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  • 1
    ISSN: 1432-0428
    Keywords: Galactosamine hepatitis ; hyperinsulinaemia ; insulin resistance ; liver plasma membranes ; insulin binding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Six to 12 h after IP injection of 400 mg/kg of D-galactosamine in rats a 5-fold increase in plasma insulin was observed. In addition, impaired glucose assimilation was present after an IV load in spite of unchanged fasting glucose levels. In streptozotocin-diabetic rats (100 mg/kg IV) plasma insulin remained diminished 12 h after induction of D-galactosamine hepatitis. Under identical conditions of preparation and incubation, the liver plasma membranes of D-galactosamine-treated rats, in both normal and diabetic states, bound only 40–60% as much insulin per mg of membrane protein as those of the control rats. Scatchard analysis suggested that this was due to a decrease in the number of receptor sites in the membranes of the D-galactosamine-injected rats. No difference in the insulin degrading capacity and in insulin-receptor dissociation of the plasma membranes between control and D-galactosaminetreated groups was found. These data suggest that a reduction in the number of hepatic insulin receptors in galactosamine hepatitis can lead to insulin resistance and hyperinsulinaemia.
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  • 2
    ISSN: 1432-0428
    Keywords: Keywords Insulin-dependent diabetes mellitus ; metaiodobenzylguanidine ; autonomic neuropathy ; nervous tissue autoantibodies ; islet cell antibodies.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To investigate the presence of autoantibodies against sympathetic nervous tissue and their correlation with cardiac sympathetic dysinnervation in insulin-dependent diabetes mellitus (IDDM), 20 newly diagnosed (age 26 ± 6 years) and 48 long-term IDDM patients (age 40 ± 13 years, duration of diabetes 22 ± 12 years) without myocardial perfusion abnormalities (normal 99 mTC-methoxyisobutylisonitrile uptake) were assessed for myocardial 123I-metaiodobenzylguanidine (123I-MIBG) uptake and complement-fixing sympathetic ganglia (CF-SG) autoantibodies. Both groups of patients were also studied for islet cell antibodies (ICA) and ECG-based cardiac autonomic neuropathy. Eighty control subjects (age 18–49 years) were investigated for CF-SG autoantibodies. Eight newly diagnosed (40 %) and 12 long-term (25 %) IDDM patients exhibited CF-SG autoantibodies, compared to 4 control subjects (5 %; p 〈 0.01, p 〈 0.05). In long-term diabetic patients, the reduction of global but not of regional myocardial 123I-MIBG uptake correlated with CF-SG autoantibodies (r = 0.34, p = 0.02). Newly diagnosed diabetic patients did not show an association between CF-SG autoantibodies and global or regional myocardial 123I-MIBG uptake. ECG-based cardiac autonomic neuropathy ( ≥ two of five cardiac reflex tests abnormal) was present in 22 and absent in 26 long-term IDDM patients, of whom 9 (41 %) and 3 (12 %), respectively were positive for CF-SG autoantibodies (p = 0.02). Only 1 newly diagnosed IDDM patient demonstrated ECG-based cardiac autonomic neuropathy and was also positive for CF-SG autoantibodies. Although they are somewhat suggestive, results concerning autoantibodies against sympathetic nervous tissue and cardiac sympathetic dysinnervation do not strongly support the view that autoimmune mechanisms play a major role in the pathogenesis of cardiac sympathetic neuropathy in IDDM. [Diabetologia (1996) 39: 970–975]
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  • 3
    ISSN: 1432-0428
    Keywords: Insulin-dependent diabetes mellitus ; metaiodobenzylguanidine ; autonomic neuropathy ; nervous tissue autoantibodies ; islet cell antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To investigate the presence of autoantibodies against sympathetic nervous tissue and their correlation with cardiac sympathetic dysinnervation in insulin-dependent diabetes mellitus (IDDM), 20 newly diagnosed (age 26±6 years) and 48 long-term IDDM patients (age 40±13 years, duration of diabetes 22±12 years) without myocardial perfusion abnormalities (normal 99mTC-methoxyisobutylisonitrile uptake) were assessed for myocardial 123I-metaiodobenzylguanidine (123I-MIBG) uptake and complement-fixing