Diabete & metabolisme最新文献_第9页

Variability of blood glucose levels in patients with type 1 diabetes mellitus on intensified insulin regimens. 强化胰岛素治疗组1型糖尿病患者血糖水平的变异性

Diabete & metabolisme Pub Date : 1994-11-01

E A Moberg, P E Lins, U K Adamson

{"title":"Variability of blood glucose levels in patients with type 1 diabetes mellitus on intensified insulin regimens.","authors":"E A Moberg, P E Lins, U K Adamson","doi":"","DOIUrl":"","url":null,"abstract":"The aim of the present study was to look for possible associations between the blood glucose variability and twenty-four clinical parameters in ninety-eight patients with Type 1 diabetes mellitus treated with multiple injections of insulin or insulin pumps and practising self-monitoring of blood glucose. The blood glucose variability was measured as the standard deviation of glucose values obtained by self-monitoring at five specified time points every two days for four weeks. The blood glucose variability significantly correlated with the mean blood glucose level (r = 0.48, p = 0.0001) and with the number of hypoglycaemic events (r = 0.31, p = 0.002), but not with HbA1c (r = 0.19, p = 0.07). Significant correlations were also found between glucose variability and patients' variations of insulin dosage (r = 0.31, p = 0.004), duration of diabetes (r = 0.22, p = 0.03), and body-mass index (r = 0.20, p = 0.04). Patients with incipient or clinical nephropathy had more variable blood glucose values, compared with patients without signs of nephropathy (p = 0.03). Other parameters studied, such as other late diabetic complications, the C-peptide level, the insulin dose and the level of insulin-binding to antibodies did not relate significantly to the blood glucose variability.","PeriodicalId":11111,"journal":{"name":"Diabete & metabolisme","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18717046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Implementation of the Declaration of St. Vincent]. [《圣文森特宣言》的执行情况]。

Diabete & metabolisme Pub Date : 1994-11-01

G Cathelineau

引用次数: 0

[Gliclazide: review of metabolic and vascular action]. [格列齐特:代谢和血管作用的综述]。

Diabete & metabolisme Pub Date : 1994-11-01

K G Alberti

{"title":"[Gliclazide: review of metabolic and vascular action].","authors":"K G Alberti","doi":"","DOIUrl":"","url":null,"abstract":"Gliclazide is a second-generation sulfonylures that is widely used in the treatment of non-insulin-dependent diabetes mellitus (Type 2 diabetes). It has been recommended for use on the basis of both its metabolic and nonmetabolic effects. It has a clear beneficial effect on metabolic control in Type 2 diabetes. Blood glucose and lipid levels are lowered. The glucose-lowering effects are secondary to both enhanced insulin secretion and a decrease in insulin resistance. The former is due to closure of a K+ adenosine triphosphate (ATP) channel in the beta cell. The mechanism whereby insulin action on the liver and muscle are potentiated remains unknown. It does not appear to involve the insulin receptor, and although glycogen synthase activation is enhanced, this is probably not specified. It has proven difficult to separate the metabolic effects of gliclazide form the effects of improved control. The metabolic actions are probably also shared with over sulfonylureas. Gliclazide also has beneficial effects on platelet behavior and function and on the endothelium, in addition to improving free radical status. These effects should be beneficial for the prevention of diabetic microangiopathy. Some evidence has appeared for the prevention of deterioration of diabetic retinopathy, but results are variable and more convincing studies are required. Many of the nonmetabolic effects of gliclazide appear to be unique to this agent. Gliclazide thus appears to be a reasonable choice in the treatment of Type 2 diabetes with diet failure, both from the metabolic and non-metabolic standpoint.","PeriodicalId":11111,"journal":{"name":"Diabete & metabolisme","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18827173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Mechanisms of macrovascular involvement in diabetic subjects]. [糖尿病患者大血管受累机制]。

