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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Preservation of own insulin production (residual pancreatic beta-cell function) has been shown to have a beneficial effect on glycemic control in insulin-dependent diabetic subjects, and its total lack has been suggested to be an independent risk factor during diabetic pregnancy. We studied the influence of residual beta-cell activity on the glucose control and the outcome of pregnancy in 29 diabetic women by sequentially measuring gestational postprandial plasma C-peptide (CPR) levels, diurnal blood glucose curves and blood glycosylated hemoglobin (Hb A1c) and by analyzing the morbidity and mortality of the offsprings. The 9 diabetics with moderate own insulin secretion (CPR levels over 1.0 microgram/l, White classes B and C, later referred to as group I) had significantly better glucose control than the remaining 20 subjects with lower CPR values (White classes C, D and NF, later referred to as group II) (figure 1, table I). There were two intrauterine deaths, both in group II. These deaths (one caused by multiple congenital contracture syndrome and the other by severe intrauterine growth retardation without any evident cause) could not be straightly connected with diabetes. Respiratory distress syndrome was seen in group II only. There was no other significant difference in the neonatal morbidity between the two groups (table II). All mothers of RDS infants were in White class NF where the birthweight was also smaller than in classes B and C. These were the only differences in neonatal morbidity between the White classes (table III). In conclusion, moderate residual beta-cell function seemed to be clinically important in maintaining strict glucose control during gestation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Maternal residual beta-cell function and the outcome of diabetic pregnancy. 329 78

A case of diabetes mellitus who had high levels of fasting immunoreactive insulin (IRI) and low levels of immunoreactive C-peptide (CPR) is reported. Examination of her serum disclosed the presence of IgG class k + lambda type anti-insulin autoantibodies. She has never been treated with insulin, nor had drugs which have been reported to be responsible for inducing insulin autoimmune syndrome. Despite the presence of autoantibodies against insulin, she has never experienced hypoglycemia. Significance of the production of autoantibodies against insulin and physicochemical parameters of anti-insulin antibodies in her serum are discussed.
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PMID:A case of diabetes mellitus associated with anti-insulin autoantibodies without previous insulin injection. 331 66

In order to better understand the role of A- and B-cell function in diabetic pregnancy, we studied four groups of pregnant women at week 34-36 of gestation. Seventeen were healthy controls (C), 24 had gestational diabetes (GD), 16 had type 2 diabetes (NIDD) and 37 had type 1 diabetes (IDD). At times -20, 0, 20, 30, 45, 60, 90 and 120 min from the beginning of a 30 min infusion of 30 g of arginine intravenously, plasma glucose, glucagon (IRG) and C-peptide (CPR) were measured. Plasma glucose was higher in diabetic than in control subjects. IRG values were also higher in the GD and the NIDD women. CPR values were similar to, or slightly higher than control values in the GD and the NIDD and were much lower in the IDD women. All three variables increased during the arginine infusion in all groups, with the exception that CPR remained unchanged in the IDD. The CPR/IRG molar ratio was similar in control, GD and NIDD women; in the IDD, it was much smaller than in the other groups and was not affected by arginine. In all the diabetic patients, IRG was negatively correlated with the maternal weight gain and in the IDD IRG was positively correlated with the increase in the insulin need and with the CPR levels. In conclusion diabetes appeared to enhance the A-cell function also in pregnancy, possibly impairing the 'facilitated anabolism' and stressing the 'accelerated starvation' which are typical of normal pregnancy. Glucagon was confirmed as one possible determinant of the insulin resistance seen in diabetic pregnancy.
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PMID:Endocrine pancreatic function in insulin-dependent diabetic pregnant women. 353 67

A 31-year-old woman with Graves' disease developed fasting hypoglycemia after treatment for 3 weeks with methimazole. Although the patient had not received exogenous insulin, high titers of insulin autoantibodies were found in serum and large amounts of total and free insulin (1550 and 82 microU/ml, respectively) and C-peptide reactivity (CPR, 22 ng/ml) were detected in serum. After glucose loading, blood glucose and total insulin levels increased abnormally. The immunoglobulin class of the autoantibodies was IgG and the light chains were of the kappa type. The titers of insulin autoantibodies, elevated serum total and free insulin, and CPR levels decreased gradually, but insulin autoantibodies and elevated insulin levels were still present in the serum 8 months after the episode of hypoglycemia. These findings suggest that the patient's fasting hypoglycemia was due to excess free insulin released from antibody-bound insulin, and that methimazole might play a role in the initiation of production of insulin autoantibodies.
Diabetes Res Clin Pract
PMID:Spontaneous hypoglycemia and insulin autoantibodies in a patient with Graves' disease. 359 31

