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  • 1
    ISSN: 1432-0428
    Keywords: Ketone body turnover ; ketogenesis ; acetone ; lipolysis ; insulin ; diabetes ; glucagon ; somatostatin ; non-esterified fatty acids ; glycerol ; glucose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To assess the role of glucagon and insulin in the acute regulation of ketone body kinetics in man, somatostatin was administered with various combinations of these hormones by replacement infusions in groups of six to seven normal subjects. Somatostatin-induced insulin and glucagon deficiency produced a threefold increase in total ketone body concentrations within 2 h. This increase was the combined result of enhanced production (71%), and decreased metabolic clearance (32%), as determined by14C-acetoacetate infusions. An associated elevation of non-esterified fatty acids (66%) and glycerol levels occurred. Glucagon replacement (2 ng · kg-1 · min-1) during insulin deficiency failed to enhance ketogenesis or lipolysis but lowered theβ-hydroxybutyrate/acetoacetate concentration ratios. Hyperglycaemia, observed during glucagon administration and insulin deficiency, did not diminish ketone body production or lipolysis. In contrast, insulin replacement (150 μU · kg-1 · min-1) diminished lipolysis, lowered ketone production, and elevated the metabolic clearance rate of ketone bodies. Glucagon infusions (2 and 4 ng · kg-1 · min-1) during somatostatin and insulin replacement did not accelerate ketone body production or raise non-esterified fatty acid levels, but produced a dose-dependent elevation of blood glucose levels. The results suggest that glucagon is not an important ketogenic hormone under the conditions studied.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; sucrose ; diet ; metabolic control
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of dietary intake of sucrose versus the use of sodium cyclamate were studied in 10 Type 1 (insulin-dependent) diabetic patients on continuous subcutaneous insulin infusion therapy. After a 4-week run-in period, the patients were randomly assigned to a cross-over protocol with two 4-week periods during which they used sucrose or sodium-cyclamate as sweetener. During the experimental periods, 24±13 g/day sucrose and 348±270 mg/day of sodium cyclamate were consumed, respectively. Metabolic control was monitored by the patients performing blood glucose self-monitoring several times daily. Bi-weekly, all patients were followed-up in our outpatient clinic. Mean daily blood glucose concentrations as well as the average daily insulin dose did not differ between the three experimental periods. HbAIc-levels, serum lipids and body weight remained unchanged and within the normal ranges throughout the study. Thus, moderate dietary intake of sucrose did not affect metabolic control in these normal weight, near-normoglycaemic, normolipidaemic, pump-treated Type 1 diabetic patients during a 1-month period. Whether similar conclusions apply to less well controlled diabetic patients remains to be seen.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Exercise ; Type 1 (insulin-dependent) diabetes ; CSII ; hypoglycaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The study was performed to investigate the effects of mild to moderate exercise on blood glucose levels, metabolite concentrations and responses of counterregulatory hormones in tightly controlled Type 1 (insulin-dependent) diabetic patients treated by continuous subcutaneous insulin infusion, and to quantify the measures necessary to prevent acute and late exercise-induced hypoglycaemia. Seven male patients started a 60 min exercise period 90 min after an insulin bolus and a standard breakfast; they were monitored during a post-exercise resting period of 5 h 30 min. Different basal and premeal insulin infusion rates were applied. (Near)normoglycaemia prevailed throughout the study during the control protocol when the subjects did not exercise and received their usual insulin dose. When they exercised without changing the insulin dose, four patients were forced to stop due to hypoglycaemia. This effect of exercise could be attenuated but not completely avoided if the basal infusion rate of insulin was discontinued during the exercise period. The pronounced increase in catecholamine and growth hormone concentrations during exercise were not sufficient to prevent hypoglycaemic reactions. Hypoglycaemia during exercise could only be prevented when the premeal insulin bolus was reduced by 50% in addition to the discontinuation of the basal insulin infusion during exercise. In order to reduce late hypoglycaemic reactions after exercise the best measure proved to be a reduction of the basal insulin infusion rate by 25% during post-exercise hours. Administration of only 50% of the basal insulin infusion rate during this time was associated with blood glucose levels being raised up to 8 mmol/l. In conclusion, Type 1 diabetic patients treated with continuous subcutaneous insulin infusion at (near)normoglycaemia need to reduce their insulin dosage before, during, and after mild to moderate endurance exercise in order to minimize the risk of acute and late hypoglycaemia.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 62 (1984), S. 328-330 
    ISSN: 1432-1440
    Keywords: Continuous subcutaneous insulin infusion ; Free insulin concentration ; Fasting blood glucose ; Target values
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 17 type-I diabetic patients on continuous s.c. insulin infusion (CSII) therapy, potential interrelationships between fasting levels of blood glucose (BG), serum free insulin (free IRI), total (free and bound) insulin (total IRI) and insulinbinding immunglobulin G (IgGI) were evaluated. There was no consistent relationship between the basal s.c. infused insulin dosages and the associated insulinaemia or glycaemia. A significant inverse correlation was found between the fasting levels of serum free IRI and BG (P〈0.005). On the basis of this interrelationship, a target range of 90–110 mg/dl for fasting BG during CSII treatment is proposed.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 25 (1983), S. 457-459 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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