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  • 1
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 1 (1965), S. 116-120 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les auteurs rapportent l'observation d'un homme âgé de 43 ans traité par l'insuline depuis 18 ans. Pendant les 3 dernières années il souffrait d'attaques nocturnes d'hypoglycémie. On constata une augmentation du foie dont une biopsie démontra une architecture normale, mais des dépôts considérablement élevés de glycogène. Après abolition des hypoglycémies par changement d'insuline, le volume et le contenu de glycogène du foie redevinrent normaux. Des rapports antérieurs d'hépatomégalie par dépôt glycogénique sont passés en revue; le mécanisme de cette hépatomégalie et particulièrement sa reversibilité, si l'hypoglycémie est évitée, est discuté.
    Abstract: Zusammenfassung Bericht über einen 43-jährigen Mann, der wegen seines Diabetes 18 Jahre lang mit Insulin behandelt wurde. In den letzten 3 Jahren hatte er nächtliche hypoglykämische Anfälle. Die Untersuchung ergab eine vergrößerte Leber, deren bioptische Untersuchung eine normale Struktur, aber einen deutlich erhöhten Glykogengehalt erkennen ließ. Nachdem das Insulin gewechselt wurde, sodaß Hypoglykämien nicht mehr auftraten, bildete sich die Lebervergrößerung zurück. Sie enthielt jetzt normale Mengen von Glykogen. Über frühere Angaben der „glycogen-laden hepatomegaly” wird berichtet, ihr Entstehungsmechanismus diskutiert, wobei besonders die Reversibilität des Zustandes berücksichtigt wird, wenn Hypoglykämien vermieden werden.
    Notes: Summary A 43-year old man is described who had been treated with insulin for diabetes for 18 years. For the last 3 years he had had nightly hypoglycaemic attacks. He was then found to have an enlarged liver, biopsy of which showed normal architecture but a markedly increased glycogen content. After his insulin was changed so that he no longer developed hypoglycaemia, his liver returned to normal size and normal glycogen content. Previous reports of glycogen-laden hepatomegaly are reviewed, and its mechanism is discussed, with special reference to its reversibility when hypoglycaemia is avoided.
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  • 3
    ISSN: 1432-0428
    Keywords: Dietary fibre ; guar ; glucose tolerance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To gain some insights about the possible cumulative metabolic effect after a high-fibre meal, 6 subjects took two 80 g oral glucose loads, 4 h apart. Addition of 22.3 g guar to the first load decreased the rise in blood glucose and insulin after the second (guar-free) load by 50% (p〈0.002) and 31% (p〈 0.02) respectively. This corresponded with decreased 3-hydroxybutyrate levels at the start of the glucose tolerance test after guar (by 20%, p〈0.02). When no guar was added to the first glucose load, both 3-hydroxybutyrate and non-esterified fatty acids tended to rise before the second test. No significant effect was seen in the responses of the gut hormones, gastric inhibitory peptide and enteroglucagon. Spreading the intake of the first 80 g of glucose over the initial 4 h (2 subjects) similarly flattened the glycaemic but increased the insulin response. The effect of guar on carbohydrate and fat metabolism, therefore, lasts at least 4 h and may result in improved carbohydrate tolerance to subsequent guar-free meals.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 23 (1982), S. 545-545 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0428
    Keywords: Diabetes ; therapy ; diet ; insulin therapy ; sulphonyl-urea ; biguanide ; epidemiology ; body weight ; fasting plasma glucose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A multi-centre, prospective randomised study of the therapy of maturity-onset diabetes has been started, and we report progress of the first 286 patients with 1-year followup. Newly presenting patients (aged 25–65 years inclusive) were initially treated by diet and divided into three categories. (1) Forty-one patients (14%) were ‘primary diet failure’ in that they continued to have symptoms or their fasting plasma glucose remained 〉15 mmol/l. Their therapy was allocated randomly to insulin, chlorpropamide or glibenclamide, and doses adjusted to try to maintain a fasting plasma glucose 〈6 mmol/l. Insulin produced a similar decrease in fasting plasma glucose to sulphonylurea therapy (median fasting plasma glucose fell from 15.4 to 8.0 mmol/l and from 15.5 to 8.6 mmol/l, respectively). (2) After 3–4 months diet, 161 patients (56%) were asymptomatic but had a fasting plasma glucose 〉6 mmol/l. In the ‘main randomisation’ their therapy was allocated to diet only, or diet plus chlorpropamide, glibenclamide or a basal insulin supplement from ultralente insulin. On diet alone, fasting plasma glucose remained constant over 1-year follow-up (from 7.7 to 7.6 mmol/l), whereas it was reduced significantly by insulin (from 8.0 to 6.4 mmol/l), chlorpropamide (8.6 to 6.1 mmol/l) and glibenclamide (7.8 to 6.5 mmol/l). On diet alone, weight remained unchanged over 1 year but increased significantly on insulin, chlorpropamide or glibenclamide (median change ideal body weight +3.5%, +4% and +4%, respectively). Obese patients (〉20% over ideal weight) did not differ from normal weight diabetic subjects in either fasting plasma glucose or weight changes. Insulin therapy was associated with few hypoglycaemic episodes, with 8% of patients on ultralente insulin alone reporting an episode compared with 7% on chlorpropamide. Fifty-one patients (86%) randomised to insulin remain on it lyear later. (3) After 3–4 months on diet, 84 patients (30%) after dieting had a fasting plasma glucose 〈6 mmol/l. During the following year on diet alone 34 patients were less well controlled with a fasting plasma glucose 〉6 mmol/l and were included in a ‘delayed randomisation’. Thus 83% of all patients entered into the study had their therapy randomised by 1 year. Insulin and sulphonylurea therapy are equally effective in reducing glycaemia, and the study is being extended to determine if either therapy will prevent the complications of diabetes or have untoward long-term side effects.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 26 (1984), S. 6-11 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Conclusion Further progress can depend only on standardised testing to determine the response precisely, after consideration of known interacting factors (e. g. initial cheek temperature, plasma chlorpropamide concentration). Until liver biopsy to identify the alcohol dehydrogenase isoenzymes becomes harmless, further studies will perhaps reveal more about the extra-pancreatic effects of one sulphonylurea than about the aetiology of Type 2 diabetes and its complications.
