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  • 1
    Electronic Resource
    Electronic Resource
    Effects of an increased content of cereal fibre in the diet of Type 2 (non-insulin-dependent) diabetic patients (1984)
    Springer
    Diabetologia 26 (1984), S. 272-277 
    Details
    ISSN: 1432-0428
    Keywords: Type 2 diabetes ; dietary treatment ; dietary fibre ; blood glucose ; serum insulin ; serum lipoproteins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The metabolic effects of an increased dietary content of cereal fibre were studied in 14 Type 2 diabetic subjects. They were given two isoenergetic diets in randomised order during two consecutive 3-week periods. A diabetic diet, containing 18.9 g dietary fibre/6.7 MJ (1600 kcal), was compared with a diet of identical composition except for an increased content of cereal fibre (42.4 g dietary fibre/6.7 MJ). The mean blood glucose level and the urinary glucose excretion were significantly lower in patients on the cereal-fibre-rich diet, while the serum insulin concentrations were similar. The mean blood glucose level was significantly reduced at 0700 h by 6% (p〈0.05) and at 1100 h by 13% (p〈0.01) on the highfibre diet. Consequently the insulin/glucose ratio was higher (33%, p〈0.02) in patients on the fibre-enriched diet. There were only minor differences with regard to the serum lipoprotein concentrations. The lipoprotein lipase activities were similar in the two dietary groups. The reduction of blood glucose concentrations together with unchanged serum insulin concentrations is compatible with improved peripheral insulin sensitivity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00283649
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  • 2
    Electronic Resource
    Electronic Resource
    Insulin sensitivity is related to the fatty acid composition of serum lipids and skeletal muscle phospholipids in 70-year-old men (1994)
    Springer
    Diabetologia 37 (1994), S. 1044-1050 
    Details
    ISSN: 1432-0428
    Keywords: Key words Cholsterol esters ; fatty acid composition ; insulin sensitivity ; palmitic acid ; phospholipids ; skeletal muscle.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Recent data indicate that peripheral insulin sensitivity may be influenced by dietary fat quality and skeletal muscle phospholipid fatty acid composition. During a health survey of 70-year-old men insulin sensitivity was measured by the euglycaemic hyperinsulinaemic clamp technique and the fatty acid composition of the serum cholesterol esters was determined (n = 215) by gas liquid chromatography. In a subsample the fatty acids of the skeletal muscle phospholipids and triglycerides were determined after fine needle biopsy from m. vastus lateralis (n = 39). The peripheral insulin sensitivity was significantly and negatively correlated to the proportion of palmitic (r = -0.31, p 〈 0.001), palmitoleic (r = − 0.25, p 〈 0.001) and di-homo-γ-linolenic (r = − 0.33, p 〈 0.001) acids and positively to the content of linoleic (r = 0.28, p 〈 0.001) acid in the serum cholesterol esters. There was an even stronger negative relationship to the proportion of palmitic acid in the skeletal muscle phospholipds (r = − 0.45, p 〈 0.004). The fatty acid composition was also significantly related to insulin sensitivity in a stepwise multiple regression analysis in the presence of other clinical variables, which were associated with insulin action in univariate analysis. Thus, more than 51 % of the variation of the insulin sensitivity was explained by an equation containing body mass index, serum triglyceride concentration and the content of palmitic acid in the skeletal muscle phospholipids. It is concluded that the fatty acid composition in serum and of the phospholipids of skeletal muscle may influence insulin action in elderly men. [Diabetologia (1994) 37: 1044–1050]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400468
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  • 3
    Electronic Resource
    Electronic Resource
    Glucose tolerance and resistance to insulin-stimulated glucose uptake in men aged 70 years in relation to size at birth (1998)
    Springer
    Diabetologia 41 (1998), S. 1133-1138 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Birthweight ; fetal-development ; insulin-resistance ; glucose-clamp-technique ; longitudinal-studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Although several studies have shown that reduced size at birth predicts glucose intolerance and insulin resistance in adult life, the relation has been inconsistent and usually stronger for ponderal index than for birthweight. We examined glucose tolerance and insulin sensitivity (by the euglycaemic clamp method) in relation to size at birth in 709 men aged 69–73 years in Uppsala, Sweden. After adjusting for adult body mass index, prevalence of glucose intolerance (defined as diabetes or impaired glucose tolerance) was inversely related to birthweight. In men born at term, there was a positive monotonic relation of insulin sensitivity with birthweight, strongest in those who were overweight at age 70. This relation was reversed in men born before term (p = 0.005 for interaction between pre-term birth and birthweight effect). Glucose intolerance and insulin resistance showed inverted U-shaped relations with ponderal index, in contrast with the monotonic inverse relation seen in this cohort at earlier ages. This change in form of the relations was partly accounted for by selective loss to follow-up between ages 60 and 70 years. These results confirm that the association between reduced fetal growth and glucose intolerance is mediated through insulin resistance and depends upon an interaction with obesity in adult life. This relation is obscured when pre-term births are included. Failure to stratify by gestational age in previous studies could account for inconsistencies in the relations of insulin resistance and glucose intolerance to size at birth and for the detection of stronger associations with ponderal index than with birthweight. [Diabetologia (1998) 41: 1133–1138]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250051042
