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

When normal volunteers ate isocaloric wheat-based meals, their plasma insulin responses (peak concentration and area under curve) increased stepwise: whole grains less than cracked grains less than coarse flour less than fine flour. Insulin responses were also greater with fine maizemeal than with whole or cracked maize grains but were similar with whole groats, rolled oats, and fine oatmeal. The peak-to-nadir swing of plasma glucose was greater with wheat flour than with cracked or whole grains. In vitro starch hydrolysis by pancreatic amylase was faster with decreasing particle size with all three cereals. Correlation with the in vivo data was imperfect. Oat-based meals evoked smaller glucose and insulin responses than wheat- or maize-based meals. Particle size influences the digestion rate and consequent metabolic effects of wheat and maize but not oats. The increased insulin response to finely ground flour may be relevant to the etiology of diseases associated with hyperinsulinemia and to the management of diabetes.
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PMID:Particle size of wheat, maize, and oat test meals: effects on plasma glucose and insulin responses and on the rate of starch digestion in vitro. 245 16

Exocrine pancreatic enzyme activities and mineral concentrations were measured in a newly developed congenic strain of corpulent rat (SHR/N-cp). Approximately 4- to 5-wk-old corpulent (cp/cp) and lean (+/?) male rats consumed a diet containing 54% carbohydrate as either cooked cornstarch or 27% cooked cornstarch and 27% fructose for 9.5 mo. After consuming the diet for 3 mo, corpulent rats were hyperinsulinemic, hyperlipidemic and exhibited glycosuria. After consuming the diet for 9.5 mo corpulent rats were twofold heavier and pancreatic weight was 77% that of their lean littermates. Corpulent rats that consumed starch exhibited lower total pancreatic protein with no significant change in total DNA and RNA. In the corpulent rat, both lipase- and chymotrypsinogen-specific activities and both the specific activities and the content of amylase or trypsinogen were lower than those of lean littermates. Fructose consumption resulted in lower pancreatic copper and iron concentrations, and zinc concentration was elevated in corpulent rats. This study suggests that the SHR/N-corpulent rat may be a useful model for studying exocrine pancreatic function in insulin-independent diabetes.
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PMID:Exocrine pancreatic enzyme activities and mineral concentrations in SHR/N-corpulent (cp) male rats. 245 79

Exocrine secretory function in response to 10 pM to 10 nM synthetic secretin was evaluated in perfused pancreas isolated from control, streptozocin-induced diabetic (STZ-D), alloxan-induced diabetic (ALX-D), and insulin-treated STZ-D rats. In STZ-D rats, the basal rate of pancreatic juice flow was significantly increased (10.3 +/- 1.0 microliters/20 min) compared with control rats (4.4 +/- 0.2 microliters/20 min). The basal rate of amylase output as well as pancreatic amylase content were significantly decreased to less than 5% of control values. The basal rates of protein and trypsinogen outputs were similar in both groups. In both control and diabetic rats, secretin caused a dose-dependent increase in exocrine secretion. Secretin (10 pM to 10 nM) induced 1.1- to 11.7-fold increases in exocrine secretion in STZ-D rats. These increases were significantly lower than the 2.1- to 20.8-fold increases in control rats. Furthermore, there was no significant increase in exocrine secretion from STZ-D rats in response to 10 pM secretin, although this concentration of secretin caused a significant increase in control rats. Secretin-induced exocrine secretion in ALX-D rats was similar to that in STZ-D rats. In insulin-treated STZ-D rats, the basal rates of pancreatic secretion were not significantly different from those of control rats. These results suggest that insulin resistance in this patient was due to a circulating factor of low molecular weight that uncoupled insulin stimulation of glucose transport from receptor binding and phosphorylation. The factor appears to increase the binding activity of the alpha-subunit of the insulin receptor without affecting the kinase activity of the beta-subunit.
Diabetes 1988 Sep
PMID:Secretin-induced exocrine secretion in perfused pancreas isolated from diabetic rats. 245 29

