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

We investigated the skin vasoreactivity to insulin in normal subjects and in treated non-insulin-dependent diabetes mellitus (NIDDM) patients. We measured cutaneous perfusion by laser-Doppler flowmetry (LDF) at rest and during skin cathodal iontophoresis (six pulses of 0.1 mA each for 20 s, with 40 s interval between stimulations) of insulin (0.1 ml Humulin R 100 IU/ml diluted 1/10 with of 0.9% saline solution) in 45 healthy subjects (HS), (25 males, 20 females, aged 45 +/- 18 years), and in 15 treated NIDDM patients (13 males), aged 66 +/- 8 years. Fifteen of the HS were used as controls. In these 15 sex- and age-matched HS and in the patients, we assessed also the skin postischemic hyperemia by LDF. In HS cutaneous blood flux response (CBF) to iontophoresis of insulin in saline (expressed as percent changes from baseline) was significantly higher than CBF response to iontophoresis of pure saline (maximum response: 360 +/- 51% versus 172 +/- 42%, respectively; P < 0.001, ANOVA for repeated measures). The maximum "net" CBF response to insulin (response to insulin minus response to saline) showed a negative correlation (r = -0.361; P < 0.01) with age in HS, and resulted significantly lower in the oldest than in the youngest HS (105 +/- 40% versus 307 +/- 45%, respectively; P < 0.01). No significant correlation was observed between the maximum CBF response to saline and the age of subjects. In NIDDM patients the "net" CBF response to insulin iontophoresis resulted significantly lower than in 15 sex- and age-matched control subjects (maximum response: -50 +/- 89% versus 201 +/- 81%, respectively; P < 0.001, ANOVA for repeated measures). No significant difference was observed between diabetics and controls, nor in basal perfusion (6.5 +/- 1.3 IU versus 6.8 +/- 1.7 IU, respectively) neither in the skin postischemic hyperemia (250 +/-14% versus 258 +/- 27%, respectively). These results confirm that insulin iontophoresis induces a skin vasodilatatory effect in normal subjects and show that this effect is reduced by aging and is absent in treated NIDDM patients. The local skin vasodilatatory effect induced by insulin seems to involve mechanisms different from those underlying the skin postischemic hyperemia.
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PMID:Skin vasoreactivity to insulin iontophoresis is reduced in elderly subjects and is absent in treated non-insulin-dependent diabetes patients. 1558 63

Antecedent hypoglycemia is a primary factor in hypoglycemia-associated autonomic failure, a pathophysiological condition characterized by impaired glucose counterregulatory function. Conventional therapeutic strategies involving administration of intermediate dosage-release formulations of insulin in the management of insulin-dependent diabetes mellitus result in frequent iatrogenic hypoglycemia. This study investigated the neuroanatomical location, direction, and magnitude of CNS neuronal genomic activation by singular versus repeated induction of hypoglycemic bouts of greater than 6 h duration achieved by administration of the intermediate-acting insulin, humulin neutral protamine Hagedorn (NPH). Adult male rats injected subcutaneously with Humulin NPH exhibited robust immunolabeling for the nuclear transcription factor, Fos, in discrete telencephalic, diencephalic, midbrain, and caudal hindbrain loci in a pattern that was not identical to that described for regular insulin. Administration of four doses of insulin on as many days significantly diminished or extinguished Fos immunostaining within the parvocellular hypothalamic paraventricular nucleus, lateral hypothalamic area, dorsomedial hypothalamic nucleus, thalamic paraventricular nucleus, nucleus tractus solitarius, and area postrema, but did not modify labeling of other metabolic loci. However, numbers of Fos-immunoreactivity-positive magnocellular neurons in the hypothalamic paraventricular and supraoptic nuclei were significantly increased after the second and fourth insulin doses, relative to the single-dose group. Concurrent observations of exacerbated hypoglycemia and modified patterns of glucoregulatory hormone secretion after serial injections of intermediate-acting insulin suggest that central mechanisms governing compensatory endocrine responses, specifically glucagon, become habituated to repetitive hypoglycemia of extended duration. Resultant alterations in CNS-islet and -adrenomedullary output and hypothalamic-pituitary-adrenal activity may reflect diminished neuronal activation within one or more of the brain loci characterized here by nonuniform transcriptional activation. The current studies provide a neuroanatomical foundation for further investigation of the neurochemical phenotypes and interconnectivity of functionally adaptive neurons, underlying cellular and molecular mechanisms of diminished or enhanced activation, as well as the impact of these modified cellular responses on glucose counterregulation during administration of intermediate-acting insulin.
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PMID:Recurrent insulin-induced hypoglycemia causes site-specific patterns of habituation or amplification of CNS neuronal genomic activation. 1565 93

