach i.V. Zufuhr hypertoner Glucoselösungen liefert Ergebnisse, die gegen einen Glucoseeffekt auf die ALA-Rückresorption in den Nierentubuli sprechen. — Die mitgeteilten Befunde werden von den Autoren als das Ergebnis einer verstärkten ALA-Synthetase- und verringerter ALA-Deydrase-Aktivität bei entgleistem Diabetes aufgefaßt. Diese Veränderungen werden durch die Störung des intracellulären Glucosestoffwechsels und die herabgesetzte ATP-Bildung erklärt.
    Notes: Summary In 56 diabetics, 24-h urinary excretion of 5-aminolevulinic acid (ALA) and porphobilinogen (PBG) was determined by the method of Mauzerall and Granick. There was no significant difference between the mean values obtained for these patients, as compared with the control group (40 subjects). No correlation was also found between ALA and PBG excretion, as calculated against body weight, duration of diabetes and kind of treatment. There was a high degree of correlation between the excretion of ALA and diuresis (r xz =+0.75), as well as glycosuria (r yz =+0.66), whereas the correlation between the excretion of PBG and diuresis, as well as glycosuria, was low. In uncontrolled diabetes with ketonuria, (10 subjects), a significant increase in the excretion of ALA, with unchanged excretion of PBG, was observed. — In healthy subjects, there was no significant correlation between the ALA and PBG excretion and diuresis. The determination of the urinary ALA and PBG excretion during water diuresis and during osmotic diuresis induced by intravenous infusion of hypertonic glucose solution in healthy subjects, disclosed evidence testifying against the effect of glucose on ALA reabsorption in the renal tubules. — The present findings are interpreted by the authors as resulting from enhanced ALA synthetase activity and impaired ALA dehydrase activity in uncontrolled diabetes; these disturbances being related to the defective intracellular glucose metabolism and reduced ATP production.
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  • 10
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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