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  • 1
    Electronic Resource
    Electronic Resource
    Bicentric evaluation of a teaching and treatment programme for Type 1 (insulin-dependent) diabetic patients: improvement of metabolic control and other measures of diabetes care for up to 22 months (1983)
    Springer
    Diabetologia 25 (1983), S. 470-476 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes education ; Type 1 diabetes ; severe hypoglycaemia ; diabetes care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In two hospitals an identical diabetes teaching and treatment programme (in-patient, Monday to Friday, group teaching) was set up. Seventy-eight consecutive, conventionally treated Type 1 diabetic patients (duration of diabetes 10±6 years), referred during a certain period, were reinvestigated after 1 year, and again (for assessment of metabolic control only) 22 months after the teaching and treatment programme. Initially, mean glycosylated haemoglobin was 2.6%, after one year 1.0%, and after 22 months 1.5% above the upper limit of the normal range (p〈0.001). Hospital admissions were reduced from a mean of 10 to a median of 1 day per patient per year (p〈0.001). The long-term quality of diabetes care achieved by the diabetes teaching and treatment programme was unrelated to intelligence quotient, diabetes duration, or diabetes-related knowledge. Patients with normal levels of glycosylated haemoglobin on follow-up (33% of all patients) had particularly good compliance rates, and significantly lower initial values of glycosylated haemoglobin than patients with glycosylated haemoglobin levels ⩾10%. The data indicate that the diabetes teaching and treatment programme resulted in a substantial long-term improvement of metabolic control and a striking reduction of hospital admissions. The study substantiates the feasibility of applying this teaching and treatment programme on a large scale to other hospitals, so as to improve the quality of diabetes care and decrease health care costs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00284453
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  • 2
    Electronic Resource
    Electronic Resource
    Evaluation of an intensified insulin treatment and teaching programme as routine management of Type 1 (insulin-dependent) diabetes (1987)
    Springer
    Diabetologia 30 (1987), S. 681-690 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; insulin therapy ; severe hypoglycaemia ; ketoacidosis ; patient education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary It has been questioned whether aiming at near-normoglycaemia by intensified insulin treatment regimens is feasible and safe for the majority of patients with insulin-dependent diabetes. In this study, intensified insulin injection therapy (including blood glucose self-monitoring and multiple insulin injections) based upon a 5-day inpatient group teaching programme was evaluated in Type 1 (insulin-dependent) diabetes mellitus in the centralised health care system of Bucharest. One hundred patients (group A, initial HbA1 12.5%) were followed for 1 year on their standard therapy (individual teaching, no metabolic self-monitoring), and thereafter for 1 year on intensified therapy. Another 100 patients (group B, HbA1 12.3%) were followed for 2 years on intensified therapy. A third 100 patients (group C, HbA1 11.7%) were assigned to a basic 4-day inpatient group teaching programme with conventional insulin therapy (including self-monitoring of glucosuria and acetonuria) and followed for 1 year. Mean HbA1 remained unchanged after standard treatment (group A: 12.8% at 12 months), but decreased during intensified therapy (group A: 10.1% at 24 months; group B: 9.3% at 12 months, 9.5% at 24 months; p〈0.0001). In group C, no change was found compared to standard treatment (i.e. group A at 12 months). Incidence rates of ketoacidosis were 0.16 episodes per patient per year during standard treatment, 0.01 during intensified treatment (p〈0.01) and 0.04 in group C (p〈0.025). Hospitalisation rates were reduced by 60% during intensified therapy and by 40% in group C. Frequency of severe hypoglycaemia was not significantly different between the three treatment regimens. Thus, under the condition that insulin treatment is based upon a structured and comprehensive training of the patient, intensified insulin injection therapy performed as routine treatment of Type 1 diabetes significantly lowers HbA1 levels without increasing the risk of severe hypoglycaemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00296989
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  • 3
    Electronic Resource
    Electronic Resource
    Moderate intake of sucrose does not impair metabolic control in pump-treated diabetic out-patients (1985)
    Springer
    Diabetologia 28 (1985), S. 204-207 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF00282233
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  • 4
    Electronic Resource
    Electronic Resource
    Antineoplastic efficacy of melphalan andN-(2-chloroethyl)-N-nitrosocarbamoyl-ω-lysine, in combination with diazoxide or insulin in autochthonous mammary carcinoma of the Sprague-Dawley rat (1990)
    Springer
    Journal of cancer research and clinical oncology 116 (1990), S. 45-50 
    Details
    ISSN: 1432-1335