Diabete & metabolisme Pub Date : 1994-11-01

L Capron

{"title":"[Mechanisms of macrovascular involvement in diabetic subjects].","authors":"L Capron","doi":"","DOIUrl":"","url":null,"abstract":"Diabetic macroangiopathy is often viewed as an accelerated and aggravated form of atherosclerosis. Several biological disturbances that are associated with diabetes partially account for a possible aggravation of atherosclerosis. Such are disorders of blood lipids (increased triglyceride concentration, modifications of low density lipoproteins) of haemostatis (increased platelet activity, decreased fibrinolytic activity) or of arterial vasomotility. Yet, many uncertainties and inconsistencies still obfuscate the links between diabetes and atherosclerosis, which remain hypothetical, and debatable. Clinical experience and all clinical epidemiological studies show that the incidence and severity of ischaemic arterial diseases (coronary heart disease, lower limb ischaemia, cerebral ischaemic events) are increased in diabetic individuals. However, intermediates other than worsened atherosclerosis may account for these associations. For instance, several anatomical epidemiological studies, based on routine autopsies, have note consistently found that atherosclerotic lesions (plaques) are larger and more extensive in diabetic than in non-diabetic individuals. The basic mechanisms of diabetic macroangiopathy could therefore be not as closely related to atherosclerosis as is usually thought. Among the non-atherosclerotic lesions that could explain the increased arterial risk in diabetic patients, the best documented and most plausible is arteriosclerosis--a pure sclerosis of the arterial wall (without lipid deposition) which, in its advanced forms, can compromise tissue vascularization. Arteriosclerosis is considered as a normal consequence of arterial ageing which would be accelerated in diabetes. Chronic hyperglycaemia is and independent and influent marker of arterial risk in diabetic patients. It could stimulate arterial sclerosis by enhancing non-enzymatic glycation of various components of the arterial matrix, through formation of advanced glycation end-products (AGEs).(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":11111,"journal":{"name":"Diabete & metabolisme","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18827175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Why is insulin tied to the prevalence of cardiovascular diseases without being a risk factor for their incidence?]. [为什么胰岛素与心血管疾病的流行有关，而不是其发病率的危险因素?]。

Diabete & metabolisme Pub Date : 1994-11-01

R J Jarrett

{"title":"[Why is insulin tied to the prevalence of cardiovascular diseases without being a risk factor for their incidence?].","authors":"R J Jarrett","doi":"","DOIUrl":"","url":null,"abstract":"Insulin is frequently considered to be a risk factor for atherosclerosis (or for coronary and vascular disease). Furthermore, hyperinsulinaemia is claimed to be the primary cause underlying the other features which make up the insulin resistance syndrome. However, if proof of these assertions is based only on prospective studies, its value is limited. Only two studies, both carried out, surprisingly, in policemen, have shown convincingly that insulin was a coronary risk factor. In one of the studies, the Paris Prospective Study, the insulin-coronary disease correlation was shown to subside with increasing duration of follow-up. The other prospective studies have failed to evidence a correlation between insulinaemia and cardiovascular events, even with univariate analysis. One study even showed a negative correlation between insulinaemia and coronary complications. In view of the fact that insulinaemia has been shown repeatedly to be associated with classic cardiovascular risk factors--systolic hypertension, decrease in HDL cholesterol, increase in triglycerides, and abdominal obesity--it is highly surprising that univariate analysis has not been able to show the same correlation between insulin and cardiovascular complications. In fact, the combination of elevated insulinaemia and classic risk factors may result in protection against the deleterious effects of these factors. Another possibility would be that insulinaemia is associated with unknown protective factors. Both hypotheses would account for the existence of a correlation between insulin and current cardiovascular disease, as well as the absence of correlation between insulin and later onset of cardiovascular disease.","PeriodicalId":11111,"journal":{"name":"Diabete & metabolisme","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18827176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Anomalies of insulin secretion and type 2 diabetes: recent information]. 【胰岛素分泌异常与2型糖尿病:最新信息】。

Diabete & metabolisme Pub Date : 1994-11-01

P J Guillausseau

引用次数: 0

Lack of relationship between Lp(a) particle levels and albumin excretion rate in type 1 diabetic patients. 1型糖尿病患者Lp(a)颗粒水平与白蛋白排泄率之间缺乏相关性。

