Acta diabetologica latina最新文献

A 10-year-old boy, in a precomatose state, was admitted to our Endocrine Unit for diabetic ketoacidosis. It took unusually long to reequilibrate the acidosis despite a bicarbonate drip. On the 4th day the patient suddenly complained of an acute abdominal pain associated with macrohematuria and oliguria; ankle edema was evident. No radio-opaque image was detected along the urinary tract. An intravenous pyelogram (IVP) showed an almost totally silent left kidney. Ten days later a control IVP showed complete normality of both kidneys. We postulated that the serious and protracted dehydration might have resulted in the formation of a blood clot along the renal tract and that the rehydration may have subsequently removed it.

The diurnal (07(30) - 16(00) profiles of glucose, 3-hydroxybutyrate (3-HB), non-esterified fatty acids (NEFA), and glycerol were studied in 19 pregnant women with gestational diabetes and eight pregnant non-diabetic controls. Nine of the gestational diabetic women were treated with intermediate and in some cases with fast acting insulin and diet and 10 were treated with diet alone. Although fasting plasma glucose levels were normal (less than 6.0 mmol/l) in 8 insulin-treated and 9 diet-treated gestational diabetics before the start of treatment, the profiles of glucose, NEFA and glycerol were generally higher in gestational diabetic compared to non-diabetic pregnant women. The insulin-treated group had lower, but not normal, plasma glucose and higher levels of glycerol than the women treated with diet only. The levels of 3-HB and NEFA were not significantly influenced by the type of therapy. It is suggested that treatment of gestational diabetes should consist of multiple injections of fast acting insulin.

The experience gained in the treatment of 700 diabetic children and adolescents over 20 years at the Beilinson Medical Center, Israel, is reviewed in the light of prevailing concepts. To deal with the psycho-social problems arising in this chronic disease with acute episodes, a multidisciplinary team approach has been used since 1966. The program of this team and the results obtained in relation to the control of the diabetes and to the habilitation and rehabilitation of patients within the family, at school and in adulthood (work and marriage) are described.

Glycosylated proteins, glycosylated albumin and HbA1 were studied in type I and type II diabetes. Glycosylated proteins were evaluated by a new method: aminophenylboronic acid affinity chromatography. A good correlation was found between total HbA1 and glycosylated proteins in both groups (r = 0.57, p less than 0.05; r = 0.67, p less than 0.01, respectively), but a positive correlation between stable HbA1 and glycosylated proteins was present only in maturity onset diabetics (r = 0.71, p less than 0.01). Glycosylated proteins correlated with glycosylated albumin only in type II diabetes (r = 0.67, p less than 0.01). We hypothesize that in maturity onset diabetes glycosylated proteins and HbA1 reflect a greater glycemic stability while in insulin-dependent diabetes the same proteins reflect a different periodic pattern of glycemic control. Moreover, our data suggest that aminophenylboronic acid affinity chromatography is a suitable tool for routine monitoring of metabolic control in maturity onset diabetes, while further investigations are needed to establish if this method is a useful index of altered glucose metabolism in type I diabetes.

Serum cholesterol and its various lipoprotein fractions and triglycerides were measured in 50 non-insulin-dependent diabetic patients, 25 without retinopathy (group A) and 25 with diabetic maculopathy (group B) initially before control of diabetes, and again, after achieving good metabolic control. The lipid parameters were also estimated in 25 healthy non-diabetic subjects. The groups were well matched for sex, age, duration of diabetes and body weight. Mean serum total cholesterol and LDL cholesterol levels were significantly higher in group B when compared to group A, before and after achieving good metabolic control of diabetes (p less than 0.001). Mean total/HDL cholesterol and mean LDL/HDL cholesterol ratios were also significantly increased in group B as compared to group A (p less than 0.01) both before and after good diabetic control in these patients. Mean serum HDL and VLDL cholesterol and triglyceride concentrations were similar in groups A and B. The mean serum lipid concentrations in the diabetic patients without retinopathy (group A) were comparable to those of non-diabetic subjects.

Treatment with pyrrole condensate of obese diabetic mice, characterized by metabolic disturbances resembling diabetes mellitus in man, has resulted in the alleviation of classical diabetic symptoms, such as hyperglycemia, glycosuria, and low levels of liver glycogen.