Diabete & metabolisme最新文献

The purpose of this study was to determine the most suitable treatment for Type 2 (non-insulin-dependent) diabetic patients with secondary failure to sulfonylureas (SFS). In a four-month comparative study, 36 Type 2 diabetic patients given SFS were allocated to three treatment groups: A (n = 12, M/F 6/6, HbAlc 9.1 +/- 1.6%) received 0.3 IU/Kg body weight (BW) of insulin-Zn between 10 and 11 p.m.; B (n = 12, M/F 6/6, HbAlc 9.2 +/- 1.6%) SFS plus 850 mg/day of metformin; and C (n = 12, M/F 6/6, HbAlc 9.5 +/- 2.4%) SFS plus acarbose 3 x 100 mg daily. Modifications in HbAlc, BW, blood pressure (BP), lipoprotein profile and insulin sensitivity were evaluated. HbAlc decreased in the three groups (A: 17.9 +/- 13.5%; B: 18.2 +/- 4.5%; C: 7.6 +/- 16.8%; all p < 0.05; A and B vs C = p < 0.05). BW increased in group A and decreased in the other groups. BP decreased statistically in group B. HDL-cholesterol increased (1.26 +/- 0.46 vs 1.49 +/- 0.36 mmol/L; p < 0.05) and triglyceride levels decreased (1.68 +/- 0.85 vs 1.16 +/- 0.43 mmol/L; p < 0.05) in group A. There were no significant changes in the other studied parameters. We conclude that, for Type 2 diabetic patients given SFS, both insulin and metformin plus SFS provided better glycaemic control than acarbose plus SFS. Metformin combined with SFS offered further advantages for the control of BW and BP.

Pregestimil, a hypoallergenic infant formula in which casein hydrolysate replaces protein, protects NOD mice against diabetes, a T-cell-mediated autoimmune disease. Female and cyclosphosphamide (Cy)-treated male NOD mice were used to assess whether a modification of cellular immune mechanisms occurred when animals were fed Pregestimil from weaning to 110 days of life. Insulitis, sialitis and thyroiditis were observed, and the splenic T-cell proliferative response was measured. The ability of splenic T-cells of NOD mice in the Pregestimil group to transfer diabetes adoptively to young irradiated male NOD mice was also assessed. Pregestimil protected female NOD mice against spontaneous diabetes and male NOD mice against acute Cy-induced diabetes. Addition of bovine serum albumin (10%) to the diet did not alter the preventive effect. The Pregestimil diet also lessened insulitis severity in Cy-treated males, though not in females. Sialitis and thyroiditis, observed mainly in females, were not modified by the diets. The TCR-mediated proliferative response of splenocytes tended to increase specifically in Pregestimil-fed and Cy-treated males. Sensitivity to IL-2 was improved. In females, the TCR-mediated proliferative response and the ability of T cells to transfer diabetes adoptively were unchanged. It is concluded that the protective effect of Pregestimil against diabetes in NOD mice cannot be explained by major changes in peripheral immune response.

The use of ozone in the treatment of peripheral vascular disease (PVD) is increasing. The purpose of this study was to evaluate the effect of ozone on haemoglobin oxygen affinity in Type-2 diabetic patients with PVD. Twenty diabetic patients presenting with PVD (Clinical stage II-IV according to Fontaine) and 20 non-diabetic healthy matched subjects were studied. In both groups, aliquots of blood were ozonised with mixtures of oxygen-ozone (O2-O3) to reach end-concentrations of 6.5, 13, 26 and 78 micrograms O3 per ml of substrate. At baseline, diabetic patients presented significantly lower haemoglobin oxygen affinity values but higher plasma levels of free haemoglobin and malonyldialdehyde (MDA) than controls. In both diabetic patients and controls, exposure of blood to ozone reduced haemoglobin oxygen affinity in an "all-or-none" fashion, without changing 2-3, diphosphoglycerate concentrations in erythrocytes. Both free haemoglobin and MDA concentrations showed significant, dose-dependent increases after blood ozonisation. Thus, ozone caused a significant increase in oxygen unloading of haemoglobin in both normal subjects and Type-2 diabetic patients with PVD.

Previous studies designed to establish in diabetic patients the relationship between metabolic control and locus of control are controversial. The aim of the present study was to find answers to the following questions: is there a link between an internal locus of control and improved metabolic control? Is this true for type I and type II diabetic subjects? Is this improved metabolic control linked directly, or even indirectly, with the locus of control by types of behaviour, such as for example a greater desire for information concerning the disease (knowledge) and closer adherence to doctors' recommendations (compliance)? Sixty-one patients (36 type I and 25 type II) on insulin therapy were compared according to the type of their locus of control using two different questionnaires (Rotter and Wallston). The extent of their knowledge about diabetes was also assessed; self-monitoring of blood glucose (SMBG) was considered to be a measure of compliance, while the HbA1 level was considered to be an indicator of metabolic control. The study compared the influence of the type of locus of control on the various parameters. The results indicate that, irrespective of the questionnaire, type I "internals" exhibited better metabolic control (p < 0.05) than type I "externals", even with a lower level of knowledge of diabetes (p < 0.01) and less frequent SMBG (p < 0.05). However, the benefits of internality as regards metabolic control were not as great when this internality was extreme.(ABSTRACT TRUNCATED AT 250 WORDS)

It has been assumed for years that male testosterone levels play a central role in worsening lipoprotein patterns and causing greater susceptibility to ischemic heart disease. Yet most clinical trials of quasi-physiologic doses of intramuscular testosterone in older men show no effect on high-density lipoprotein (HDL)-cholesterol, while cross-sectional epidemiologic studies almost uniformly find that endogenous testosterone levels are positively associated with HDL-cholesterol levels. Further work is required to determine whether and why physiologic testosterone levels in the high normal range appear to be conducive to optimal cardiovascular health for adult men.

To test whether impaired glutathione redox status may be related to lens oxidative damage in humans, we measured glutathione (total and oxidised forms) and malondialdehyde, a lipid peroxidation product, in clear lenses and diabetic and non-diabetic cataracts. Diabetic cataracts were divided into 2 subgroups with either intact or abnormal haemo-ocular barrier as evaluated by preoperative iridography. Decreased total glutathione values were observed in cataractous (diabetic and non-diabetic) as compared to clear lenses (p < 0.001), whereas enhanced oxidised glutathione levels were found in diabetic caracts as compared to non-diabetic ones and clear lenses (p < 0.001). Malondialdehyde concentrations were significantly higher in all types of cataracts, especially myopic and diabetic ones, than in clear lenses (p < 0.001). Moreover, malondialdehyde levels in diabetic lenses were inversely correlated with total glutathione (r = 0.80; p < 0.001) and linearly correlated with oxidised glutathione values (r = 0.76; p < 0.001). Finally, glutathione redox status was found to be more seriously impaired in lenses from diabetic patients with abnormal than intact haemo-ocular barrier. These data suggest a contributory role of lipid peroxidation and glutathione oxidation and consumption in the pathogenesis of cataract, especially in diabetic lenses with haemo-ocular barrier abnormality.