Muscle capillary basement-membrane thickness and long-term glycemia in type I diabetes mellitus

We explored the relation between the thickness of the quadriceps-muscle capillary basement membrane and the glycemia level in 102 young patients with Type I diabetes (median age, 17 years; range, 12 to 29). Membrane thickness was measured in serial biopsy specimens obtained after two consecutive 2 1/2-year observation periods, and glycemia was assessed in terms of glycosylated hemoglobin and fasting blood glucose levels determined at eight-week intervals. An association between membrane thickness and glycemia level was apparent in both cross-sectional and longitudinal analysis. Cross-sectional analysis of data on 39 postpubertal patients (growth less than 1.0 cm during the five years) showed a positive association of membrane thickness to glycosylated hemoglobin (r = 0.53, P = 0.0002) and blood glucose values (r = 0.37, P = 0.01) averaged over the antecedent 2 1/2-year period. By contrast, in 32 pubertal patients (growth greater than 7.5 cm) there was a significant negative association of membrane thickness to both glycosylated hemoglobin (r = -0.40, P = 0.01) and blood glucose (r = -0.42, P = 0.009). In longitudinal analysis, there was no correlation between changes in membrane thickness and average glycemia levels during the two follow-up periods in 32 pubertal patients (for glycosylated hemoglobin, r = 0.11; P = 0.25), but in the postpubertal group (n = 20) there was a significant positive covariation (r = 0.57, P = 0.0004). The data indicate that in postpubertal diabetic patients, the thickness of the muscle capillary basement membrane is positively related to the level of glycemia, but this relation does not obtain in the pubertal state.     

益生元对2型糖尿病患者糖脂代谢的影响

目的 探讨益生元对2型糖尿病患者血糖血脂代谢的影响,分析益生元在糖尿病进程中的作用。方法 选取2017年1月~2018年3月本院104例2型糖尿病患者,按随机数字表法分为对照组和实验组,每组52例,对照组给予安慰剂,实验组服用益生元,12周后再次检测血液中的血糖血脂生化指标,统计分析服用前后生化指标的变化。结果 实验组服用12周益生元后,患者空腹血糖、餐后2 h血糖、糖化血红蛋白、胆固醇及低密度脂蛋白水平低于治疗前,差异有统计学意义 (P＜0.05)。治疗后实验组糖脂生化指标中空腹血糖、糖化血红蛋白、胆固醇及低密度脂蛋白浓度水平均低于对照组,差异具有统计学意义 (P＜0.05);治疗后两组餐后2 h血糖、甘油三酯、高密度脂蛋白对比,差异无统计学意义（P＞0.05）。结论 补充益生元有助于降低2型糖尿病患者的空腹血糖、糖化血红蛋白、胆固醇及低密度脂蛋白浓度水平,对2型糖尿病患者的血糖及血脂可能具有积极的作用。     

长效胰岛素联合口服降糖药治疗2型糖尿病的 疗效与安全性评价

目的 探究对2型糖尿病患者采用长效胰岛素联合口服降糖药治疗的效果。方法 抽取在我院接受治疗的2型糖尿病患者78例,使用电脑随机数字表法分为对照组和治疗组,各39例,对照组予以常规口服降糖药物治疗,治疗组在此基础上联合长效胰岛素进行治疗,比较两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白、尿微量改善情况及不良反应发生率。结果 治疗后,治疗组患者的尿微量（30.57±1.67）kg/m3、糖化血红蛋白（6.32±0.35）%及空腹血糖值（6.52±0.42）mmol/L、餐后2 h血糖值（10.68±0.87）mmol/L改善情况优于对照组的尿微量（26.31±2.85）kg/m3、糖化血红蛋白（9.04±1.45）%、空腹血糖值（8.02±0.78）mmol/L、餐后2 h血糖值（12.63±1.21）mmol/L,差异均有统计学意义（P＜0.05）;治疗组患者经药物治疗后的不良反应发生率为2.56%,低于对照组的20.51%,差异有统计学意义（P＜0.05）。结论 对2型糖尿病患者采用口服降糖药联合长效胰岛素进行治疗,能有效促进患者机体血糖得到调节与提升血糖控制率,且安全性高。     