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  • 7
    ISSN: 1432-0428
    Keywords: Type 2 diabetes ; mean fasting blood glucose ; vibration sensory threshold ; biothesiometer ; age ; gender ; obesity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Seventy-one Type 2 (non-insulin-dependent) diabetic patients showed only a slight deterioration in mean vibration sensory threshold (measured biothesiometrically) on the feet during the 5 years from diagnosis. However, multiple linear regression analysis of the wide range of individual changes in this threshold showed as significant independent associated factors the initial sensory threshold (p〈0.001), age, gender, and both the mean fasting blood glucose and failure to become thinner under treatment (p〈0.05 for all). The relationship with fasting glucose was stronger if the pre-treatment value was included in calculation of the mean (p〈0.001). Mean fasting blood glucose under treatment accounted for only a small fraction of the total variance of the deterioration of the vibration sensory threshold, but represented one-twelfth of that attributable to identified factors, and one-third of the variance ascribable to factors subject to therapy. Interim values revealed the persistent effect of hyperglycaemia over the 5 years. An increase of 1 mmol/l in mean fasting blood glucose has an equivalent effect on the sensory threshold to an extra 5 years of age.
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  • 8
    ISSN: 1432-0428
    Keywords: Quantitative morphometry ; amyloid ; diabetes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Quantitative morphometry of the pancreases of five ‘maturity-onset’ diabetic subjects has demonstrated more amyloid in islets of the head, body and tail (where it was found in a mean 29% of the islets occupying a mean 11% islet area) than in islets of the ‘pancreatic-polypeptide-rich’ lobule of the head (where amyloid was found in a mean of 3% of the islets occupying a mean of 0.7% islet area, both p〈 0.005). The nonuniform amyloid distribution may relate to the hormone content of the islet; the head and tail contained significantly more A, B and D-cells than the pancreatic-polypeptide-rich lobule in both non-diabetic subjects (n = 8) and diabetic patients (n = 5; p〈0.005). This result is compatible with the previous suggestion that amyloid may be derived from insulin or its precursors.
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  • 9
    ISSN: 1432-0428
    Keywords: Ambient temperature ; glucose tolerance ; tropical countries ; hot hand technique ; post-prandial glucose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary When either a 960-kcal, 140-g carbohydrate meal, or a 75-g glucose load was ingested by non-diabetic Caucasians, the 2-h venous plasma glucose concentration was higher by 0.82 and 1.25 mmol/l, respectively, if the ambient temperature was 33 °C rather than 23 °C. It is likely that this is a result of relative ‘arterialisation’ of the venous blood. Even at 23 °C room temperature, use of the ‘hot hand’ technique to obtain ‘arterialised’ venous blood increases post-load glucose levels in contralateral antecubital veins. If these observations apply to those acclimatised to the heat, they could affect the diagnosis of both diabetes and impaired glucose tolerance in the tropics.
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  • 10
    ISSN: 1432-0428
    Keywords: Diabetes ; leucocyte ; sodium ; adenosine-triphosphatase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Leucocyte sodium efflux and sodium content were studied in 41 insulin treated diabetic patients and compared to 41 age, body mass index and blood pressure matched nondiabetic control subjects. Fasting leucocyte Na ouabain-sensitive efflux rate constants were lower in diabetic patients (median [range] 2.30 [1.04–3.73] versus 2.45 [1.57–3.95] h−1, p〈0.04) suggesting a reduced sodium pump activity. The 22Na ouabain-insensitive efflux rate constant which reflects passive sodium efflux was raised in insulin treated diabetes (0.92 [0.42–1.73] versus 0.79 [0.28–1.49] h−1, p〈0.01). Leucocyte sodium content was raised in the diabetic patients (47.7 [26.9–93.4] versus 26.5 [15.9–67.7] mmol/kg, p〈0.0001). Abnormal cellular sodium handling could lead to hypertension or other complications in diabetes.
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