Diabete & metabolisme Pub Date : 1994-11-01

B Guerci, B Igau, O Ziegler, T Crea, J C Fruchart, P Drouin, C Fievet

{"title":"Lack of relationship between Lp(a) particle levels and albumin excretion rate in type 1 diabetic patients.","authors":"B Guerci, B Igau, O Ziegler, T Crea, J C Fruchart, P Drouin, C Fievet","doi":"","DOIUrl":"","url":null,"abstract":"The excess risk of cardiovascular disease in Type 1 diabetes mellitus compared to non diabetic subjects is only partially explained by standard risk factors. Several studies suggest that Lp(a) concentrations are increased in Type 1 diabetes mellitus, but data are still controversial. Moreover, a high cardiovascular risk has been reported in diabetic patients with persistent proteinuria. Therefore, the aim of this study was to compare the Lp(a) particle levels in insulin-dependent diabetic patients with or without increased urinary albumin excretion. Cross-sectional study of Lp(a) plasma levels in a population of 140 insulin-dependent diabetic patients: 83 without increased proteinuria, 14 with borderline elevation of urinary albumin excretion, 27 with micro- and 16 with macro-proteinuria. Simultaneous determination of plasma lipids, fasting blood glucose and HbA1c was performed. The mean plasma Lp(a) concentrations and the distribution of the levels were comparable in all of the diabetic patient groups. No relationship existed between Lp(a) and HbA1c, fasting blood glucose or any lipid plasma levels. No influence of albumin excretion rate on Lp(a) levels was observed. These data provide no evidence of a specific contribution of Lp(a) particles to the increased morbidity and mortality from cardiovascular disease observed among patients with nephropathy.","PeriodicalId":11111,"journal":{"name":"Diabete & metabolisme","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18715168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Intravenous glucose tolerance test in the functional exploration of segmental pancreatic autografts in the dog]. 静脉糖耐量试验在犬节段性自体胰腺移植功能探索中的应用。

Diabete & metabolisme Pub Date : 1994-11-01

J J Duron, P Imbaud, J Duhault, M Dubois, D Ravel, M C Jaudon, S Challal

引用次数: 0

[Cardiovascular risk factors in type 2 diabetes]. 2型糖尿病的心血管危险因素。

Diabete & metabolisme Pub Date : 1994-11-01

B Lesobre

{"title":"[Cardiovascular risk factors in type 2 diabetes].","authors":"B Lesobre","doi":"","DOIUrl":"","url":null,"abstract":"Morbidity and mortality through coronary atherosclerosis are higher in Type 2 diabetic patients than in nondiabetic subjects, roughly by a factor of 2 in males and 3 in females. Methodological problems in attempting to weigh the relative effects of each factor make it difficult to accurately interpret the numerous epidemiological data already available. Three issues are discussed here:--Do diabetics have more \"classic\" risk factors than nondiabetics? The incidence of hypertension, lipid disorders, and even smoking is practically consistently higher in diabetics, with \"diabetic\" lipid disorders (decreased HDL cholesterol and hypertriglyceridemia) topping the list.--Do diabetics have specific risk factors which could explain the observed increase in coronary morbidity and mortality? The answer would appear to be yes, as patent microalbuminuria--between 30 and 300 mg/24 hours--is found, as well as retinopathy and an increase in fibrinogen and PAI1 plasminogen activator inhibitor. Recent genetic studies have highlighted the role of Lp (a), and particularly that of angiotensin converting-enzyme gene polymorphism (DD allele).--What are the respective roles of hyperglycalmia and elevated levels of circulating insulin? In contrast to the importance of insulin in nondiabetics as demonstrated in longitudinal studies, insulin appears to play a marginal or even nil role in diabetics once the disease is established. It is probably glycaemia itself which remains the fundamental factor, even though the mechanisms leading from hyperglycemia to macrovascular complications remain unknown.","PeriodicalId":11111,"journal":{"name":"Diabete & metabolisme","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1994-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18827174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Non Insulin Dependent Diabetes: metabolic and vascular disease. Conference proceedings. Paris, France, 26 March 1994]. 非胰岛素依赖型糖尿病:代谢和血管疾病。会议论文集。法国巴黎，1994年3月26日]。

Diabete & metabolisme Pub Date : 1994-11-01

引用次数: 0