Clinical outcome of using insulin at 40 IU/ml and 100 IU/ml in pump treatment. Results of a controlled multi-center trial

In three different diabetes centers the use of insulin at a strength of 40 IU/ml (U40) and 100 IU/ml (U100) in continuous subcutaneous insulin infusion (CSII) treatment of insulin dependent (Type I) diabetic patients was compared in a randomized cross-over design. Forty-six Type I diabetic patients, all previously treated with CSII for at least one year, completed consecutively two 13-week periods of treatment with U40 and U100. Body weight and insulin requirements were identical at the end of the two periods. Slightly higher levels of glycemia were recorded during U40 when compared to U100 treatment: mean blood glucose was 142 +/- 34 (SD) vs. 133 +/- 34 mg/dl (2 p less than 0.01). The same tendency was observed in the mean glycosylated hemoglobin value (6.84 +/- 1.35 vs. 6.65 +/- 1.13%, 2 p greater than 0.1). There were no significant differences between U40 and U100 in the number of catheters used and the number of catheter blockages reported, while the development of subcutaneous nodules at the insertion sites was significantly more frequent during U40 treatment. It is concluded that the implementation of insulin in the strength of 100 IU/ml is as effective as the use of insulin in the strength of 40 IU/ml for CSII therapy, and might even be associated with slightly improved glycemic control and less subcutaneous side-effects.     

A stereological study of the renal glomerular vasculature in the db/db mouse model of diabetic nephropathy

In diabetic nephropathy, glomerular hypertrophy is evident early in response to hyperglycaemia. Alterations of capillary length and vascular remodelling that may contribute to glomerular hypertrophy and the subsequent development of glomerulosclerosis remain unclear. The present study used the db/db mouse model of Type 2 diabetes to examine the glomerular microvascular changes apparent with long-term diabetic complications. Unbiased stereological methods and high-resolution light microscopy were used to estimate glomerular volume, and glomerular capillary dimensions including length and surface area in 7-month-old db/db diabetic mice and age-matched db/m control mice. The db/db diabetic mice showed significant glomerular hypertrophy, corresponding with elevated blood glucose levels, and increased body weight and kidney weight, compared with db/m control mice. Glomerular enlargement in db/db mice was associated with increases in the surface area (5.387 +/- 0.466 x 10(4) microm2 vs. 2.610 +/- 0.287 x 10(4) microm2; P < 0.0005) and length (0.3343 +/- 0.022 x 10(4) microm vs. 0.1549 +/- 0.017 x 10(4) microm; P < 0.0001) of capillaries per glomerulus, compared with non-diabetic mice. Stereological assessment at the electron microscopic level revealed increased glomerular volume density of mesangial cells and mesangial matrix, and thickening of the glomerular basement membrane in db/db mice. These results demonstrate that glomerular hypertrophy evident in advanced diabetic nephropathy in this model is associated with increased length and surface area of glomerular capillaries. The contribution of angiogenesis and vasculogenesis to the glomerular microvascular alterations in response to hyperglycaemia remain to be determined.     

