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  • 1
    ISSN: 1432-0428
    Keywords: Type 1 and Type 2 diabetes ; circulating thyroid hormones ; glycosylated haemoglobin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Basal plasma levels of thyroxine (T4), triiodothyronine (T3) and reverse T3 were determined by radioimmunoassay in 44 control subjects, 44 Type 1 (insulin-dependent) and 39 Type 2 (non insulin-dependent) diabetic patients aged from 15 to 75 years. All were clinically euthyroid. The quality of diabetic control was assessed by the percentage of glycosylated haemoglobin. In both the diabetic groups there was a significant decrease in T3 and a rise in reverse T3 whereas T4 was normal. We found no significant differences between plasma thyroid hormone levels in Type 1 and Type 2 diabetic patients. In the poorly controlled diabetics (glycosylated haemoglobin ⩾ 12%), T3 was 90±5 ng/dl, which differed significantly from the level found in the better controlled patients (106±5 ng/dl, p〈0.01). In the diabetic patients without associated illness, a negative linear correlation was found between T3 and glycosylated haemoglobin and a positive correlation between reverse T3/T3 and glycosylated haemoglobin. No correlation between T3 or reverse T3 and fasting blood glucose could be established. In conclusion, many diabetics showed a low T3 syndrome suggesting that there may be an impairment in the extrathyroidal conversion of T4 to T3. This may well be enhanced by a poor diabetic control (glycosylated haemoglobin ⩾12%).
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Glucose ; insulin ; C-peptide ; diabetic ; ultradian rhythm ; enteral nutrition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Concomitant oscillations of plasma glucose, insulin and C-peptide levels with a period of about 80 min between peak levels have been identified in normal man. To determine whether these oscillations persist in Type 2 (non-insulin-dependent) diabetic patients, peripheral plasma levels of glucose, insulin and C-peptide were measured at 10 min intervals over 12 h in six patients and in six matched control subjects during continuous enterai nutrition (90 kcal.h−1; 50% carbohydrate, 35% fat, 15% protein). The insulin secretion rate was estimated from peripheral C-peptide levels using an open two-compartment model. For the control subjects, mean plasma glucose, insulin and insulin secretion profiles rose sharply and then attained a steady-state; in contrast, for the diabetic patients, the mean insulin and insulin secretion profiles were characterized by a slow ascending trend throughout the day. Mean glucose levels rose sharply and reached higher levels than in the control subjects. The individual 12 h profiles revealed synchronous oscillations of plasma glucose, plasma insulin, and insulin secretion in the control subjects. In the diabetic patients, the number of plasma insulin and insulin secretion pulses was significantly lower; they had a smaller amplitude and were less frequently associated with the glucose pulses. However, plasma glucose levels had a similar oscillatory pattern in the diabetic patients compared with the control subjects, albeit with a higher absolute amplitude. The poor association between glucose and insulin secretion pulses in the diabetic patients suggests that insulin pulses are insufficient to account for the glucose pulses. Slowness in the dynamics of insulin secretion may explain the large initial rise in glucose in the diabetic patients under continuous enteral nutrition.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Intravenous glucose load ; anorexia nervosa ; obesity ; maturity onset diabetes ; insulinogenic index and body weight ; insulinogenic index and age ; basal plasma insulin and body weight
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Chez 79 patients nous avons pratiqué des épreuves rapides d'hyperglycémie provoquée par voie I. V. (0.33 g de glucose/kg poids corporel) et dosé parallèlement l'insulinémie plasmatique (IRI). Les sujets étudiés se répartissent en normaux (N), dénutris par anorexie mentale (M), obèses (O), diabétiques latents de poids normal (Dl), diabétiques patents de poids normal (D2), obèses diabétiques latents (OD1) et obèses diabétiques patents (OD2). Chez l'ensemble des sujets, les poids varient de 59 à 290 pour cent du poids idéal et les âges s'étendent de 14 à 75 ans. Nous ne trouvons aucune relation significative entre l'IRI basale et le poids corporel. Par contre, la riposte insulinique au glucose, en particulier l'index insulinogénique, s'élève en fonction du poids corporel chez tous les sujets, chez les non diabétiques (N-M-O) comme chez les diabétiques (D1-D2-OD1-OD2). Les dénutris par anorexie mentale ont une insulinémie basale normale; leur riposte insulinique au glucose est normale du moins chez les sujets étudiés dans ce travail. Il s'est avéré que les diabétiques (D2 et OD2) sont significativement plus âgés que les témoins (N-O) de même poids corporel. L'index insulinogénique s'abaisse en fonction de l'âge chez les obèses et les diabétiques. Les relations entre l'insulinémie et la glycémie sont discutées.
