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  • 1
    Electronic Resource
    Electronic Resource
    Plasma prolactin in juvenile diabetics (1978)
    Springer
    Diabetologia 15 (1978), S. 369-371 
    Details
    ISSN: 1432-0428
    Keywords: Juvenile diabetics ; plasma prolactin ; somatostatin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In normal subjects during 24-hours saline infusion, plasma prolactin showed a number of small rises during day and night. The mean night-time level was significantly higher than the day-time level (8.2 ±0.6 ng/ml as against 4.7±0.5 ng/ml). In 12 insulin-dependent diabetics the 24 h plasma prolactin pattern was identical to that found in normals. Somatostatin infusion (4 mg/24 h in normals; 2–6 mg/24 h in diabetics) had no effect on the 24 h plasma prolactin pattern in either normals or in diabetics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01219645
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  • 2
    Electronic Resource
    Electronic Resource
    The effect of 8 years of strict glycaemic control on peripheral nerve function in IDDM patients: the Oslo Study (1994)
    Springer
    Diabetologia 37 (1994), S. 579-584 
    Details
    ISSN: 1432-0428
    Keywords: Key words IDDM, nerve conduction velocity, neuropathy, intensified insulin treatment.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We have investigated the effect of long-term strict glycaemic control on peripheral and autonomic nerve function in 45 IDDM patients (age 18–42 years, diabetes duration 7–23 years) without clinical signs of neuropathy or other neurological disease. They were randomly assigned to treatment either with continuous insulin infusion, multiple injections (4–6 times daily), or conventional treatment (twice daily) for 4 years and followed prospectively for 8 years. Motor and sensory nerve conduction velocities were measured at the start and after 8 years. Autonomic nerve function tests were performed only once, after 8 years. A significant reduction of nerve conduction velocity was observed during 8 years in patients with mean HbA1 more than 10 % (n =12, group mean 10.9 %, range 10.1–13.2 %) compared to patients with HbA1 less than 10 % (n =33, group mean 9.0 %, range 7.5–9.9 %). Change of motor nerve conduction velocity in the peroneal nerve was: –4.8±4.9 (SD) vs –2.2±5.3 m/s (p〈0.01). Change of motor nerve conduction velocity in the posterior tibial nerve was: –6.8±5.7 vs –3.9±5.1 m/s (p〈0.05). No significant changes were observed in the ulnar nerve. Change of sensoric nerve conduction velocity in the sural nerve was: –8.9±8.0 vs –4.6±5.3 m/s (p〈0.05). Multiple regression analysis showed that a change in HbA1 of 1 % resulted in a 1.3 m/s change in nerve conduction velocity during 8 years. A significantly lowered heart-rate variation during deep breathing (p〈0.05) and heart-rate response to standing (p〈0.01) was found in patients with HbA1 more than 10 % compared to patients with HbA1 less than 10 %. This study confirms that the long-term lowering of blood glucose retards the deterioration in nerve conduction velocity observed in the diabetic nerve. [Diabetologia (1994) 37: 579–584]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403376
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Glomerular charge selectivity and the influence of improved blood glucose control in Type 1 (insulin-dependent) diabetic patients with microalbuminuria (1992)
    Springer
    Diabetologia 35 (1992), S. 1165-1169 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; nephropathy ; microalbuminuria ; continuous subcutaneous insulin infusion ; metabolic control ; glomerular charge selectivity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We first compared glomerular charge selectivity index in two matched groups of Type 1 (insulin-dependent) diabetic patients with micro and normoalbuminuria respectively, and secondly, investigated prospectively in a randomized clinical trial, the influence of improved metabolic control on selectivity index in diabetic patients with microalbuminuria. In Study 1, 27 patients with microalbuminuria (albumin excretion 〉-15 μg/min in at least two out of three overnight urine samples) were matched (age, diabetes duration, mean 1-year HbA1c, gender) with normoalbuminuria patients (n=24), and in Study 2, 23 microalbuminuric patients were randomly allocated to either intensive (continuous subcutaneous insulin infusion) or conventional treatment. Glomerular charge selectivity index was measured as IgG/IgG4 selectivity index, i.e. total IgG/IgG4 clearance ratio in timed overnight urine samples. The microalbuminuric patients had a significantly reduced selectivity index compared to the normoalbuminuric patients: 1.20 (0.92–1.40) vs 1.68 (1.22–2.21), median and 95% confidence interval (p〈0.01). In Study 2, the HbA1c improved in the intensive-treatment group compared to the conventional-treatment group: at 2, 6 and 12 months the difference in mean percentage HbA1c between the groups was 1.1, 1.2 and 1.4, respectively (p〈0.01). A sharp 50% increment in IgG/IgG4 selectivity index was seen in the intensive-treatment group during the first 6 months (p〈0.05 compared to the conventional group). We conclude that adolescents and young adults in an early stage of diabetic nephropathy have reduced glomerular charge selectivity, which may be improved by reducing the mean blood glucose level.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00401371
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  • 4
    Electronic Resource
    Electronic Resource
    Improvement of blood glucose control in IDDM patients retards the progression of morphological changes in early diabetic nephropathy (1994)