DPP-Ⅳ抑制剂联合胰岛素强化降糖治疗对胰岛修复的影响

目的：考察DPP-Ⅳ抑制剂联合胰岛素强化降糖治疗对胰岛修复的影响。方法：选取90例初诊2型糖尿病患者随机分为观察组和对照组,每组45例。观察组患者给予预混型胰岛素早、晚餐前皮下注射治疗,设定靶血糖值(fasting blood glucose,FBG)<6.1 mmol/L,2hPG <7.8 mmol/L,沙格列汀起始剂量5 mg/次,1次/d。对照组给予胰岛素早预混型胰岛素早、晚餐前皮下注射治疗,设定靶血糖值FBG <6.1 mmol/L,2hPG <7.8 mmol/L,安慰剂1次/d。比较两组患者血糖水平、血脂水平、糖化血红蛋白(hemoglobin A1c,HbA1C)、胰岛β细胞功能(HOMA-β)和胰岛素抵抗指数(HOMA-IR)差异。结果：治疗前两组患者各指标差异无统计学意义(P>0.05),治疗12周后,观察组患者血糖水平显著低于对照组患者(t=1.756,t=2.369,P<0.05),血脂水平与对照组患者比较差异无统计学意义(P>0.05)。观察组患者治疗后HOMA-β显著高于对照组,且HbA1C、HOMA-IR水平显著低于对照组(t=2.219,t=1.896,t=1.934,P<0.05)。结论：DPP-Ⅳ抑制剂联合胰岛素强化降糖治疗可以更好地修复胰岛功能。     

利拉鲁肽联合胰岛素泵对2 型糖尿病合并肝硬化患者血糖代谢及肝纤维化的影响

目的 观察利拉鲁肽联合胰岛素泵强化治疗对2型糖尿病合并肝硬化患者血糖代谢及肝纤维化的影响。方法 选择2017年1月~2018年6月山东医学高等专科学校附属医院收治的2型糖尿病合并肝硬化患者80例按随机数字表法分为对照组和实验组,每组40例。对照组给予单纯胰岛素泵控制血糖,实验组给予利拉鲁肽联合胰岛素泵强化治疗。观察两组患者治疗前后血清c肽、糖化血红蛋白、胰岛素敏感性指数、肝纤维化指标层黏连蛋白、透明质酸、Ⅲ型前胶原、Ⅳ型胶原变化。结果 治疗后,两组患者血清c肽水平、胰岛素敏感性指数均较治疗前升高,糖化血红蛋白较治疗前降低,差异有统计学意义（P＜0.05）,实验组血清c肽水平、胰岛素敏感性指数较对照组高,糖化血红蛋白较对照组低,差异有统计学意义（P＜0.05）。治疗后,两组患者肝纤维化指标层黏连蛋白、透明质酸、Ⅲ型前胶原、Ⅳ型胶原均较治疗前降低,实验组肝纤维化指标层黏连蛋白、透明质酸、Ⅲ型前胶原、Ⅳ型胶原均较对照组低,差异有统计学意义（P＜0.05）。结论 2型糖尿病合并肝硬化患者治疗中,利拉鲁肽联合胰岛素泵强化治疗可以更加有效的控制血糖,改善胰岛素抵抗,降低肝脏纤维化水平,进而改善肝脏微环境,降低肝脏应激反应,促进肝脏纤维化的缓解。     

The clinical information value of the glycosylated hemoglobin assay

We evaluated the clinical information value of the glycosylated hemoglobin assay by comparing it with practitioners' estimates of glucose control over the preceding 10 weeks in 216 patients with diabetes. Twenty-four per cent of the practitioners' estimates, which were based on historical and laboratory data collected during a routine office visit, differed by more than +/- 75 mg per deciliter from the actual mean blood glucose levels calculated with the glycosylated hemoglobin assay. One third of the mean blood glucose concentration fell outside the confidence intervals physicians used to bound their estimates. When examined individually or in the aggregate, historical information, such as polyuria, nocturia, or home urine testing for glucose, and laboratory information, such as fasting or random blood glucose levels, were weak predictors of the actual mean concentration of blood glucose. We conclude that the glycosylated hemoglobin assay provides information about the degree of long-term glucose control that is not otherwise obtainable in the usual clinical setting.     