sympathetic ganglia (CF-SG) autoantibodies. Both groups of patients were also studied for islet cell antibodies (ICA) and ECG-based cardiac autonomic neuropathy. Eighty control subjects (age 18–49 years) were investigated for CF-SG autoantibodies. Eight newly diagnosed (40%) and 12 long-term (25%) IDDM patients exhibited CF-SG autoantibodies, compared to 4 control subjects (5%; p〈0.01, p〈0.05). In long-term diabetic patients, the reduction of global but not of regional myocardial 123I-MIBG uptake correlated with CF-SG autoantibodies (r=0.34, p=0.02). Newly diagnosed diabetic patients did not show an association between CF-SG autoantibodies and global or regional myocardial 123I-MIBG uptake. ECG-based cardiac autonomic neuropathy (≥ two of five cardiac reflex tests abnormal) was present in 22 and absent in 26 long-term IDDM patients, of whom 9 (41%) and 3 (12%), respectively were positive for CF-SG autoantibodies (p=0.02). Only 1 newly diagnosed IDDM patient demonstrated ECG-based cardiac autonomic neuropathy and was also positive for CF-SG autoantibodies. Although they are somewhat suggestive, results concerning autoantibodies against sympathetic nervous tissue and cardiac sympathetic dysinnervation do not strongly support the view that autoimmune mechanisms play a major role in the pathogenesis of cardiac sympathetic neuropathy in IDDM.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: oral glucose tolerance test ; serum insulin ; insulin release ; glucose absorption ; starch hydrolyzate ; diabetes diagnostic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé 6 groupes de 8–14 sujets en bonne santé ont reu 50 g,ç 100 g ou 200 g de glucose ou d'une préparation d'hydrolysat d'amidon par voie orale. Les modifications de la glycémie étaient largement indépendantes du type ou de la quantité d'hydrates de carbone administrés. Les valeurs de l'insuline sérique, par contre, montraient une corrélation nette avec la quantité d'hydrates de carbone ingérés. Aprés 50 g d'hydrates de carbone, l'augmentation de l'insuline sérique était environ de 50 μU/ml; aprés 100 g d'hydrates de carbone, elle atteignait 90–100 μU/ml. Il n'y avait pas d'autres augmentations des valeurs maximales aprés ingestion de quantités plus grandes d'hydrates de carbone, mais la normalisation des taux d'insuline était nettement retardée. A partir du comportement des taux d'insuline sérique aprés ingestion de grandes quantités d'hydrates de carbone, on peut conclure que la résorption du glucose n'est pas terminée à 120 min malgré des valeurs normales de glucose sanguin. Comme l'indiquent ces résultats, 100 g de glucose ou de sirop d'amidon conviennent mieux à des buts diagnostiques que 50 g d'hydrates de carbone. Seulement l'ingestion de 100 g d'hydrates de carbone stimule suffisamment la sécrétion d'insuline, ce qui est d'un intérêt diagnostique spécial pour le moment le plus important du test, c'est-à-dire 2h aprés l'ingestion d'une charge d'hydrates de carbone.
    Abstract: Zusammenfassung Bei 6 Gruppen stoffwechselgesunder Personen (8–14 Probanden pro Gruppe) wurden orale Belastungen mit 50 g, 100 g oder 200 g Glucose bzw. Stärkehydrolysat durchgeführt. Die Blutglucoseveränderungen waren von der Art und der Menge der verabreichten Kohlenhydrate weitgehend unabhängig. Bei den Seruminsulinwerten war dagegen eine deutliche Beziehung zur verabreichten Kohlenhydratmenge vorhanden. Nach 50 g Kohlenhydraten betrug der Anstieg des Seruminsulins etwa 50 μE/ml, nach 100 g Kohlenhydraten etwa 90 100 μE/ml. Eine weitere Erhöhung der verabreichten Kohlenhydratmenge bewirkt zwar keine weitere Steigerung der Maximalwerte, jedoch war die Normalisierung der Seruminsulinwerte stark verzögert. Aus dem Verhalten der Seruminsulinwerte nach Verabreichung großer Kohlenhydratmengen kann geschlossen werden, daß trotz Normalisierung der Blutglucosewerte die Glucoseresorption nach 120 min noch nicht abgeschlossen ist. 100 g Glucose oder Stärkesirup sind nach diesen Ergebnissen für die orale Belastungsprobe zu diagnostischen Zwecken besser geeignet als 50 g Kohlenhydrate. Erst bei Einnahme von 100 g Kohlenhydraten wird die Insulinsekretion ausreichend stimuliert, was besonders für den wichtigsten Zeitpunkt der Untersuchung — zwei Stunden nach Einnahme der Kohlenhydrate von wesentlicher diagnostischer Bedeutung ist.