    Springer
    Diabetologia 37 (1994), S. 483-490 
    Details
    ISSN: 1432-0428
    Keywords: Key words Diabetic glomerulopathy, microalbuminuria, basement membrane thickness, mesangial expansion, mesangial matrix, stereology, hyperglycaemia.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We investigated in a randomized, prospective study the influence of improved blood glucose control during 2–3 years in young insulin-dependent diabetic (IDDM) patients with microalbuminuria, which is indicative of early nephropathy. Patients were randomized either to intensive treatment by continuous subcutaneous insulin infusion (CSII) (n =9) or CT (n =9). Kidney biopsies were taken at baseline and after 26–34 months. End points were structural changes in the glomeruli. Sensitive, quantitative, morphometric methods were used. The blood glucose control improved significantly (p =0.01) during the study in the CSII-group as glycated haemoglobin (HbA1 c) fell from 10.1 % ([95 % CI] 8.9–11.3) to 8.6 % (7.9–9.2), but not in the CT-group, 10.1 % (8.3–11.9) vs 9.7 % (8.7–10.8). Mean HbA1 c during the study period was significantly lower in the CSII-group than in the CT-group, 8.7 % (8.1–9.3) vs 9.9 % (8.5–11.3), p =0.04. Basement membrane thickness (BMT) increased in both groups, most (CT vs CSII, p =0.03) in the CT-group: 140 nm (50–230) vs CSII: 56 nm (27–86). In the CT-group only an increase was seen in matrix/mesangial volume fraction (p =0.006) and matrix star volume (p =0.04). Furthermore, a positive correlation between mean HbA1 c during the study and change from baseline in BMT (r =0.70, p =0.001) and matrix/glomerular volume fraction (r =0.33, p =0.09, NS) was demonstrated. Albumin excretion rate correlated significantly to BMT and most of the matrix parameters. The present study shows that during a period of only 2.5 years, a close relationship between the level of mean blood glucose and progression of glomerular morphological changes in early diabetic nephropathy can be demonstrated. [Diabetologia (1994) 37: 483–490]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050136
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  • 5
    Electronic Resource
    Electronic Resource
    The effect of 8 years of strict glycaemic control on peripheral nerve function in IDDM patients: the Oslo study (1994)
    Springer
    Diabetologia 37 (1994), S. 579-584 
    Details
    ISSN: 1432-0428
    Keywords: IDDM ; nerve conduction velocity ; neuropathy ; intensified insulin treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We have investigated the effect of long-term strict glycaemic control on peripheral and autonomic nerve function in 45 IDDM patients (age 18–42 years, diabetes duration 7–23 years) without clinical signs of neuropathy or other neurological disease. They were randomly assigned to treatment either with continuous insulin infusion, multiple injections (4–6 times daily), or conventional treatment (twice daily) for 4 years and followed prospectively for 8 years. Motor and sensory nerve conduction velocities were measured at the start and after 8 years. Autonomic nerve function tests were performed only once, after 8 years. A significant reduction of nerve conduction velocity was observed during 8 years in patients with mean HbA1 more than 10% (n=12, group mean 10.9%, range 10.1–13.2%) compared to patients with HbA1 less than 10% (n=33, group mean 9.0%, range 7.5–9.9%). Change of motor nerve conduction velocity in the peroneal nerve was: −4.8±4.9 (SD) vs −2.2±5.3 m/s (p〈0.01). Change of motor nerve conduction velocity in the posterior tibial nerve was: −6.8±5.7 vs −3.9±5.1 m/s (p〈0.05). No significant changes were observed in the ulnar nerve. Change of sensoric nerve conduction velocity in the sural nerve was: −8.9±8.0 vs −4.6±5.3 m/s (p〈0.05). Multiple regression analysis showed that a change in HbA1 of 1% resulted in a 1.3 m/s change in nerve conduction velocity during 8 years. A significantly lowered heart-rate variation during deep breathing (p〈0.05) and heart-rate response to standing (p〈0.01) was found in patients with HbA1 more than 10% compared to patients with HbA1 less than 10%. This study confirms that the long-term lowering of blood glucose retards the deterioration in nerve conduction velocity observed in the diabetic nerve.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403376
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    Glomerular epithelial foot processes and filtration slits in IDDM patients (1995)
    Springer
    Diabetologia 38 (1995), S. 1197-1204 
    Details
    ISSN: 1432-0428
    Keywords: Key words Albuminuria ; diabetic glomerulopathy ; diabetic nephropathy ; filtration slits ; glomerular epithelial cells ; stereology.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diabetic nephropathy is associated with functional changes in the glomerular filtration barrier but the structural counterpart remains unknown. Width of glomerular epithelial cell foot processes and of filtration slits were determined by morphometric methods in 11 non-diabetic kidney donors and in 28 diabetic patients with albumin excretion rates ranging from normal to proteinuria. Foot process width was estimated from the ratio of tuft surface density to length density of slits. At high magnification independently sampled, perpendicularly cut slits were classified. Foot process width on peripheral basement membrane was increased in microalbuminuric compared to normoalbuminuric diabetic patients (p 〈 0.05) but showed no significant correlation with the level of albumin excretion when patients with increased barrier permeability were considered. Width of filtration slits in normo- and microalbuminuric diabetic patients exceeded that in non-diabetic control subjects (p 〈 0.05). Filtration slits were narrower in patients with overt proteinuria than in patients with microalbuminuria (p 〈 0.05) and correlated with glomerular filtration rate in all of the diabetic patients (r = 0.65, p 〈 0.005). The results show that insulin-dependent diabetic patients with nephropathy present changes of epithelial cells and filtration slits, demonstrable already in the stage of microalbuminuria. The mechanism of albumin leakage is not achieved by these measures. The dimension of filtration slits may play a contributing role in the level of glomerular filtration rate in diabetic patients. [Diabetologia (1995) 38: 1197–1204]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00422369