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  • 4
    Electronic Resource
    Electronic Resource
    Birth weight and the insulin resistance syndrome: association of low birth weight with truncal obesity and raised plasminogen activator inhibitor-1 but not with abdominal obesity or plasma lipid disturbances (2000)
    Springer
    Diabetologia 43 (2000), S. 54-60 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Insulin resistance, birth weight, hyperlipidaemia, plasminogen activator inhibitor-1, waist:hip ratio, proinsulin.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. To distinguish the physiological disturbances related to birth weight from the cluster of disturbances called the insulin resistance syndrome.¶Methods. Men participating in a population-based study in Uppsala, Sweden, with recordings of birth weight, were metabolically characterised at age 50 (n = 1268) and re-investigated at age 70 (n = 734). Blood pressure, BMI, glucose and insulin concentrations are associated with birth weight in this cohort.¶Results. Birth weight was inversely associated (p 〈 0.03) with subscapular:triceps skinfold ratio (truncal fat), plasminogen activator inhibitor-1 (PAI-1) activity, specific insulin and proinsulin-like molecules when adjusted for BMI. Birth weight was not related (p 〉 0.10) with waist circumference, serum triglycerides or HDL cholesterol. The insulin resistance syndrome was defined as the combination of hypertension, insulin resistance and dyslipidaemia. The prevalence of this syndrome at age 50 and 70 was inversely related to birth weight with odds ratio 0.66 and 0.71, respectively, per kg increase in birth weight. When the syndrome was defined to include truncal obesity or raised plasminogen activator inhibitor-1 instead of dyslipidaemia, the corresponding odds ratios were 0.51 and 0.66, respectively.¶Conclusions/interpretation. Low birth weight predicts high blood pressure, insulin resistance, truncal obesity and high plasminogen activator inhibitor-1 activity but not the abdominal obesity or dyslipidaemia present in the insulin resistance syndrome. The cluster of disturbances associated with low birth weight is a subset of the disturbances that are clustered in the general population as the insulin resistance syndrome. This subset of physiological disturbances is possibly linked by a specific pathway. [Diabetologia (2000) 43: 54–60]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050007
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  • 5
    Electronic Resource
    Electronic Resource
    Different aetiologies of Type 2 (non-insulin-dependent) diabetes mellitus in obese and non-obese subjects (1991)
    Springer
    Diabetologia 34 (1991), S. 483-487 
    Details
    ISSN: 1432-0428
    Keywords: Insulin ; glucose ; obesity ; glucose disposal ; insulin secretion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin responses to intravenous glucose infusion and glucose utilization during hyperinsulinaemic euglycaemic clamp were determined in a large homogeneous group of 65-year-old male subjects. Twenty-eight had untreated Type 2 (non-insulin-dependent) diabetes mellitus and the remaining 44 control subjects had a normal glucose tolerance. Diabetic patients with abdominal obesity displayed peripheral insulin resistance in combination with defective insulin secretion, whereas non-obese diabetic patients showed only a secretory defect. Thus, Type 2 diabetes in obese and non-obese elderly male subjects may take two forms where the cause of hyperglycaemia differs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403284
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  • 6
    Electronic Resource
    Electronic Resource
    Relationship between diastolic hypertension and myocardial morphology and function in elderly males with diabetes mellitus (1996)
    Springer
    Diabetologia 39 (1996), S. 1603-1606 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Non-insulin diabetes mellitus ; hypertension ; M-mode echocardiography ; heart function.