甘精胰岛素与格列美脲联合治疗口服降糖药控制不佳 2型糖尿病的疗效

目的 观察甘精胰岛素与格列美脲联合治疗口服降糖药控制不佳2型糖尿病的疗效。方法 选择2018年6月~2019年3月在我院诊治的90例口服降糖药控制不佳2型糖尿病患者作为研究对象,随机分为对照组和观察组,各45例,对照组采用格列美脲治疗,观察组在对照组基础上联合甘精胰岛素治疗,对比两组临床治疗疗效、空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）水平以及低血糖发生情况。结果 治疗后,观察组治疗总有效率（93.33%）与对照组治疗总有效率（91.11%）比较,差异无统计学意义（P＞0.05）。治疗后两组FPG、2hPG、HbA1c水平均较治疗前降低,差异有统计学意义（P＜0.05）;观察组FPG、2hPG与对照组比较,差异无统计学意义（P＞0.05）;观察组HbA1c与对照组比较,差异有统计学意义（P＜0.05）;观察组低血糖发生率（17.78%）低于对照组（35.56%）,差异有统计学意义（P＜0.05）。结论 口服降糖药控制不佳2型糖尿病患者采用甘精胰岛素联合格列美脲治疗疗效理想,且可降低治疗期间低血糖发生率,安全性高,值得临床应用。     

苯扎贝特改善2型糖尿病合并高甘油三酯血症患者 胰岛素抵抗的临床分析

目的 探讨苯扎贝特对2型糖尿病合并高甘油三酯血症患者降低血脂,同时改善胰岛素敏感性的影响及作用机制。方法选取我院2016年12月~2018年2月收治的符合入选标准2型糖尿病合并高甘油三酯血症患者56例,随机分为A组（n=29）和B组（n=27）。两组均使用苯扎贝特及非诺贝特降脂治疗,其他常规服用药物不变。A组:治疗顺序为苯扎贝特+非诺贝特,疗程各1个月,期间清洗期为1周;B组:治疗顺序为非诺贝特+苯扎贝特,疗程各1个月,期间清洗期为1周。监测两组患者实验前、第一阶段及第二阶段的甘油三酯（TG）、胆固醇、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）,并计算胰岛素敏感指数（IsI）。结果 两组患者实验前、第一阶段和第二阶段的TG和胆固醇水平比较,差异无统计学意义（P＞0.05）。两组实验前和第一阶段的FBG、HbA1c及IsI比较,差异无统计学意义（P＞0.05）;B组第二阶段的FBG高于A组[（6.73±0.28）mmol/L vs （6.52±0.51）mmol/L],HbA1c和IsI均低于A组[（6.54±0.32）% vs （6.76±0.71）%,（-4.19±0.34）vs（-4.13±0.28）],差异有统计学意义（P＜0.05）。结论 苯扎贝特可改善血脂,调节糖代谢,降低2型糖尿病患者血糖,并能改善胰岛β细胞分泌功能,提高机体胰岛素敏感性。     

On glomerular structural alterations in type-1 diabetes

Glomerular structural modifications were measured in kidney biopsies from two follow-up studies in type-1 diabetic patients with microalbuminuria and in kidney donors. Stereologic methods were used to obtain data on glomerular composition and absolute quantities per glomerulus to supplement data on diabetic glomerulopathy previously published. Diabetic patients at baseline (n=37) showed significant changes compared with controls (n=11). The volume fraction of tuft/glomerulus was increased, the proportion of capillary surface facing peripheral basement membrane was decreased (0.72+/-0.04 vs 0.77+/-0.03, P=0.0008), the ratio of mesangial surfaces, urinary/capillary, was decreased (0.67+/-0.17 vs 1.11+/-0.28, P<10(-4)), and the average capillary diameter was increased (8.9+/-0.9 microm vs 7.5+/-1.0 microm, P=0.0002). The total volume of mesangial extracellular material per glomerulus was increased (P=0.01), whereas glomerular volume was not significantly different from controls. Follow-up biopsies after antihypertensive treatment with ACE-inhibitor (n=7) or beta-blocker (n=6; 36-48 months) and after intensive insulin treatment (n=7; 24-33 months) showed no change. In a conventionally treated group (n=9), the glomerular volume, the volume of extracellular material/glomerulus, and the capillary length increased. The mean capillary diameter did not correlate with the glomerular volume. In conclusion, the development of diabetic glomerulopathy entails structural modifications of the glomerular tuft. Antihypertensive and intensified insulin treatment seem to slow the progression of ultrastructural changes.     