In vivo insulin clearance in 10 subjects with non-insulin-dependent diabetes mellitus (NIDDM) has been compared with clearance in eight equally obese nondiabetic control subjects by two different methods. The first approach consisted of determining the metabolic clearance rates of exogenously infused insulin (MCRI) during hyperinsulinemic (100 mU/m2/min) glucose clamp studies. The results indicated that mean (+/- SEM) MCRI was 1.4-fold greater in the diabetic subjects (436 +/- 22 ml/m2/min) than in the controls (325 +/- 24 ml/m2/min, P less than 0.005), resulting in a lower steady-state plasma insulin concentration in the diabetic (255 +/- 8 microU/ml) compared with the nondiabetic subjects (329 +/- 29 microU/ml, P less than 0.001). The impact of NIDDM on insulin removal rates was also estimated by a second method in which extraction of endogenously secreted insulin (EXTI) in response to an oral glucose load was calculated from the integrated area above basal of plasma insulin (IRI) and of plasma C-peptide (CPR), an estimate of beta-cell secretion. The results demonstrated that fractional extraction of endogenously secreted insulin (EXTI = 100 [(CPR - IRI)/CPR]) was also 1.2-fold greater for diabetic subjects (88.9 +/- 2.5%) than for nondiabetic controls (72.0 +/- 2.8%, P less than 0.001). Finally, these two independent measurements of in vivo insulin removal rates (MCRI and EXTI) were significantly correlated with each other (r = 0.71, P less than 0.002). These observations are consistent with the view that elevated insulin clearance may contribute to the postchallenge hypoinsulinemia of NIDDM in Pima Indians.
Diabetes 1985 Jul
PMID:Elevated in vivo insulin clearance in pima indians with non-insulin-dependent diabetes mellitus. 389 74

The prevalence of islet cell surface antibodies (ICSA) in patients with insulin-dependent (IDD), noninsulin-dependent (NIDD) or newly-diagnosed diabetes mellitus was studied. The antibodies were present in 14 (27%) of 15 IDD patients below the age of 30 years, and in 11 (12%) of 91 NIDD patients. Among 46 newly-diagnosed diabetic patients, (aged over 30 years), 14 (30%) were antibody-positive and had a fasting blood sugar exceeding 11 mmol glucose. The glucose tolerance after a standardized breakfast decreased in IDD or insulin-treated patients with ICSA compared to patients without antibodies. C-peptide was also lower in patients with circulating ICSA (xi CPR/xi BS during a standardized breakfast test 0.61 +/- 0.30 vs. 1.09 +/- 0.3 in IDD, 1.18 +/- 0.13 vs. 1.46 +/- 0.43 in the patients with insulin treatment). These results suggest that circulating ICSA be also present in some newly-diagnosed patients of over 30 years of age who require insulin treatment and who have an associated decreased glucose tolerance and C-peptide response.
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PMID:Islet cell surface antibodies in diabetes and their possible influence on glucose tolerance. 637 61

Serum free C-peptide immunoreactivities (serum free CPR) during a 100 g oral glucose tolerance test (OGTT) were measured in 21 patients with insulin-dependent diabetes mellitus (IDDM, with abrupt onset and ketosis-prone), 57 insulin-treated patients with noninsulin-dependent diabetes mellitus ( INIDDM , with gradual onset and not ketosis-prone), 39 oral hypoglycemic agent-treated patients with noninsulin-dependent diabetes mellitus ( ONIDDM ) and 9 healthy young men for control study. Although the fasting blood glucose value of the INIDDM group was not significantly different from that of the IDDM and ONIDDM groups, the free CPR response at each interval during OGTT in the INIDDM group was significantly higher than that in the IDDM group and lower than that in the ONIDDM group. The sum of serum free CPR during OGTT (sigma serum free CPR) was found to be negatively correlated to the duration of insulin treatment either in bivariate or multivariate analysis in INIDDM patients. Using 9.5 ng/ml as an index, all sigma serum free CPR values in the ONIDDM group were above this index, whereas all the values except one in the IDDM group were below it. The values in the INIDDM were scattered within the ranges of the other two groups. The insulinogenic index delta serum free CPR/delta blood glucose (30 min-fasting) of the ONIDDM group was significantly lower than that of normal subjects, although sigma serum free CPR values were not significantly different. The results indicate that: 1. Residual pancreatic B-cell function in INIDDM patients is lower than that in ONIDDM patients and is negatively correlated to the duration of insulin treatment in INIDDM patients. 2. Measuring serum free CPR may be a discriminative method for establishing insulin dependency in insulin-treated patients. 3. Impairment of early insulin secretion after the oral glucose load is a distinguished characteristic of diabetic patients.
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PMID:A study of serum free C-peptide responses to oral glucose load in diabetic patients: with special reference to types of diabetes and methods of treatment. 637 68

