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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 13 (1977), S. 345-350 
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; mortality ; coronary heart disease ; cerebrovascular disease ; hypoglycaemic therapy ; cohort studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A retrospective analysis of a cohort of 5210 diabetic patients revealed a mortality rate 1.3 times higher than in the general population of Warsaw. The higher death rate in the cohort under study was mainly due to an excess mortality from coronary heart disease and cerebrovascular disease. The excess mortality was greater in men than in women. The risk of death from cardiovascular diseases was higher among the patients with early onset diabetes. Mortality from cerebrovascular disease was highest in patients treated with insulin, intermediate in the group treated with oral drugs, and lowest in the group treated only with diet. The mortality ratio from coronary heart disease in men was not related to the method of hypoglycaemic therapy given at the onset or during the course of the diabetes. In women, the highest mortality was in the group treated with insulin, intermediate in the group treated with oral agents, and lowest in the group treated with diet only.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Biguanides ; blood lactate ; ethanol ; fructose ; exercise
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In three groups of healthy subjects (n = 56) changes in blood lactate, pyruvate and bicarbonate concentrations and pH were determined during three different loading tests. These were an oral ethanol load (0.5 g/kg body wt), an IV fructose load (1 g/kg body wt over 60 min), and a 15 min submaximal exercise load. The same tests were repeated after administration of biguanides for 3 days in the following doses: phenformin 150 mg, buformin 300 mg and metformin 2.55 g daily. All three derivatives induced a significant rise in blood lactate level as well as a significant increase in blood [lactate]/[pyruvate] ratio in relation to control tests. The differences in the effect of individual biguanides were minimal. It was observed, on the other hand, that increments in blood lactate concentrations depended markedly on the type of load given. The highest rise in blood lactate level was found after fructose loading; in the 60th minute of the test after phenformin it was 1.60±1.29 (SD), after buformin 1.32±0.79, and after metformin 1.31±0.64 mmol/1. The smallest rise of lactate was observed after oral ethanol loading: in the 1st hour of the test the respective values were 0.41±0.24, 0.52 ±0.18, and 0.91±0.86 mmol/1. In the exercise test the highest increment of the blood lactate level was observed 15 min after the end of the exercise, being 1.06±0.37, 1.21±0.25 and 1.26±0.33 mmol/1, respectively. The results of these investigations show that all three biguanide derivatives used in treatment of diabetes — phenformin, buformin and metformin — are risk factors which may induce lactic acidosis under suitable conditions.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Diabetes ; antidiabetic biguanides ; amino acids ; L-arginine ; blood glucose ; plasma insulin ; intraduodenal amino acid administration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty-one patients with mild maturity-onset diabetes were given introduodenal infusions of an amino acid mixture (0.5 g amino acids per kg body weight). In 9 other patients L-arginine was infused intravenously in a constant dose of 25 g. Alpha-amino nitrogen, blood glucose and plasma insulin levels were assayed under control conditions and after three days of treatment with phenformin, 150 mg daily, plus the same 150 mg dose 60 min before the second loading. Intraduodenal infusion of the amino acid mixture provoked a greater increase in plasma insulin than intravenous infusion of L-arginine, this increase being significantly inhibited by phenformin only in the first case. Since no evident influence of phenformin on the intestinal absorption of amino acids could be demonstrated, this effect may be explained by a local action on the intestinal wall exposed to high concentrations of the drug, resulting in the inhibition of the insulin secretion stimulating activity of the gut.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Keywords: Diabetes ; antidiabetic biguanides ; blood glucose ; plasma pancreatic GLI ; plasma gut GLI ; intraduodenal glucose administration ; intraduodenal amino acid administration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Five patients with mild maturity-onset diabetes were given 250 ml of a 20% glucose solution by intraduodenal infusion and eight other patients similarly received an amino acid solution in a dose of 0.5 g amino acids per kg body weight. The pancreatic and gut glucagon-like immunoreactivity (pancreatic GLI and gut GLI) in plasma were measured before and after the application of the two stimuli. Each person was tested twice; the first (control) test was followed by a second test after three days of treatment with phenformin 150 mg daily, plus the same 150 mg dose taken 60 min before the intubation. The plasma pancreatic GLI increased slightly during both infusions, but was not affected by phenformin. Intraduodenal infusion of both glucose and the amino acid solution induced a greater rise in plasma gut GLI. After treatment with phenformin, the fasting plasma gut GLI was higher than the control value in eleven of thirteen patients. In most cases higher gut GLI plasma levels were also found after duodenal administration of glucose and amino acids. These data furnish further evidence of the local action of antidiabetic biguanides on the intestinal wall, including its hormonal activity. The hypothesis is advanced that the phenformin-induced increase in gut GLI secretion may bring about competition of the latter with pancreatic glucagon for receptors in liver cell membranes, reducing the effect of glucagon on the liver, and thus contributing to a decrease in glycaemia.
    Type of Medium: Electronic Resource
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