    Abstract: Zusammenfassung Bei 79 Patienten wurde der Plasma-Insulinspiegel (IRI) vor und nach rascher intravenöser Gabe von Glucose (0.33 g/kg Körpergewicht) bestimmt. Die Patienten wurden in verschiedene Gruppen eingeteilt: Stoffwechselgesunde (N), Unterernährte (M), latente Diabetiker (D1), Diabetiker (D2), Fettsüchtige (O), fettsüchtige latente Diabetiker (OD1) und fettsüchtige Diabetiker (OD2). Das Körpergewicht schwankte zwischen 59% und 290% des idealen Körpergewichts. Das Alter lag zwischen 14 und 75 Jahren. - Wir fanden keine Korrelation zwischen dem Nüchtern-IRI-Wert und dem Körpergewicht. Jedoch bestanden signifikante Korrelationen zwischen den IRI-Werten nach Glucose-Gabe und dem Körpergewicht. Insbesondere stieg das Verhältnis IRI zu Blutzucker mit wachsendem Körpergewicht bei allen Patienten, bei den Diabetiker (D1-D2-OD1-OD2) und bei den Nicht-Diabetiker (N-M-O). Die untersuchten unterernährten Patienten (Anorexia nervosa) haben einen normalen Nüchternwert des IRI im Plasma sowie eine normale Erhöhung der IRI-Plasmawerte nach Glucosegabe. Die Diabetiker D2 und OD2 sind bei gleichem Körpergewicht signifikant älter als die Nicht-Diabetiker N und O. Das Verhältnis Plasma-IRI zu Blutzucker sinkt signifikant mit zunehmendem Alter bei fettsüchtigen und diabetischen Patienten. Die Korrelation zwischen Plasma-IRI und Blutzucker wird erörtert.
    Notes: Summary Determinations of plasma insulin levels (IRI) were performed in 79 patients before and after a quick intravenous glucose load (0.33 g/kg body weight). The patients were divided in normals (N), underweight patients (M), obese (O), latent diabetics (D1) and overt diabetics (D2), obese latent diabetics (OD1) and obese diabetics (OD2). The body weight varied from 59 to 290 per cent of ideal body weight and the age from 14 to 75 years. We were unable to find any significant correlation between basal IRI values and body weight. We found significant correlations between IRI values obtained after glucose administration and body weight. The insulinogenic index rises with increasing body weight in all subjects, in non diabetics (N-M-O) as well as in diabetics (D1-D2-OD1-OD2). In undernutrition due to anorexia nervosa, the basal plasma IRI and the plasma IRI increase after the glucose load are normal in the studied patients. Overt diabetic patients (D2 and OD2) were significantly older than non diabetic patients having the same body weight (N-O). The insulinogenic index fell with increasing age in obese and in diabetic patients. The correlations between plasma IRI and blood sugar are discussed.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Rat ; ammonium infusion ; blood ammonia ; glucose metabolism ; plasma immunoreactive insulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to explain the abnormalities of glucose metabolism previously observed in patients with blood ammonia elevation, the effect of a transitory hyperammonemia on I. V. glucose tolerance was investigated in rats. An I. V. glucose tolerance test was performed in 3 groups of 15 rats 60 min after the beginning of a 95 min infusion of either a 2 ml isotonic NaCl solution (control group) or ammonium acetate solutions at low (0.50 μmol/kg/min. NH4+) or high doses (1.70 μmol/kg/min NH4+). The “high” NH4+infusion produced an increase of blood ammonia to levels near 1000 μg/100 ml, a significant decrease in the K coefficient for glucose disappearance (2.53 × 10−2±0.20 compared to 4.92 × 10−2±0.13 in control group) and a suppression of the radioimmunological plasma insulin (I.R.I.) response to glucose. With the “low” NH4 + infusion the hyperammonemia was less pronounced (200–300 μg/100 ml), but the decrease in K(3.02 × 10−2±0.15) and in the first phase of I.R.I, release remained significant. The decrease in glucose disappearance rate could be accounted for by the proportional decrease in insulin secretion. Thus glucose intolerance induced by ammonium acetate infusions may be due to a direct effect of NH4 + on the pancreas. These abnormalities in glucose metabolism depend on the quantity of infused ammonium.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Clinica Chimica Acta 82 (1978), S. 61-67 
    ISSN: 0009-8981
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1433-8580
    Keywords: Rat ; Intestinal ammoniagenesis ; Glutamine metabolism ; Small intestine ; Colon
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The intestinal ammonium production and the intestinal uptake of circulating glutamine were investigated in anesthetized intact rats and rats with resected small intestine or colon by simultaneous measurements performed on portal and arterial blood. It was shown that ammonium release into the portal blood by the small intestine is of equal magnitude to that released by the colon, and that circulating glutamine participates in ammonium production by the small intestine. Increased levels of circulating glutamine induced by its i.v. infusion to intact rats were not accompanied by an increase in intestinal ammonium production.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Research in experimental medicine 186 (1986), S. 353-363 
    ISSN: 1433-8580
    Keywords: Ammonia metabolism ; Glutamine metabolism ; Kidney ; Muscle ; Gut
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of this study was to investigate the influence of acid and alkali food supplementation on systemic ammonemia to explain the hyper-ammonemia previously observed in rats fed a high protein diet. In normal rats, arterial ammonia concentration significantly increases after 4 days of HCl-supplemented diet. Following a NaHCO3-enriched food, there is only a slight but not significant decrease in arterial ammonia level. These changes occur before any variation in arterial acid-base status and are of renal origin. Indeed, there is a positive linear correlation (r = 0.946;P 〈 0.001) between arterial ammonia level and the ammonia concentration difference between the renal vein and artery (which varies proportionally to the urinary ammonium excretion). Hindquarter uptake and intestinal release of ammonia do not significantly participate in the arterial ammonia changes observed. Following HCl-enriched diets, increased renal glutamine uptake, enhanced hindquarter glutamine release, and perhaps decreased intestinal glutamine uptake occur simultaneously. In conclusion, acid and alkali food supplementation intervenes on the renal ammonia release into the circulation with concomitant arterial ammonemia changes.
    Type of Medium: Electronic Resource
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