We investigated the relationship between the recovery or improved response of endogenous insulin and the control of blood glucose in juvenile diabetes (IDDM) treated with the continuous subcutaneous infusion of insulin (CSII). (1) It is unlikely that the decrease in endogenous insulin secretion over several years following onset of IDDM in 43 subjects was uniform in terms of urinary c-peptide (u-CPR) excretion. (2) In 27 newly diagnosed cases of IDDM, the group receiving CSII (n = 18) showed more satisfactory results, including greater stability of blood glucose, a more rapid decrease in insulin requirements and an earlier improvement in u-CPR compared to the control group who were receiving conventional subcutaneous insulin therapy (n = 9). (3) U-CPR increased with the improvement in blood glucose control within 2 to 4 wks of the initiation of CSII in 6 of 8 already-treated cases of IDDM, while daily insulin requirements did not differ significantly before and after CSII. Since short-term CSII therapy improved u-CPR response by normalizing blood glucose not only in newly diagnosed but also known diabetic, therapy should be directed toward the long-term intensive control of blood glucose in order to maintain the potency of endogenous insulin secretion especially in newly-diagnosed cases of insulin secretion especially in newly-diagnosed cases of IDDM.
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PMID:The improved response in endogenous insulin due to continuous subcutaneous infusion of insulin therapy in juvenile diabetes. 639 45

Acarbose, 300 mg/day, was administered over one month in a cross-over trial to 18 hyperglycemic patients aged 41-66 years with non-insulin-dependent diabetes mellitus (NIDDM). All showed "normal" or exaggerated insulin release after a glucose challenge and remained in poor control (random glucose levels greater than or equal to 13 mmol/l) despite involvement in a diabetes intervention programme and prior use of oral hypoglycemic agents. During the one month treatment with Acarbose, fasting glucose and % HbAl concentrations were not different from those observed during placebo therapy. Furthermore, glucose tolerance was unchanged by Acarbose treatment. Glucose concentrations after a 1.6 MJ test meal were reduced by Acarbose from peak values of 17.3 +/- 1.0 to 15.0 +/- 1.1 mmol/l and were associated with lower post-prandial C-peptide (CPR) and insulin responses. Nevertheless, daily insulin production, as assessed by CPR excretion rates and plasma CPR and insulin concentrations, was not reduced by Acarbose. In fact, fasting plasma insulin and CPR levels were significantly higher during Acarbose then placebo therapy. Acarbose (100-400 mg/day) was continued for six months in 12 of these patients. During treatment, post-prandial glucose levels remained lower but monthly MBG values, determined by self-measurement of blood glucose, were unchanged except for small reductions in the 4th and 5th treatment months. % HbAl levels did not change. These data show that Acarbose treatment of a defined group of patients with poorly controlled NIDDM: resulted in small but sustained reductions of post-prandial glucose levels but without improving glucose tolerance, and reduced the circulating concentrations of insulin and CPR postprandially, but overall did not reduce daily production.
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PMID:Treatment of poorly controlled non-insulin-dependent diabetic patients with Acarbose. 639 78

Differences in glucose intolerance within various occupational groups, i.e. laborers, clerks, and managers, and the related environmental factors were studied in ca. 9000 male workers of a certain factory. Age-and weight-adjusted prevalence rates of glucose intolerance were 3.2% in the laborers, 5.8% in the clerks, and 9.3% in the managers. In the managers, the total intake of calories was excessive for the amount of exercise expended; food intake was relatively low in complex carbohydrates and high in animal fats. The clerks were characterized by a high sugar intake. The low prevalence of glucose intolerance in the laborers was ascribed to the greater amount of exercise. Assigned work hours, however, probably affected the prevalence of diabetes in the laborers, which was 2.1% in subjects who worked all three shifts, but 0.9% in subjects working only day shifts. Thirty laborers from all 3 shifts consented to give urine specimens during their working time (8 hr), after the same amount of food and exercise in all of them. Urinary excretion of HGH and VMA during the midnight shift was significantly higher (p less than 0.05) than that during the day shift although urinary 170HCS was significantly low (p less than 0.01) at midnight. There were no significant changes in urinary CPR excretion between day and night shifts. These data indicate the importance of environmental factors, such as exercise, nutrition and stress, in glucose intolerance.
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PMID:Glucose intolerance in an employed population. 668 Apr 94


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