    Notes: Summary 6 groups consisting of 8–14 healthy control persons received 50 g, 100 g or 200 g of glucose or of a starch-hydrolyzate preparation by mouth. Blood sugar changes were largely independent of the type or amount of carbohydrate given. Serum insulin values, however, showed a definite correlation with the amount of ingested carbohydrate. After 50 g of carbohydrate the rise of serum insulin was about 50 μU/ml; after 100 g of carbohydrate it reached 90–100 μU/ml. There was no further rise of maximal values after ingestion of larger amounts of carbohydrate, but the normalization of insulin levels was markedly delayed. From the pattern of serum insulin levels after ingestion of large amounts of carbohydrates, it can be concluded that glucose absorption is not finished at 120 min despite normal blood glucose values. As indicated by these results, 100 g of glucose or starch-syrup is better suited for diagnostic purposes than is 50 g of carbohydrates. Only the ingestion of 100 g of carbohydrates stimulates insulin release sufficiently, which is of special diagnostic interest for the most significant interval of the test, i.e. 2 h after ingestion of the carbohydrate load.
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  • 5
    ISSN: 1432-0428
    Keywords: Insulin-dependent diabetes mellitus ; metaiodobenzylguanidine ; autonomic neuropathy ; sympathetic dysinnervation ; QT interval
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To analyse the presence and extent of global and regional distributions of cardiac sympathetic dysinnervation in long-term insulin-dependent diabetes mellitus (IDDM) without myocardial perfusion abnormalities (99mTc-methoxy isobutyl isonitrile study), 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy was performed in two clinically-comparable groups (20 diabetic patients with and 22 diabetic patients without ECG-based cardiac autonomic neuropathy). For comparison nine control subjects without heart disease were investigated. Only six diabetic patients (27%) without and one diabetic patient (5%) with ECG-based autonomic neuropathy were found to have a uniform homogeneous uptake of 123I-MIBG, in contrast to a uniform homogeneous uptake in all control subjects. The uptake of 123I-MIBG in the posterior myocardium of diabetic patients was smaller than in the anterior, lateral and septal myocardium (p〈0.001, p〈0.001, p=0.001). In addition, diabetic patients with cardiac autonomic neuropathy (≥ two of five age-related cardiac reflex tests abnormal) demonstrated a more reduced uptake in the global, lateral and posterior myocardium than diabetic patients without (p〈0.01, p〈0.01, p〈0.001). A correlation between global or regional myocardial 123I-MIBG uptake, however, and duration of diabetes, HbA1c, body mass index or QT interval length was not observed. Our study demonstrates that cardiac sympathetic dysinnervation is common in long-term IDDM even in patients without ECG-based cardiac autonomic neuropathy and that the posterior myocardium is predominantly affected. We conclude that 123I-MIBG scintigraphy is a promising approach to further elucidate the pattern and natural history of myocardial dysinnervation in IDDM.
