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  • 1
    Electronic Resource
    Electronic Resource
    Renal function and insulin sensitivity during simvastatin treatment in Type 2 (non-insulin-dependent) diabetic patients with microalbuminuria (1993)
    Springer
    Diabetologia 36 (1993), S. 1079-1086 
    Details
    ISSN: 1432-0428
    Keywords: Type 2 (non-insulin-dependent) diabetes mellitus ; microalbuminuria ; glomerular filtration rate ; plasma lipoproteins ; insulin sensitivity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of simvastatin (10–20 mg/day) on kidney function, urinary albumin excretion rate and insulin sensitivity was evaluated in 18 Type 2 (non-insulin-dependent) diabetic patients with microalbuminuria and moderate hypercholesterolaemia (total cholesterol ≥5.5 mmol·l−1). In a double-blind, randomized and placebo-controlled design treatment with simvastatin (n=8) for 36 weeks significantly reduced total cholesterol (6.7±0.3 vs 5.1 mmol·l−1 (p〈0.01)), LDL-cholesterol (4.4±0.3 vs 2.9±0.2 mmol·l−1 (p〈0.001)) and apolipoprotein B (1.05±0.04 vs 0.77±0.02 mmol·l−1 (p〈0.01)) levels as compared to placebo (n=10). Both glomerular filtration rate (mean±SEM) (simvastatin: 96.6±8.0 vs 96.0±5.7 ml·min−1·1.73 m−2, placebo: 97.1±6.7 vs 88.8±6.0 ml·min−1·1.73 m−2) (NS) and urinary albumin excretion rate (geometric mean x/÷ antilog SEM) (simvastatin: 18.4x/÷1.3vs 16.2 x/÷1.2 μg·min−1, placebo 33.1 x/÷ 1.3 vs 42.7 x/÷ 1.3 μg·min−1)(NS) were unchanged during the study. A euglycaemic hyperinsulinaemic clamp was performed at baseline and after 18 weeks in seven simvastatin-and nine placebo-treated patients. Isotopically determined basal and insulin-stimulated glucose disposal was similarly reduced before and during therapy in both the simvastatin (2.0±0.1 vs 1.9±0.1 (NS) and 3.1±0.6 vs 3.1±0.7 mg·kg−1·min−1 (NS)) and the placebo group (1.9±0.1 vs 1.8±0.1 (NS) and 4.1±0.6 vs 3.8±0.2 mg·kg−1·min−1 (NS)). No different was observed in glucose storage or glucose and lipid oxidation before and after treatment. Further, the suppression of hepatic glucose production during hyperinsulinaemia was not influenced by simvastatin (−0.7±0.8 vs −0.7±0.5 mg·kg−1·min−1 (NS)). In conclusion, despite marked improvement in the dyslipidaemia simvastatin had no impact on kidney function or urinary albumin excretion rate and did not reduce insulin resistance in these microalbuminuric and moderately hypercholesterolaemic Type 2 diabetic patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02374502
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  • 2
    Electronic Resource
    Electronic Resource
    Basal and insulin stimulated substrate metabolism in tumour induced hypoglycaemia; evidence for increased muscle glucose uptake (1991)
    Springer
    Diabetologia 34 (1991), S. 17-20 
    Details
    ISSN: 1432-0428
    Keywords: Glucose turnover ; forearm technique ; intermediary metabolites ; euglycaemic and hypoglycaemic glucose clamp ; indirect calorimetry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary While it has very recently been reported that tumour induced hypoglycaemia is characterised by elevated production of insulin-like growth factor 2, the tissues responsible for induction of hypoglycaemia are largely unknown. We have investigated a patient with a large retroperitoneal mass and spontaneous hypoglycaemia. When compared to a reference population the patient displayed: (1) An increased glucose disposal rate and a five-fold elevation of forearm glucose uptake. (2) A decreased endogenous glucose production rate. (3) Decreased circulating levels of lipid intermediates. (4) Increased glucose oxidation and decreased lipid oxidation. (5) Low circulating levels of insulin-like growth factor 2 and insulin-like growth factor-binding protein-3 and normal levels of insulin-like growth factor 1. (6) Normal insulin sensitivity (euglycaemic glucose clamp). Blood concentrations of insulin, C-peptide, proinsulin, glucagon, growth hormone and catecholamines were within normal range, but the growth hormone response to hypoglycaemia was blunted. The data suggest that the mechanisms behind tumour induced hypoglycaemia are of systemic nature and that the tissue most prominently affected is striated muscle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00404019