Effect of improved glycemic control by continuous subcutaneous insulin infusion on hormonal responses to insulin-induced hypoglycemia in type 1 diabetics

Glucose counter-regulatory capacity and the hormonal responses to insulin-induced hypoglycemia were studied in eight type 1 diabetics before and after improvement of metabolic control by continuous subcutaneous insulin infusion (CSII). The intensified treatment resulted in a decrease in mean glycosylated hemoglobin from 11.6 +/- 0.5 to 9.3 +/- 0.4% within a mean period of 14 weeks. During a constant rate infusion of insulin (2.4 U/h), steady state levels of glucose appeared in all subjects. The steady state glucose level was identical before and after CSII. The counter-regulatory hormonal responses showed significantly higher epinephrine levels, while glucagon, growth hormone, and cortisol were not influenced. In parallel with the heightened epinephrine response the pulse rate response was significantly enhanced. The restitution of blood glucose after insulin hypoglycemia was not modified. It is concluded that a more vigorous catecholaminergic response to hypoglycemia is achieved after improved metabolic control by CSII.     

应用微信平台对初发中青年2型糖尿病患者进行 健康管理模式的研究

目的 探讨应用微信平台对初发中青年2型糖尿病患者进行健康管理的效果。方法 选取2016 年1月~2017年6月初发中青年2型糖尿病患者275例,给予空腹血糖、糖化血红蛋白、血脂等检查。随机分为对照组140例和观察组135例,对照组给与常规的健康管理模式,观察组应用微信平台健康管理模式,两组均随访6个月,比较两组患者干预6个月后空腹血糖、糖化血红蛋白、血脂及低血糖的发生率等的区别,用糖尿病自我管理行为量表对两组患者进行评分比较。结果 初始两组患者性别、年龄、空腹血糖、糖化血红蛋白,血脂水平对比,差异无统计学意义（P＞0.05）;两组患者随访6个月后,观察组空腹血糖、HbA1c,血脂水平均低于对照组（P＜0.05）,两组低血糖症的发生率,差异无统计学意义（P＞0.05）;观察组SDSCA评分大于对照组（P＜0.05）。结论 应用微信平台健康管理模式对初发中青年2型糖尿病患者进行健康管理可以取得较好的效果,能够有效降低空腹血糖和血脂水平,改善糖尿病患者自我管理行为。     

胰岛素联合唑来膦酸治疗糖尿病骨质疏松症对患者血清指标的影响

目的 分析胰岛素联合唑来膦酸治疗对糖尿病骨质疏松（DOP）患者血糖血脂以及骨代谢指标的影响。方法 选择2016年12月~2019年4月于我院诊治的DOP患者共136例进行研究,采用随机数字表法分为对照组和实验组,每组68例,对照组采用二甲双胍联合唑来膦酸治疗,实验组采用胰岛素联合唑来膦酸治疗,比较两组干预后血脂水平（TG、TC、LCL-C、HDL-C）、血糖指标（空腹、餐后2h、糖化血红蛋白）以及骨代谢相关指标（BAP、TRAP-5b、BGP以及s-CTX）。结果 治疗后实验组空腹、餐后2h血糖及HbA1c均低于对照组（P＜0.05）;实验组治疗后TG、TC、LCL-C、HDL-C水平均低于对照组（P＜0.05）;实验组BAP、BGP水平均高于对照组（P＜0.05）;实验组TRAP-5b水平均低于对照组（P＜0.05）;两组s-CTX指标比较,差异无统计学意义（P＞0.05）。结论 对DOP患者使用胰岛素与唑来膦酸联合治疗方案,有助于改善患者的血脂以及血糖水平,同时利于患者骨骼骨质的沉积,值得临床应用。     

Hypoglycemia in diabetics on dialysis with poor glycemic control: hemodialysis versus continuous ambulatory peritoneal dialysis.