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  • 6
    ISSN: 1432-0428
    Keywords: Key words Insulin-dependent diabetes mellitus ; metaiodobenzylguanidine ; autonomic neuropathy ; sympathetic dysinnervation ; QT interval.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To analyse the presence and extent of global and regional distributions of cardiac sympathetic dysinnervation in long-term insulin-dependent diabetes mellitus (IDDM) without myocardial perfusion abnormalities (99 mTc-methoxy isobutyl isonitrile study), 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy was performed in two clinically-comparable groups (20 diabetic patients with and 22 diabetic patients without ECG-based cardiac autonomic neuropathy). For comparison nine control subjects without heart disease were investigated. Only six diabetic patients (27 %) without and one diabetic patient (5 %) with ECG-based autonomic neuropathy were found to have a uniform homogeneous uptake of 123I-MIBG, in contrast to a uniform homogeneous uptake in all control subjects. The uptake of 123I-MIBG in the posterior myocardium of diabetic patients was smaller than in the anterior, lateral and septal myocardium (p 〈 0.001, p 〈 0.001, p = 0.001). In addition, diabetic patients with cardiac autonomic neuropathy ( ≥ two of five age-related cardiac reflex tests abnormal) demonstrated a more reduced uptake in the global, lateral and posterior myocardium than diabetic patients without (p 〈 0.01, p 〈 0.01, p 〈 0.001). A correlation between global or regional myocardial 123I-MIBG uptake, however, and duration of diabetes, HbA1 c, body mass index or QT interval length was not observed. Our study demonstrates that cardiac sympathetic dysinnervation is common in long-term IDDM even in patients without ECG-based cardiac autonomic neuropathy and that the posterior myocardium is predominantly affected. We conclude that 123I-MIBG scintigraphy is a promising approach to further elucidate the pattern and natural history of myocardial dysinnervation in IDDM. [Diabetologia (1995) 38: 1345–1352]
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  • 7
    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
    Journal of molecular medicine 54 (1976), S. 539-542 
    ISSN: 1432-1440
    Keywords: Maltose infusion ; Diabetes mellitus ; Maltose utilization ; Parenteral nutrition ; Maltoseinfusion ; Diabetes mellitus ; Maltoseverwertung ; parenterale Ernährung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Maltose wurde als 10%ige Lösung bei stoffwechselgesunden Personen (n=9) und bei Diabetikern vom Erwachsenentyp (n=9) über 2 Std kontinuierlich infundiert (0,25 g/kg Körpergewicht/Std). Während und nach Infusion sind die Änderungen der untersuchten Parameter (Blutglucose, Seruminsulin, freic Fettsäuren, Laktat, Pyruvat, Harnsäure, Säure-Basenwerte, Ketonkörper) minimal. Nur bei Stoffwechselgesunden ist der Anstieg der Blutglucose signifikant. Die Maltosekonzentrationen im Serum steigen während der Maltosezufuhr stetig und in beiden Gruppen nahezu identisch bis auf Maximalwerte um 150 mg/100 ml an. Nach Infusionsende sind über weitere 7 Std abnehmende Maltosekonzentrationen im Serum sowie über 18 Std eine Maltoseausscheidung im Harn nachweisbar. Bei stoffwechselgesunden Personen werden innerhalb der ersten 3 Std 4% der zugeführten Maltosemenge (1,3% als Maltose und 2,7% als Glucose) im Harn ausgeschieden. Die Kohlenhydratausscheidung bei Diabetikern ist mit 14 (1,1–35,9) % höher und individuell variabler. Die gegenüber Glucose insbesonders bei Diabetikern geringen metabolischen Veränderungen sowie die Möglichkeit einer höheren Kalorienzufuhr sind günstige Effekte parenteral applizierter Maltose. Jedoch sprechen langsame Elimination sowie die je nach Untersuchungsbedingungen und Dosierung des Disaccharids ansteigenden Verluste im Harn für die limitierte Fähigkeit des menschlichen Organismus Maltose zu verwerten. Solange weitere Untersuchungen während langdauernder Zufuhr am Menschen fehlen, kann eine alleinige Verwendung von Maltose als Kohlenhydrat in der parenteralen Ernährung nicht empfohlen werden.
    Notes: Summary Maltose (10% solution) was infused continuously over 2 h (0,25 g/kg BW/h) in maturity onset diabetics (n=9) and in non-diabetic patients (n=9) serving as controls. During and after infusion changes of parameters measured (blood glucose, IRI, FFA, lactate, pyruvate, uric acid, acid-base status, ketone bodies) were minimal. A significant rise in blood-glucose was observed only in non-diabetics. Serum maltose concentrations increased continuously up to 150 mg/100 ml during infusion and were nearly identical in both groups. Post infusion serum maltose decreased slowly during 7 h and urinary maltose excretion was found for 18 h. During the first 3 h controls excreted 4% of infused maltose (1.3% as maltose and 2.7% as glucose). In diabetics excretion of carbohydrates was higher and more variable: 14 (1.1–35.9) %. The slight metabolic changes, especially in diabetics and the possibility of supplying more calories are favorable effects of parenteral maltose. However slow elimination and increasing urinary losses depending on dosage and conditions of i.v. maltose application account for the limited utilization of the disaccharide in men. Unless further investigations will have been done maltose cannot be recommended as a sole substitute for carbohydrate in parenteral nutrition.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 59 (1981), S. 411-412 
    ISSN: 1432-1440
    Keywords: Nephrolithiasis ; Hypertension ; Renal stone surgery ; Nierensteinleiden ; Hypertonus ; Nierenstein-Operation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An einer Bevölkerungsstichprobe (261 Männer; 242 Frauen; Alter 15–65 Jahre) wurde anläßlich einer ärztlichen Untersuchung eine anamnestische Befragung über Nierenkoliken mit Steinabgang durchgeführt. Insgesamt fand(en) sich, mit steigendem Lebensalter in zunehmender Häufigkeit, bei insgesamt 6,9% der Männer und 6,6% der Frauen anamnestisch ein (oder mehrere) Steinabgang (Steinabgänge). Im Mittel wurden jährlich bei 0,6% der Männer und Frauen eine Steinkolik mit Steinabgang gefunden. Die im Vergleich zu früheren Angaben außerordentlich hohe Häufigkeit unterstreicht die große volksgesundheitliche Bedeutung des Nierensteinleidens.