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  • 3
    Electronic Resource
    Electronic Resource
    Effects of growth hormone on insulin sensitivity and forearm metabolism in normal man (1989)
    Springer
    Diabetologia 32 (1989), S. 105-110 
    Details
    ISSN: 1432-0428
    Keywords: Growth hormone ; intermediary metabolism ; insulin sensitivity ; glucose turnover ; non-esterfied fatty acids ; ketone bodies and forearm technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To elucidate the short-term actions of growth hormone on insulin sensitivity and forearm metabolism, we have studied six normal male subjects receiving a 6-h hyperinsulinaemic euglycemic clamp with and without a concomitant 4-h growth hormone infusion. When infused, serum growth hormone rose to 25±4 mU/l and during administration of insulin serum insulin increased by 11±1 mU/l. During euglycemic clamp, administration of growth hormone decreased forearm glucose uptake after 180 min and onward (240 min 0.216±0.031 vs 0.530±0.090 mg/100 ml/min, p〈0.05). Glucose infusion rate (240 min 2.83±0.24 vs 4.35±0.28 mg·kg−1· min#x2212;1, p〈0.05) and glucose disposal rate (240 min 3.57±0.17 vs 4.00±0.15 mg·kg−1· min−1, p〈0.05) also decreased. Growth hormone persistently increased hepatic glucose production after 120 min. After 210 min, all circulating lipid intermediates increased slightly. The decrease in forearm glucose uptake and glucose infusion rate and the increase in hepatic glucose production was observed before there was any detectable increase in circulating levels and forearm uptake of lipid intermediates. These data suggest that growth hormone induces insensitivity to insulin in liver, muscle and fat after 120, 180 and 210 min respectively. The early effects of growth hormone on glucose metabolism seems independent of changes in the rate of lipolysis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00505182
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  • 4
    Electronic Resource
    Electronic Resource
    Insulin resistance in relatives of NIDDM patients: the role of physical fitness and muscle metabolism (1996)
    Springer
    Diabetologia 39 (1996), S. 813-822 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Insulin resistance ; relatives ; non-insulin-dependent diabetes mellitus ; oral glucose tolerance test ; physical fitness ; forearm blood flow ; muscle metabolism.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary First degree relatives of patients with non-insulin-dependent diabetes mellitus (NIDDM) are often reported to be insulin resistant. To examine the possible role of reduced physical fitness in this condition 21 first degree relatives of NIDDM patients and 22 control subjects without any history of diabetes were examined employing a 150-min hyperinsulinaemic (0.6 mU insulin · kg–1· min–1) euglycaemic clamp combined with the isotope dilution technique (3-3H-glucose, Hot GINF), the forearm technique and indirect calorimetry. During hyperinsulinaemia glucose disposal (Rd) and forearm glucose extraction were significantly diminished in the relatives (p 〈 0.01 and p 〈 0.05), but glucose oxidation and the suppressive effect on hepatic glucose production were normal. Arteriovenous differences across the forearm of the gluconeogenic precursors lactate, alanine and glycerol as well as the increments in forearm blood flow during hyperinsulinaemia were similar in the two groups. Maximal oxygen uptake (VO2 max) was lower in the relatives than in the control subjects (36.8 ± 1.9 vs 42.1 ± 2.0 ml · kg–1· min–1; p = 0.03). There was a highly significant correlation between Rd and VO2 max in both relatives and control subjects (r = 0.68 and 0.66, respectively; both p 〈 0.001). Comparison of the linear regression analyses of insulin-stimulated Rd on VO2 max in the two groups showed no significant differences between the slopes (0.10 ± 0.03 vs 0.09 ± 0.02) or the intercepts. In stepwise multiple linear regression analyses with insulin-stimulated Rd as the dependent variable VO2 max significantly determined the level of Rd (p 〈 0.01), whereas forearm blood flow and anthropometric data did not. In conclusion, the insulin resistance in healthy first degree relatives of patients with NIDDM is associated with a diminished physical work capacity. Whether, this finding is ascribable to environmental or genetic factors (e. g. differences in muscle fibre types, capillary density etc) remains to be determined. [Diabetologia (1996) 39: 813–822]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050515