The results of the present study, using the conscious beagle dog, demonstrate that inhaled insulin (INH; Exubera) provides better glycemic control during an intraportal glucose load than identical insulin levels induced by insulin (Humulin) infusion into the inferior vena cava (IVC). In the INH group (n = 13), portal glucose infusion caused arterial plasma glucose to rise transiently (152 +/- 9 mg/dl), before it returned to baseline (65 min) for the next 2 h. Net hepatic glucose uptake was minimal, whereas nonhepatic uptake rose to 12.5 +/- 0.5 mg x kg(-1) x min(-1) (65 min). In the IVC group (n = 9), arterial glucose rose rapidly (172 +/- 6 mg/dl) and transiently fell to 135 +/- 13 mg/dl (65 min) before returning to 165 +/- 15 mg/dl (125 min). Plasma glucose excursions and hepatic glucose uptake were much greater in the IVC group, whereas nonhepatic uptake was markedly less (8.6 +/- 0.9 mg x kg(-1) x min(-1); 65 min). Insulin kinetics and areas under the curve were identical in both groups. These data suggest that inhalation of Exubera results in a unique action on nonhepatic glucose clearance.
Diabetes 2005 Apr
PMID:Inhalation of insulin (Exubera) is associated with augmented disposal of portally infused glucose in dogs. 1579 57

Gestational diabetes is a syndrome of significant pathophysiological and clinical heterogeneity. This type of diabetes mellitus can be treated with diet, exercise and insulin in cases of unsatisfactory results of nonpharmacologic treatment. It has been reported the case of a 28-year -old female with gestational diabetes treated with high doses of insulin (128 U/per day) on four injections regimens. During the therapy allergic type III reactions to human insulin preparations (Ultratard HM, Actrapid HM Humulin U, Humulin R, Humalog) has been occurred at the injection site. The insulin was omitted. We applied diet modification and 15-30 minutes walking before meals till the afternoon with god metabolic control. High insulin resistance index HOMA-IR, type 2 diabetes history in both parents god metabolic control of nonpharmacologic treatment, and impaired glucose tolerance after post-partum may suggest, the early stage of diabetes type 2 in presented case.
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PMID:[Outcome of non-pharmacologic treatment in a gestational diabetic woman with high insulin resistance HOMA-IR index and allergy to human insulin. Case report]. 1614 61

To compare blood glucose (BG) responses during a 60 min moderate intensity exercise session performed in early or late postprandial periods. Nine generally well-controlled (HbA(1c): 7.3+/-0.1%) type 1 diabetic patients performed, at least one week apart, two exercise sessions, 60 (early exercise) and 180 min (late exercise) after a standardized breakfast. All subjects were using Humulin N (N) and Humalog (Lispro, LI) insulin. During exercise, the overall decrease in BG was 4.8+/-0.6 mmol/l and 3.6+/-0.8 mmol/l in early and late exercise, respectively (P=0.051). To prevent hypoglycemia, a dextrose infusion was initiated when BG reached 5 mmol/l. The quantity of dextrose infused was 6.2+/-3.0 g and 10.5+/-3.2g in early and late exercise, respectively (NS). The time free of dextrose infusion during exercise was 41.2+/-7.8 min and 31.7+/-7.5 min in early and late exercise, respectively (NS). In N-LI users, overall drop in BG during exercise tends to be greater in the early postprandial period. However, early and late exercise present similar quantity of dextrose infused and time free of dextrose infusion. Consequently, the similar risk of exercise-induced hypoglycemia suggests similar precautions in either exercise times.
Diabetes Res Clin Pract 2006 May
PMID:Is early and late post-meal exercise so different in type 1 diabetic lispro users? 1630 77

Non-hypercalcemic analogs of vitamin D(3) modulate the immune response through antigen-presenting cells (APCs) and activated T-cells. A large population-base case-control showed that vitamin D(3) intake significantly decreases the risk of type 1 diabetes development. The aim of this study was, therefore, to observe the in vivo effects of a vitamin D(3) analog administered to Bio Breeding (BB) rats. 1,25-Dihydroxy-16,23Z-diene-26,27-hexafluoro-19-nor vitamin D(3) (BXL-219, formerly Ro 26-2198) (BioXell, Milan, Italy) was administered in vivo to BB rats from days 42 to 110 of life at 0.2 microg/Kg BW. Control animals received only vehicle (olive oil, 4.8 microl/100 g BW). The animals of these two groups were subjected to insulin treatment as they became diabetic. Insulin (Humulin, 28.6 UI/day) was administered irrespective of diabetes occurrence to another group of rats for comparison. Blood glucose, insulin levels, glycosuria, degree of islet infiltration, and the expression of some antigens were observed. Results showed that the vitamin D(3) analog reduced diabetes incidence, although limitedly, in BB rats while administration of oral insulin increased diabetes incidence. In addition, the vitamin D(3) analog did not stimulate an enhancement in the expression of CD4 and CD25 in BB rats as it does in NOD mice, which may explain the failure of this as well as other antidiabetic treatments in the BB animal model of type 1 diabetes.
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PMID:Effects of a vitamin D3 analog on diabetes in the bio breeding (BB) rat. 1696 Aug 73