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The existence of a distinct diabetic cardiomyopathy, characterized by a raised left ventricular mass, has previously been suggested. However, as diabetes mellitus is associated with both left ventricular hypertrophy and hypertension a confounding effect of raised blood pressure in diabetic patients has to be considered. In the present cross-sectional study an echocardiographical examination was performed as part of a health screening survey in 582 males, aged 70 years. After the exclusion of subjects with coronary heart disease or those on regular antihypertensive treatment, 30 normotensive subjects with diabetes were compared with 10 subjects with non-insulin-dependent diabetes (NIDDM) and a diastolic blood pressure 90 mm Hg or more and 203 normotensive control subjects with normal glucose tolerance. Both groups with NIDDM showed a significantly increased left atrial diameter (4.4 ± 0.7 vs 4.0 ± 0.5 cm, p 〈 0.05) and an increased atrial component in diastole (A-wave, p 〈 0.01) compared to the control subjects. Left ventricular mass was, however, only marginally and not significantly elevated in the diabetic subjects when compared to the healthy control subjects (133 ± 19 and 133 ± 28 vs 128 ± 25 g/m2). Only in the subjects with concomitant diabetes and a raised blood pressure was the intraventricular septum significantly enlarged (p 〈 0.05). Thus, in the present sample no distinct diabetic cardiomyopathy with an increased left ventricular mass, independent of the influence of hypertension could be detected. The myocardial alterations in these diabetic males were restricted to an increased left atrial size and an impaired diastolic function. [Diabetologia (1996) 39: 1603–1606]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050621
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  • 7
    Electronic Resource
    Electronic Resource
    Insulin sensitivity is related to the fatty acid composition of serum lipids and skeletal muscle phospholipids in 70-year-old men (1994)
    Springer
    Diabetologia 37 (1994), S. 1044-1050 
    Details
    ISSN: 1432-0428
    Keywords: Cholsterol esters ; fatty acid composition ; insulin sensitivity ; palmitic acid ; phospholipids ; skeletal muscle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Recent data indicate that peripheral insulin sensitivity may be influenced by dietary fat quality and skeletal muscle phospholipid fatty acid composition. During a health survey of 70-year-old men insulin sensitivity was measured by the euglycaemic hyperinsulinaemic clamp technique and the fatty acid composition of the serum cholesterol esters was determined (n=215) by gas liquid chromatography. In a subsample the fatty acids of the skeletal muscle phospholipids and triglycerides were determined after fine needle biopsy from m. vastus lateralis (n=39). The peripheral insulin sensitivity was significantly and negatively correlated to the proportion of palmitic (r=−0.31, p〈0.001), palmitoleic (r=−0.25, p〈0.001) and di-homo-γ-linolenic (r=−0.33, p〈0.001) acids and positively to the content of linoleic (r=0.28, p〈0.001) acid in the serum cholesterol esters. There was an even stronger negative relationship to the proportion of palmitic acid in the skeletal muscle phospholipds (r=−0.45, p〈0.004). The fatty acid composition was also significantly related to insulin sensitivity in a stepwise multiple regression analysis in the presence of other clinical variables, which were associated with insulin action in univariate analysis. Thus, more than 51% of the variation of the insulin sensitivity was explained by an equation containing body mass index, serum triglyceride concentration and the content of palmitic acid in the skeletal muscle phospholipids. It is concluded that the fatty acid composition in serum and of the phospholipids of skeletal muscle may influence insulin action in elderly men.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400468
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  • 8
    Electronic Resource
    Electronic Resource
    Studies of the genetic variability of the coding region of the hepatocyte nuclear factor-4α in Caucasians with maturity onset NIDDM (1997)
    Springer
    Diabetologia 40 (1997), S. 980-983 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Hepatocyte nuclear factor-4α ; non-insulin-dependent diabetes mellitus ; insulin response ; mutations ; transcription factors.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Mutations in the hepatocyte nuclear factor-4α (HNF-4α) gene cause the type 1 form of maturity onset diabetes of the young (MODY1). To address the question of whether genetic variability of HNF-4α is associated with late onset non-insulin-dependent diabetes mellitus (NIDDM) we have sequenced the coding region and intron/exon boundaries of the gene in 36 randomly recruited Danish NIDDM patients. Two nucleotide substitutions that changed the sequence of HNF-4α were identified: Thr/Ile130, which has been reported previously and a novel Val/Met255. The Val/Met 255 mutation was found in 4 of 477 Danish NIDDM patients and in none of 217 glucose tolerant control subjects; thus it cannot be excluded that this mutation may have an impact on NIDDM susceptibility. Among 509 NIDDM patients the allelic frequency of the Thr/Ile130 variant was 4.7 % (95 % confidence interval: 3.4–6.0 %) compared to 1.9 % (0.7–3.1 %) among 239 control subjects (p = 0.008). However, in a population sample of 942 Swedish men with an average age of 70 years the allelic frequency of the variant was similar in 246 men with either impaired glucose tolerance (5.6 % [2.6–8.6 %]) or NIDDM (5.4 % [2.7–8.1 %]) as compared to 666 glucose tolerant men (5.1 % [3.9–6.3 %]). Also in a population sample of 369 young healthy Danes the prevalence of the codon 130 variant (4.7 % [3.2–6.2 %]) was similar to what was found in Swedish Caucasians. Thus, the allelic frequency of the Thr/Ile130 variant among the control subjects in the Danish case-control study deviates from the prevalence in the two other studies which is why we consider the significant association between the codon 130 variant and NIDDM an incidental finding. In glucose tolerant subjects the codon 130 variant in its heterozygous form had no major effect on glucose-induced insulin and C-peptide release although a tendency to a lower insulin secretion during an oral glucose tolerance test was seen in middle-aged subjects. In conclusion, variability in the coding region of the HNF-4α gene is not a common cause of NIDDM among whites of Danish ancestry. However, a Val/Met255 mutation was found exclusively in NIDDM patients (0.8 % of cases) and functional as well as family segregation studies are needed to determine whether this HNF-4α variant is a NIDDM causing mutation. [Diabetologia (1997) 40: 980–983]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050778