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  • 5
    Electronic Resource
    Electronic Resource
    Decreased hepatic glucagon responses in Type 1 (insulin-dependent) diabetes mellitus (1991)
    Springer
    Diabetologia 34 (1991), S. 521-526 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 diabetes mellitus ; Glucagon ; Hepatic glucose production
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of glucagon infusion on hepatic glucose production during euglycaemia was evaluated in seven Type 1 (insulin-dependent) diabetic patients and in ten control subjects. In the diabetic subjects normoglycaemia was maintained during the night preceding the study by a variable intravenous insulin and glucose infusion. During the study endogenous insulin secretion was suppressed by somatostatin (450 μg/h) and replaced by insulin infusion (0.15 mU·kg−1·min−1). 3H-glucose was infused for isotopic determination of glucose turnover. Plasma glucose was clamped at 5 mmol/1 for 2 h 30 min and glucagon (1.5 ng· kg−1·min−1) was then infused for the following 3 h. Hepatic glucose production and glucose utilisation were measured during the first, second and third hour of the glucagon infusion. Basal hepatic glucose production (just prior to glucagon infusion) was similar in diabetic (1.2±0.3 mg·kg−1·min−1) and control (1.6±0.1 mg·kg−1·min−1) subjects. In diabetic patients hepatic glucose production rose slowly to 2.1±0.5 mg·kg−1·min−1 during the first hours of glucagon infusion and stabilized at this level (2.4±0.5 mg·kg−1·min−1) in the third hour. In control subjects hepatic glucose production increased sharply to higher levels than in the diabetic subjects (3.4±0.3 mg·kg−1·min−1) during the first and second hour of glucagon infusion (p〈0.05) and then gradually fell (2.9±0.4 mg·kg−1·min−1) during the third hour. In conclusion, when stimulated with glucagon at a physiologic plasma concentration diabetic patients had 1) an overall reduced hepatic glucose production response and 2) an abnormal sluggish response pattern. These abnormalities may imply inappropriate counter-regulation following a hypoglycaemic episode.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403290
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  • 6
    Electronic Resource
    Electronic Resource
    In vivo insulin action and muscle glycogen synthase activity in Type 2 (non-insulin-dependent) diabetes mellitus: effects of diet treatment (1992)
    Springer
    Diabetologia 35 (1992), S. 777-784 
    Details
    ISSN: 1432-0428
    Keywords: Insulin resistance ; Type 2 (non-insulin-dependent) diabetes mellitus ; hyperinsulinaemic clamp ; indirect calorimetry ; forearm glucose uptake ; muscle ; glycogen synthase ; insulin receptor kinase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin resistant glucose metabolism is a key element in the pathogenesis of Type 2 (non-insulin-dependent) diabetes mellitus. Insulin resistance may be of both primary (genetic) and secondary (metabolic) origin. Before and after diet-induced improvement of glycaemic control seven obese patients with newly-diagnosed Type 2 diabetes were studied with the euglycaemic clamp technique in combination with indirect calorimetry and forearm glucose balance. Muscle biopsies were obtained in the basal state and again after 3 h of hyperinsulinaemia (200 mU/l) for studies of insulin receptor and glycogen synthase activities. Similar studies were performed in seven matched control subjects. Insulin-stimulated glucose utilization improved from 110±11 to 183±23 mg·m−2·min−1 (p〈0.03); control subjects: 219+23 mg·m−2·min−1 (p=NS, vs post-diet Type 2 diabetes). Nonoxidative glucose disposal increased from 74±17 to 138+19 mg·m−2·min−1 (p〈0.03), control subjects: 159±22 mg· m−2·m−1 (p=NS, vs post-diet Type 2 diabetic patients). Forearm blood glucose uptake during hyperinsulinaemia increased from 1.58±0.54 to 3.35±0.23 μmol·l−1·min−1 (p〈0.05), control subjects: 2.99±0.86 μmol·l−1·min−1 (p=NS, vs post-diet Type 2 diabetes). After diet therapy the increase in