Salivary composition and flow rate were examined in 35 patients with insulin-dependent diabetes mellitus (IDDM) and compared to 31 healthy controls. Significantly lower whole-saliva flow rate was observed in the IDDM patients, but was not correlated with the subjective complaint of xerostomy. Glucose concentration was significantly higher in the parotid saliva of the IDDM patients. Potassium concentration was significantly higher in whole and parotid, resting and stimulated saliva, as was total protein concentration in resting whole and in stimulated parotid saliva of the diabetics. No significant difference between diabetics and healthy controls was found in sodium and IgA concentration or in amylase activity. The significantly higher glucose, lower flow rate, and higher potassium and protein concentrations indicate that salivary glands are affected in IDDM. The subjective complaint of dry mouth, often present in diabetics, while not correlated with salivary flow rate, might reflect qualitative changes in salivary composition and/or altered mucosal perception. Salivary glucose concentration, although significantly higher in the diabetics, was not significantly correlated with serum glucose, preventing the use of saliva for monitoring blood sugar.
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PMID:Salivary composition in diabetic patients. 245 69

Expression of an amylase/CAT hybrid gene was analyzed in transgenic mice. The amylase promoter was derived from a pancreatic amylase gene whose expression is repressed in diabetic animals. Pancreas-specific expression of the amylase/chloramphenicol acetyl-transferase (CAT) construct was observed in two independent transgenic lines. Correct initiation of transcription was demonstrated by protection of an anti-sense riboprobe. To evaluate the insulin dependence of the hybrid gene, diabetes was induced by treatment with streptozotocin. As a result of this treatment, pancreatic CAT activity was reduced to undetectable levels. Subsequent administration of insulin restored CAT activity to normal levels. The abundance of CAT transcripts was also greatly reduced in diabetic pancreas. These studies localize the determinants of pancreas specificity and insulin dependence to the region between -208 and +19 of the mouse pancreatic Amy-2.2 gene. The results are consistent with an effect of insulin on amylase transcription, rather than post-transcriptional regulation of mRNA processing or stability.
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PMID:Insulin response of a hybrid amylase/CAT gene in transgenic mice. 246 Apr 51

The authors report a case of renal and pancreatic transplantation in a patient with renal failure and type I diabetes. The entire pancreas and duodenum were transplanted, the duodenum was drained into the bladder in order to assay the urinary amylase which is an early criterion of rejection of the exocrine pancreas.
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PMID:[The value of dual kidney and pancreas transplantation, with bladder drainage in type I diabetic patients with renal insufficiency]. 246 Nov 44

Whole pancreas isografts or allografts (ACI donors, RT1a) with bladder drainage of exocrine secretions were performed in Lewis rats (RR1(1] with streptozotocin-induced diabetes. Urinary amylase, pH, and volume and serum glucose were measured daily. They were analyzed alone, or in combination, to determine patterns in deviations from normal values, from isograft control values, or from a posttransplant baseline in relation to rejection (defined as reversion of plasma glucose of greater than 200 mg/dl) in nonimmunosuppressed recipients. Also studied were the sensitivity and specificity by which such deviations predicted rejection. Functioning grafts were associated with increased urinary amylase and pH compared with normal or diabetic controls; urinary volume was less than that of diabetic rats, but greater than that of normal rats. In nonimmunosuppressed allograft recipients (n = 9), rejection occurred at a mean (+/- SD) of 7.78 +/- 0.44 days. Serum glucose rose to above normal (greater than 134 mg/dl) 1 day before rejection in 3 animals (sensitivity 33%, false negative rate 66%; false positive rate in 9 isograft recipients, 44%). Urinary volume dropped below 3 ml at a mean of 3.17 +/- 0.98 days (range 2-5 days) before rejection in 6 animals (sensitivity 66%, false negative rate 33%; false positive rate 0%). Urinary pH fell below 7.25 at a mean of 3.13 +/- 1.81 days (range 1-5 days) before rejection in 8 rats (sensitivity of 89%, false negative rate 11%; false positive rate 29%). Urinary amylase dropped from a posttransplant peak at a mean of 3.56 +/- 1.42 days (range 1-6 days) before rejection in 9 animals (sensitivity 100%, false negative rate 0%; false positive rate 43%), and dropped below 1500 units per 24 hr at a mean of 2.00 +/- 1.32 days (range 1-5 days) before rejection in 8 animals (sensitivity 89%, false negative rate 11%; false positive rate 0%). A drop in urinary amylase combined with a drop in urinary volume or pH occurred at a mean of 3.22 +/- 1.48 days (range 1-5 days) before rejection in 9 rats (sensitivity 100%, false negative rate 0%; false positive rate 0%). In a separate group of 10 allograft recipients, immunosuppression with prednisone and cyclosporine was begun concomitant with, or within 2 days of, the drop in urinary amylase from the peak value; rejection did not occur in 3 animals and was delayed to a mean of 12.0 +/- 5.0 days posttransplant in 7 animals (P less than .05 compared with the nonimmunosuppressed group).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Monitoring urinary amylase and pH in pancreas transplantation with urinary drainage in rats. 246 57