    Keywords: Antineoplastic efficacy ; Melphalan ; Diazoxide ; Insulin ; Mammary carcinoma ; Sprague-Dawley rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The anticancer activity of melphalan andN-(2-chloroethyl)-N-nitrosocarbamoyl-ω-lysine (CNC-ω-Lys), was compared in the autochthonous, methylnitrosourea-induced mammary carcinoma of the Sprague-Dawley rat. In addition, the influence on the therapeutic efficacy of the combination with diazoxide, causing a mild, reversible diabetes, and with insulin was investigated. The comparison of melphalan and CNC-ω-Lys clearly showed the superiority of melphalan. Both compounds displayed a significant tumour inhibition in their medium and the highest dosages in comparison to the untreated control. The combination with diazoxide resulted for almost all groups in an increased tumour inhibition. Only the lowest dose of CNC-ω-Lys + diazoxide did not reduce the tumour volume significantly versus the control group. The combination with insulin, however, resulted in a loss of tumour inhibition compared to the effect of the cytotoxic drug alone, although in these groups, too, a significant decrease of tumour volumes versus controls could be observed. Mortality was within tolerable limits (〈20%) through the treatment period for all experimental groups. Median lifespans were increased in all therapy groups, but no additional benefit could be observed in the combination treatment groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01612639
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  • 5
    Electronic Resource
    Electronic Resource
    Differential relationship of vitamin A and E levels in methylnitrosourea-induced Sprague-Dawley rats following prolonged feeding of fatty diets enriched with the vitamins (1990)
    Springer
    Journal of cancer research and clinical oncology 116 (1990), S. 470-474 
    Details
    ISSN: 1432-1335
    Keywords: Vitamins A, E ; Semisynthetic fatty diet ; Methylnitrosourea ; Mammary carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Prolonged supplementation of vitamins A and E (2500 IU and 11.3 IU/rat daily) in 10.3% and 21.6% fatty diets administered to methylnitrosourea-induced Sprague-Dawley rats caused alterations in plasma and liver levels of both vitamins as well as of the total lipids. Liver vitamin A levels increased steadily (more than four-fold) until termination of the experiment, whereas plasma vitamin A levels only showed a minor increase at the end of the study in comparison to rats fed a standard diet. Liver vitamin E levels initially showed no difference from those of rats treated with a standard diet, and were decreased at the end of the experiment, whereas the respective plasma levels were increased throughout the study, only showing a decrease relative to initial values at termination of the experiment. Plasma total lipids increased with age and following supplementation of the vitamins in the high-fat diet, whereas liver total lipids were influenced less by aging than by the fat and vitamin contents of the respective diets. The observed alterations were, however, not related to significant chemopreventive activity of the vitamins A and E contained in high-fat diets.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01612996
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  • 6
    Electronic Resource
    Electronic Resource
    Androgen-linked alkylating agents: biological activity in methylnitrosourea-induced rat mammary carcinoma (1990)
    Springer
    Journal of cancer research and clinical oncology 116 (1990), S. 538-549 
    Details
    ISSN: 1432-1335
    Keywords: Androgen-linked alkylating agents ; Methylnitrosourea ; Mammary carcinoma ; Anticancer activity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This article gives a comprehensive survey on the anticancer activity of nitrosoureas linked to steroidal androgens in methylnitrosourea (MMU)-induced rat mammary carcinoma. cis-Androsterone, testosterone, 19-nortestosterone and 5-α-dihydrotestosterone were used as carrier hormones and were linked to various cytotoxic N-[N′-(2-chloroethyl)-N′-nitrosocarbamoyl] (CNC)-aminoacids and to N-(2-hydroxyethyl)-N′-(2-chloroethyl)-N′-nitrosourea hemisuccinate (HECNU-hemisuccinate). In the MNU-model used esters of dihydrotestosterone (DHT) invariably were more active and less toxic than those of testosterone, nortestosterone and cis-androsterone. Within the DHT esters of CNC-aminoacids those of CNC-glycine, CNC-methionine and CNC-alanine showed the highest antineoplastic activities and superiority compared with equimolar dosages of their unlinked mixtures. Additionally, CNC-alanine-DHT ester had the highest therapeutic ratio of all agents investigated. HECNU-hemisuccinate-DHT ester, on the other hand, achieved even higher antitumor activity at the optimal dose but had a narrower therapeutic ratio. No obvious correlation between antineoplastic efficacy and receptor binding affinity could be demonstrated, but, to be active, a conjugate apparently had to have some receptor binding affinity for both androgen and progesterone receptors. The results obtained indicate that linking antineoplastic agents to transport molecules with affinity to steroid receptors is a highly promising approach to obtain drugs with specific activity in steroid receptor containing tumors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01637072
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