insulin sensitivity correlated with reductions in fasting plasma glucose levels (r=0.97, p〈0.001), reductions in serum fructosamine (r=0.77, p〈0.05), and weight loss (r=0.78, p〈0.05). Values of muscle glycogen synthase sensitivity to glucose 6-phosphate (A0.5 for glucose 6-phosphate) were similar in the basal state. However, insulin stimulation of glycogen synthase was more pronounced after diet treatment (A0.5: 0.43±0.06 (before) vs 0.30±0.04 mmol/l (after); p〈0.03; control subjects: 0.22±0.03 mmol/l). Muscle insulin receptor binding and kinase activity were similar before and after diet treatment and comparable to values in the control group. The data suggest that impaired insulin stimulation of in vivo glucose turn-over and muscle glycogen synthase activity tend to be restored during successful diet treatment of patients with Type 2 diabetes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00429100
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  • 7
    Electronic Resource
    Electronic Resource
    Inhibition of muscle glycogen synthase activity and non-oxidative glucose disposal during hypoglycaemia in normal man (1996)
    Springer
    Diabetologia 39 (1996), S. 226-234 
    Details
    ISSN: 1432-0428
    Keywords: Hypoglycaemia ; counter-regulation ; glucose disposal ; muscle glycogen synthase activity ; glucose mass effect
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The purpose of the present study was to evaluate the role of muscle glycogen synthase activity in the reduction of glucose uptake during hypoglycaemia. Six healthy young men were examined twice; during 120 min of hyperinsulinaemic (1.5 mU · kg−1 · min−1) euglycaemia followed by: 1) 240 min of graded hypoglycaemia (plasma glucose nadir 2.8 mmol/l) or 2) 240 min of euglycaemia. At 350–360 min a muscle biopsy was taken and indirect calorimetry was performed at 210–240 and 330–350 min. Hypoglycaemia was associated with markedly increased levels of adrenaline, growth hormone and glucagon and also with less hyperinsulinaemia. During hypoglycaemia the fractional velocity for glycogen synthase was markedly reduced; from 29.8±2.3 to 6.4±0.9%, p〈0.05. Total glucose disposal was decreased during hypoglycaemia (5.58±0.55 vs 11.01±0.75 mg · kg−1 · min−1 (euglycaemia); p〈0.05); this was primarily due to a reduction of non-oxidative glucose disposal (2.43±0.41 vs 7.15±0.7 mg · kg−1 · min−1 (euglycaemia); p〈0.05), whereas oxidative glucose disposal was only suppressed to a minor degree. In conclusion hypoglycaemia virtually abolishes the effect of insulin on muscle glycogen synthase activity. This is in keeping with the finding of a marked reduction of non-oxidative glucose metabolism.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403967
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  • 8
    Electronic Resource
    Electronic Resource
    Changes in penicillin contamination and allergy in factory workers (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 22 (1990), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0536.1990.tb01528.x
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  • 9
    Electronic Resource
    Electronic Resource
    Contact dermatitis to semisynthetic penicillins in factory workers (1986)
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 14 (1986), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 45 workers developed dermatitis after handling semi-synthetic penicillins in a factory. All reacted on patch lest, but several agents had to be used. Only 7 reacted to benzyl penicillin. 1/2 reacted to only one allergen, while 2/3 reacted to several. The duration of exposure before symptoms was short, often less than 2 months, 19 had hay lever or asthma, and they developed their symptoms after a shorter exposure time. A survey for airborne antibiotics was performed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0536.1986.tb05282.x
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  • 10
    Electronic Resource
    Electronic Resource
    Hypersensitivity to semisynthetic penicillins and cross-reactivity with penicillin (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 26 (1992), S. 0 
    Details
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0536.1992.tb00134.x
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