In a series of 101 pancreas transplants from brain cadaver donors, serum amylase levels were determined preoperatively in 47 donors, and plasma glucose levels were monitored in 94 donors. Eighty-six percent of the donors died from head injury and 14% from asphyxia. No donors had a history of diabetes or pancreatitis, and the pancreas was grossly normal in all donors. Of the 47 cadaver pancreas donors in whom serum amylase levels were measured, the values of 20 donors were elevated (110-994 IU/L), and the values of 11 donors were greater than 300 IU/L. In 51 of 94 braindead cadaver pancreas donors in whom plasma glucose determinations were made, hyperglycemia was present (200-980 mg/dl). Early posttransplant pancreas-graft function was excellent in all recipients except for 5 patients in whom the grafts had to be removed for reasons not related to donor serum amylase and plasma glucose levels. Hyperamylasemia and hyperglycemia are probably not contraindications for cadaver pancreas organ donation unless overt pancreatic trauma, pancreatitis, or a history of diabetes is present.
Diabetes 1989 Jan
PMID:Influence of serum amylase and plasma glucose levels in pancreas cadaver donors on graft function in recipients. 246 94

Rejection episodes were studied in 15 patients, in whom no kidney graft could serve as a marker for rejection, subjected to pancreas transplantation with pancreatoenterostomy and temporary exteriorization of the pancreatic juice (10 pancreas alone, 3 pancreas after kidney, and 2 combined pancreas and kidney in which the kidney was not functioning.) Twelve patients (80%) had a total of 18 rejection episodes. In the first 11 patients, 13 rejection episodes were diagnosed by a decline in amylase activity in the pancreatic juice, whereas in the next 4 patients, 5 rejection episodes were diagnosed by positive cytology in the pancreatic juice. Neopterin in pancreatic juice and immunoreactive anionic trypsin in serum showed promise as rejection markers, whereas serum neopterin, serum amylase, and serum immunoreactive cationic trypsin did not. Unspecific signs of rejections were an increase in white blood cell count, clinical symptoms such as fever, abdominal pain, and arthralgia. All acute rejection episodes were successfully reversed by antirejection treatment. However, late rejections diagnosed by impaired endocrine function were seen in 6 of the 15 (40%) patients, and the prognoses for these rejections were worse: 4 patients (27%) lost their grafts because of chronic rejections, and 2 patients still had impaired endocrine function.
Diabetes 1989 Jan
PMID:Markers for pancreas-graft rejection in humans. 246 97

A major dilemma in pancreas transplantation is the lack of reliable methods for the early detection of allograft rejection. Over a 26-mo period, 70 rejection episodes occurred in 36 patients (13 isolated-pancreas, 23 simultaneous pancreas-kidney recipients) with pancreaticoduodenocystostomy. A total of 300 radionuclide pancreas examinations were performed (mean 8.3/patient) utilizing 99mTc-labeled DTPA. Computer analysis generated a quantitative measure of blood flow to the allograft (technetium index, TI). Rejection episodes were defined as isolated pancreas, isolated kidney, or combined pancreas-kidney. Mean urinary amylase (UA) levels and TI during normal allograft function were 30,256 U/L and 0.57%, respectively, whereas levels heralding rejection were 6873 U/L and 0.39% (P less than .05). The treatment of rejection based on kidney dysfunction or combined pancreas-kidney dysfunction resulted in significantly higher graft salvage and a lower incidence of hyperglycemia compared with isolated-pancreas-allograft rejection. After therapy, a TI greater than 0.3% was associated with 95.9% graft survival, whereas levels less than 0.3% resulted in a 72.7% rate of graft loss (P less than .001). Similarly, pancreas allografts with a UA greater than 10,000 U/L had 92.2% functional survival, whereas levels less than 10,000 U/L resulted in a 53.3% rate of graft loss (P less than 0.001). Overall, reversal of rejection occurred in 80% of cases, with 10 pancreas and 2 kidney allografts lost due to rejection. Monitoring pancreas-allograft function by UA, TI, and renal function in simultaneous transplants allows for the timely diagnosis and successful treatment of pancreas-allograft rejection.
Diabetes 1989 Jan
PMID:Early detection of rejection in pancreas transplantation. 246 98


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