    Notes: Summary 261 male and 242 female patients (age 15–65 years) were questioned about renal colics with passage of renal stones. The patients were questioned while undergoing a medical examination. The prevalence of renal stones varied between 1.1% (males 15–29 years) and 20.6% (males 50–65 years) with an average of 6.9%. The incidence of passage of a calculus was 0.62% percent of the population per year. These figures in a German population sample are in agreement with more recent data from other industrialized countries and point to the magnitude of renal stone disease as a public health problem.
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  • 10
    ISSN: 1432-1440
    Keywords: Blutlaktat ; Buformin ; Diabetes ; Dichlorazetat ; Blood lactate ; buformin ; diabetes ; dichloroacetate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In animals, dichloroacetate (DCA) which activates pyruvate dehydrogenase has been shown to diminish increased blood lactate concentrations due to biguanide treatment. In 10 maturity onset diabetics, therefore, the effect of a combined therapy with buformin and DCA (200 mg b.i.d.) was studied on blood lactate concentrations and compared with an analogous pre- and postinvestigation period of 6 days with buformin treatment alone (100 mg b.i.d.). Mean blood glucose concentrations remained the same during all 3 investigation periods. Also, neither fasting nor postprandially significant differences were found in blood lactate and ketones. In association with a standardized ergometer test, however, the rise in blood lactate was significantly smaller (p〈0.05) while the patients were on buformin plus DCA, compared to the periods when only buformin was given. Furthermore, less ketone bodies appeared to be utilized by the exercising muscle under the influence of the combined treatment (p〈0.05). These results are in good agreement with animal studies and suggest that DCA might be as effective in decreasing enhanced blood lactate concentrations in biguanide treated man as in animals.
    Notes: Zusammenfassung Im Tierversuch vermag Dichlorazetat (DCA), das die Pyruvatdehydrogenase stimuliert, erhöhte Blutlaktatspiegel unter Biguaniden zu senken. Bei 10 Erwachsenendiabetikern wurde daher der Einfluß einer Kombinationsbehandlung mit Buformin und DCA (400 mg tgl.) auf die Blutlaktatspiegel untersucht und mit einer analogen Vor- und Nachperiode einer alleinigen Buforminbehandlung (200 mg tgl.) über 6 Tage verglichen. Die Diabeteseinstellung blieb gemessen an den mittleren Blutglucosekonzentrationen während der 3 Untersuchungsperioden unverändert. Ebenfalls keine signifikanten Unterschiede, weder nüchtern noch postprandial, ergaben sich hinsichtlich der Laktat-und Ketonkörperspiegel im Blut. Im Anschluß an einen standardisierten Ergometertest jedoch stieg unter der Kombinationstherapie mit Buformin und DCA das Blutlaktat wesentlich geringer an (p〈0,05) als unter Buformin allein. Gleichzeitig wurden unter der Kombinationstherapie weniger Ketonkörper vom arbeitenden Muskel utilisiert (p〈0,05). Diese Ergebnisse stimmen mit Tierversuchen gut überein und können im Sinne einer vermehrten Pyruvatoxidation unter DCA interpretiert werden; es ist zu hoffen, daß DCA ähnlich wie beim Tier auch bei biguanidbehandelten Diabetikern einem excessiven Ansteigen der Blutlaktatspiegel vorbeugen kann.
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