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  • 9
    Electronic Resource
    Electronic Resource
    Search for variants of the gene-promoter and the potential phosphotyrosine encoding sequence of the insulin receptor substrate-2 gene: evaluation of their relation with alterations in insulin secretion and insulin sensitivity (1999)
    Springer
    Diabetologia 42 (1999), S. 1244-1249 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Insulin receptor substrate-2 ; mutations ; Type II diabetes ; insulin secretion ; insulin sensitivity.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. The aim of this study was to screen part of the putative promoter sequence in addition to 14 potential phosphotyrosine residues of human IRS-2 for genetic variability which might cause changes in protein expression or function. Furthermore, the potential impact on insulin secretion and sensitivity of a previously identified IRS-2 variant (Gly1057Asp) was analysed Methods. The screenings were carried out by the SSCP-heteroduplex technique on DNA from Type II (non-insulin-dependent) diabetic patients. The impact of the Gly1057Asp variant was analysed in four glucose-tolerant Scandinavian study groups. Results. The results showed no nucleotide substitutions in the promoter sequence, however, a novel heterozygous amino acid variant was identified (Leu647Val). In an association study, the new variant was found in 3 of 413 diabetic patients and in none of 280 glucose tolerant subjects. The variant did not affect the binding of IRS-2 to the insulin receptor or p85α of phosphatidylinositol 3-kinase when measured in the yeast two-hybrid system. Examination of the common Gly1057Asp variant in 363 young healthy subjects and in 228 glucose tolerant offspring of one diabetic parent showed no differences in insulin secretion or insulin sensivity after an intravenous glucose tolerance test. Glucose tolerant middle-aged subjects homozygous for the polymorphism (n = 31), however, had on average a 25 % decrease in fasting serum insulin concentrations (p = 0.009) and 28 % (p = 0.01) and 34 % (p = 0.003) reductions in serum insulin concentrations at 30 and 60 min, respectively, during an OGTT compared with wildtype carriers (n = 107). In a cohort of 639 elderly Swedish men the amino acid variant did not have any detectable impact on insulin secretion after an OGTT. Conclusion/interpretation. No genetic variability was found in the IRS-2 promoter. A rare IRS-2 variant at codon 647 has been identified in Type II diabetic patients. The prevalent codon 1057 polymorphism had no consistent effect on insulin secretion or insulin sensitivity. [Diabetologia (1999) 42: 1244–1249]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250051299
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  • 10
    Electronic Resource
    Electronic Resource
    Effects of small doses of bisoprolol on blood pressure and lipoprotein concentrations in hypertensive patients (1993)
    Springer
    European journal of clinical pharmacology 44 (1993), S. 19-22 
    Details
    ISSN: 1432-1041
    Keywords: Bisoprolol ; Lipoproteins ; Hypertension ; β-adrenoceptor antagonists
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The effects of bisoprolol 2.5 and 5 mg per day on blood pressure, and lipoprotein and apolipoprotein concentrations were compared in 18 newly detected hypertensives in a double-blind, crossover study. All treatment results were related to the values at the end of a four-week placebo run-in period. Each of the two following treatment periods lasted for 3 months. The systolic and diastolic pressures in the supine position were reduced by 19.5/11.7 mm Hg and 14.6/10.4 mm Hg by 2.5 and 5 mg bisoprolol per day, respectively, with no significant difference in effect. Supine heart rate was reduced by 4.7 and 8.2 beats · min−1, respectively, (P=0.0517 for different effects). The cholesterol concentration in low-density (LDL) and high-density (HDL) lipoproteins was reduced during both regimens, by about 0.3 and 0.1 mmol·l−1, respectively, difference not significant. Triglyceride concentrations were not significantly affected during either regimen. We conclude that, in this study population, treatment with bisoprolol 2.5 mg per day was equally effective as 5.0 mg per day in reducing blood pressure. The effects on lipoprotein concentrations were small and included an unexpected reduction in LDL-cholesterol concentration. A low dose of a highly selective β-adrenoceptor blocker like bisoprolol appears to retain the blood pressure reducing capacity and has lost most of the unfavourable effects on lipoproteins characteristic of higher doses.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00315274
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