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  • 7
    Electronic Resource
    Electronic Resource
    Blood glucose control and microvascular complications — what do we do now? (1994)
    Springer
    Diabetologia 37 (1994), S. 1172-1177 
    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/BF00399789
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    Paper (German National Licenses)
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  • 8
    Electronic Resource
    Electronic Resource
    Blood glucose control and microvascular complications – what do we do now? (1994)
    Springer
    Diabetologia 37 (1994), S. 1172-1177 
    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/BF00399789
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 9
    Electronic Resource
    Electronic Resource
    Glomerular epithelial foot processes and filtration slits in IDDM patients (1995)
    Springer
    Diabetologia 38 (1995), S. 1197-1204 
    Details
    ISSN: 1432-0428
    Keywords: Albuminuria ; diabetic glomerulopathy ; diabetic nephropathy ; filtration slits ; glomerular epithelial cells ; stereology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diabetic nephropathy is associated with functional changes in the glomerular filtration barrier but the structural counterpart remains unknown. Width of glomerular epithelial cell foot processes and of filtration slits were determined by morphometric methods in 11 non-diabetic kidney donors and in 28 diabetic patients with albumin excretion rates ranging from normal to proteinuria. Foot process width was estimated from the ratio of tuft surface density to length density of slits. At high magnification independently sampled, perpendicularly cut slits were classified. Foot process width on peripheral basement membrane was increased in microalbuminuric compared to normoalbuminuric diabetic patients (p〈0.05) but showed no significant correlation with the level of albumin excretion when patients with increased barrier permeability were considered. Width of filtration slits in normo- and microalbuminuric diabetic patients exceeded that in non-diabetic control subjects (p〈0.05). Filtration slits were narrower in patients with overt proteinuria than in patients with microalbuminuria (p〈0.05) and correlated with glomerular filtration rate in all of the diabetic patients (r=0.65, p〈0.005). The results show that insulin-dependent diabetic patients with nephropathy present changes of epithelial cells and filtration slits, demonstrable already in the stage of microalbuminuria. The mechanism of albumin leakage is not achieved by these measures. The dimension of filtration slits may play a contributing role in the level of glomerular filtration rate in diabetic patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00422369
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    Paper (German National Licenses)
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  • 10
    Electronic Resource
    Electronic Resource
    NIDDM: a rapid progressive disease Results from a long-term, randomised, comparative study of insulin or sulphonylurea treatment (1996)
    Springer
    Diabetologia 39 (1996), S. 1629-1633 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Insulin treatment ; sulphonylurea treatment ; metabolic control.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The objective of the present study was to assess the relative efficacy of insulin or glibenclamide treatment for non-insulin-dependent diabetes mellitus (NIDDM) over 42 months. We performed a randomised, controlled trial allocating patients treated with diet and oral antihyperglycaemic agents to treatment with glibenclamide or insulin to achieve HbA1c levels under 7.5 %. We included 36 subjects with established NIDDM of more than 2 years' duration. Mean HbA1c levels were significantly reduced in patients allocated to insulin treatment from 9.1 ± 1.4 % before the start to 7.8 ± 1.3 % (p〈 0.05) after 1 year, and did not change significantly thereafter throughout the study period. Mean HbA1c levels increased during the study in the patients allocated to glibenclamide treatment, and 11 of 18 patients had to be switched to insulin treatment due to increasing hyperglycaemia (HbA1c 〉 10 %). Mean body weight increased in the subjects allocated to insulin by 7.2 ± 4.1 kg during the study period. In conclusion, insulin was more effective than glibenclamide treatment in obtaining control over hyperglycaemia in these patients, and once improved, glycaemic control did not deteriorate over 42 months in the insulin-treated group. Two thirds of the patients allocated to glibenclamide treatment had to be given insulin due to inadequate glycaemic control. [Diabetologia (1996) 39: 1629–1633]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050626
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