Eight diabetic men with poor glycemic control, probably worsened by severe congestive heart failure and gastroparesis, were sequentially dialyzed by CAPD and hemodialysis. Mean blood glucose concentration, blood glycosylated hemoglobin, and insulin dose were higher during CAPD than during hemodialysis. Among blood glucose determinations, however, the frequency of hypoglycemia (glucose less than 3.3 mmol/L) was higher during hemodialysis (13.2 +/- 8.9%) than during CAPD (2.8 +/- 2.1% p = 0.012), whereas the frequencies of hyperglycemia (glucose greater than 11.1 mmol/L) and euglycemia (glucose between 3.5 and 11.1 mmol/l) did not differ between the two dialysis modalities. Furthermore, hypoglycemia was severe during hemodialysis and was associated with two deaths. There were no deaths linked to abnormalities in blood glucose concentration during CAPD. When hypoglycemia is frequent in diabetics with poor glycemic control, CAPD is preferable to hemodialysis.     

产后护理管理对妊娠期糖尿病患者血糖控制及疾病认知水平的影响

研究产后护理管理对妊娠期糖尿病患者血糖控制及疾病认知水平的影响效果。方法 选择2015年2月~2017年2月我院收治的1500例妊娠期糖尿病患者,随机分为对照组和观察组。两组患者均采用降糖药物治疗,对照组行常规护理管理,观察组行产后护理管理。对比其两组患者血糖控制及疾病认知水平。结果 观察组患者空腹血糖水平为（5.02±1.13）mmol/L、餐后2 h血糖（8.02±1.24）mmol/L、糖化血红蛋白（7.12±1.03）%,对照组患者空腹血糖水平为（6.89±1.54）mmol/L、餐后2 h血糖（10.67±1.85）mmol/L、糖化血红蛋白（8.85±1.57）%,组间比较,差异有统计学意义（P＜0.05）;观察组患者疾病认知、临床诊断、疾病处理方式、疾病代谢特点得分情况均高于对照组,差异有统计学意义（P＜0.05）。结论 产后护理管理对妊娠期糖尿病患者血糖控制具有重要作用,同时能够提高患者疾病认知水平。     

成人糖尿病患者FBG、PG2h、GHbA1C和INS的检测

探讨成人糖尿病胰岛功能减退的原因。将成人糖尿病患者 92例分为A组 (5 0例 ,胰岛功能良好 )和B组(4 2例 ,胰岛功能较差 )。A组中 ,A1组 30例 ,用正规治疗控制血糖 ;A2 组 2 0例 ,未用正规治疗控制血糖。B组中 ,B1组 2 2例 ,在饮食控制、运动疗法基础上加用胰岛素控制血糖 ;B2 组 2 0例 ,在同样基础上加用磺脲类药物控制血糖。疗程均为 3- 5年。结果表明 :A1组血糖得到控制 ,A2 组胰岛功能减退 ;B1组胰岛功能恢复至正常 ,B2 组胰岛功能未得到改善。胰岛素水平分析 ,A2 与A1,A2 与A ,B2 与B1,B1与B对比 ,P均小于 0 .0 1;A1与A ,B2 与B对比 ,P均大于 0 .0 5。成人糖尿病胰岛功能减退的原因有 :(1)高血糖的毒性作用。 (2 )胰岛功能较差时应用磺脲类药物 ,加重了存活胰岛 β细胞分泌负担 ,使胰岛 β细胞的功能进一步减退     

Long-term treatment of acromegaly with the somatostatin analogue SMS 201-995 over 6 months