Insulin resistance may coexist with diabetes type 1 and make treatment of diabetes difficult. Case of 24-year-old type 1 diabetic female with insulin resistance features prior to pregnancy is reported. Exacerbating of insulin resistance during pregnancy was manifested by difficulties to overcome excessive weight gain and necessity to initiate treatment with high doses of insulin. The treatment was based on diet with progressive caloric restriction to 800 kcal/day in 35 week of pregnancy. That diet was continued till the delivery in 37 week. The fast acting analog insulin (Humalog) and long acting insulin (Humulin U) were used in treatment of diabetes. Treatment with low calorie diet did not cause negative effects on diabetic female metabolism and on the neonate state.
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PMID:[Insulin resistance in pregnant type 1 diabetic female. Case report]. 1707 94

The aim of this study was to evaluate, for the first time, the histomorphometry of the cellular and lacunar features of the osteocytes of alveolar bone in acute streptozotocin-induced diabetic insulin-treated or untreated rats. Eighteen male Wistar rats weighing 200 to 260 g were assigned to one of the following groups: I) control group (C), II) diabetic group (DBT), and III) insulin treated diabetic group (DBT+INS). Experimental diabetes was induced by a single intraperitoneal injection of 60 mg/kg of body weight of streptozotocin. Insulin treatment began 24 h after the streptozotocin injection in animals of group DBT+INS in a dose of 4-6 IU of Humulin NPH insulin given as a single daily subcutaneous (s.c.) injection each morning between 07.00 and 10.00 h. The animals were euthanized on the 8th day. The upper maxillae were removed and fixed in buffered formalin, decalcified in EDTA, embedded in paraffin and stained with H-E for histologic and histomorphometric evaluation. Bone activity and lacunar density, osteocyte and empty lacunar densities, lacunar volume and lacunar shape were evaluated. Differences between variables were assessed by one-way ANOVA. Surface bone activity values revealed that bone resorption was significantly greater in the DBT group than in the C group (p < 0.05). Total lacunar density was significantly reduced in the DBT and DBT+INS groups as compared to control (p < 0.05). Concomitantly, a statistically significant reduction in osteocyte density and an increase, albeit not statistically significant, in empty lacunar density was observed in DBT and DBT+INS groups versus control. Lacunar volume did not exhibit statistically significant differences. The osteocyte lacunae in the DBT group lost their rounded shape and acquired intermediate shapes. This study reveals an early response of osteocytes to hyperglycemia, before systemic compensatory mechanisms are turned on. The effects are not always compensated by insulin treatment.
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PMID:Influence of short-term diabetes on osteocytic lacunae of alveolar bone. A histomorphometric study. 1712 Nov 95

This study assessed the site of increased glucose uptake resulting from insulin inhalation, quantified its effect under steady-state glucose concentrations, and identified the time to onset of effect. Human insulin was administered to 13 beagles via inhalation (Exubera [insulin human (rDNA origin)] Inhalation Powder; n = 7) or infusion into the inferior vena cava (Humulin R; n = 6) using an algorithm to match plasma insulin levels and kinetics for both groups. Somatostatin and glucagon were infused. Glucose was delivered into the portal vein (4 mg x kg(-1) x min(-1)) and a peripheral vein, as needed, to maintain arterial plasma glucose levels at 180 mg/dl. Hepatic exposure to insulin and glucose and liver glucose uptake were similar in both groups. Despite comparable arterial insulin and glucose levels, hind-limb glucose uptake increased 2.4-fold after inhalation compared with infusion due to increased muscle glucose uptake. Glucose infusion rate, nonhepatic glucose uptake, and tracer-determined glucose disposal were about twice as great compared with intravenous insulin. The effect appeared after 1 h, persisting at least as long as arterial insulin levels remained above basal. Pulmonary administration of insulin increases nonhepatic glucose uptake compared with infusion, and skeletal muscle is the likely site of that effect.
Diabetes 2006 Dec
PMID:Inhalation of human insulin (exubera) augments the efficiency of muscle glucose uptake in vivo. 1713 May 10

SoloStar (sanofi-aventis) is a new, disposable insulin pen for the administration of insulin glargine (Lantus, sanofi-aventis) or insulin glulisine (Apidra, sanofi-aventis). SoloStar was developed to address a wide range of patient needs and demonstrates advancement over previous devices, owing to its appropriate combination of ergonomically-tested and mechanically improved features. The authors report the results of key investigations carried out by sanofi-aventis as part of the SoloStar development plan, including dose accuracy and injection force testing. Comparisons between SoloStar and two commonly used pens, FlexPen (Novo Nordisk) and the Humulin/Humalog pen (Eli Lilly) establish SoloStar as a state of the art pen that is suitable for most patients with diabetes.
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PMID:Dose accuracy and injection force dynamics of a novel disposable insulin pen. 1733 13


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