Summary This study examined the effects of the long-acting selective mini somatostatin analogue (SMS) 201-995 in two acromegalic patients who were treated for 3 and 6 months, respectively. During treatment the mean growth hormone levels (25.3 and 20.8 ng/ml vs 5.9 and 10.6 ng/ml) and somatomedin C levels (6.2 and 6.2 IU/ml vs 3.3 and 3.8 IU/ml) decreased and the patients reported an improvement in their symptoms. The main side effect was an increase in stool fat excretion which did exceed the normal range (<7 g/day) in one patient. Five acromegalics who received 2 × 50 µg SMS 201-995/day for 5 days showed a significant increase of stool fat excretion (1.7 vs 3.5 g/day;p<0.05). Fasting blood glucose levels, glucose tolerance, and glycosylated hemoglobin were not essentially effected. It is concluded that SMS 201-995 offers new possibilities in the treatment of acromegaly. The gastrointestinal and diabetogenic side effects of this substance, however, should be carefully monitored.Abbreviations GH growth hormone - HbA₁ glycosylated hemoglobin - OGTT oral glucose tolerance test - SMS selective mini somatostatin - TRH thyrotropin-releasing hormone - TSH thyroid-stimulating hormone     

Efficacy of a new needleless insulin delivery system monitoring of blood glucose fluctuations and free insulin levels

A new insulin delivery system Vitajet has been invented which involves a high-pressure spring and obviates the use of needle injections. To study its efficacy we compared blood glucose fluctuations, integrated glycemia, free insulin and total free insulin concentrations in six insulin-dependent diabetics. After obtaining a steady state of carbohydrate metabolism overnight by feedback control through the artificial endocrine pancreas (AEP) Biostator, the patients received their usual morning and evening doses of insulin by either conventional injection or Vitajet in random order. Blood glucose levels were significantly lower after Vitajet than conventional injections (p less than 0.04) between 10 a.m. and 4 p.m., but the difference disappeared from 4 p.m. onwards. The areas under the curve (AUCs) of glucose fluctuations were lower after Vitajet (28036 +/- 4655 vs 31086 +/- 2310 mg. min% mean +/- SEM, p less than 0.01). AUCs for free insulin concentrations (microU.min/ml) were close: 39286 +/- 4510 (Vitajet) vs 30597 +/- 3575 (conventional). It is concluded that Vitajet constitutes an efficient needleless route for administering insulin pulses.     

Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance

We studied the relation of serum insulin levels to plasma lipid levels and blood pressure in two groups drawn from among 247 healthy, normotensive nonobese subjects with normal glucose tolerance. One group of 32 subjects was defined as having hyperinsulinemia (serum insulin, greater than 2 SD above the mean) and then compared with 32 normoinsulinemic subjects (serum insulin within 1 SD of the mean) matched for age (mean, 39 years), sex (22 men and 10 women), and body-mass index (24.7). The two groups had similar patterns of smoking, drinking, and physical exercise. Plasma glucose levels after an oral glucose challenge were significantly higher (P less than 0.05) in the hyperinsulinemic group. In addition, the mean (+/- SEM) fasting plasma triglyceride levels in subjects with hyperinsulinemia were significantly higher (1.73 +/- 0.2 vs. 1.24 +/- 0.1 mmol per liter) and the plasma high-density lipoprotein cholesterol concentrations were lower (1.21 +/- 0.06 vs. 1.43 +/- 0.06 mmol per liter) than in subjects with normoinsulinemia. Both systolic (126 vs. 119 mm Hg; P less than 0.05) and diastolic (85 vs. 78 mm Hg; P less than 0.01) blood pressures were significantly elevated in the group with hyperinsulinemia. We conclude that healthy persons with hyperinsulinemia and normal glucose tolerance have an increase in risk factors for coronary artery disease, as compared with a well-matched group of healthy subjects with normal insulin levels.