Differential effect of Type I and Type II diabetes on antipyrine disposition in man

Summary As the influence of diabetes on drug metabolism in patients is controversial, a study was performed to assess antipyrine (AP) disposition in controlled Type I and Type II diabetics and 2 age-and sex-matched control groups. In Type I diabetics, the half-life of AP was significantly reduced from 12.0 (controls) to 7.9 h, and the volume of distribution (V) was lowered from 733 to 569 ml·kg^–1. The resulting plasma clearance and cumulative urinary excretion of AP and its metabolites over 24 h did not differ from controls. In Type II diabetics, the AP half-life (14.5 h) and V (568 ml·kg^–1) did not differ from their age- and sex-matched controls (11.1 h and 643 ml·kg^–1, respectively), but the plasma clearance of AP was significantly reduced by 30%, and urinary excretion was significantly reduced to 44% of controls.The differential effects of Types I and II diabetes on AP metabolism may explain, at least in part, the controversial data in the literature.     

SERUM LIPIDS IN INSULIN-DEPENDENT DIABETICS ARE MARKEDLY ALTERED BY DIETARY FISH OILS

1. The effect of dietary fish oil supplementation on serum lipids was examined in normolipidaemic insulin-dependent male diabetics and healthy controls. Fish oil was given as Max eicosapentaenoic acid (EPA), 15 g daily (equivalent to 2.7 g/day of EPA) for 3 weeks. 2. There was a substantial increase in EPA but a depletion of arachidonic acid content of platelet phospholipids. 3. Diabetics showed a rise in total cholesterol, attributable to increases in low density and high density lipoprotein (LDL and HDL) cholesterol. The rise in HDL cholesterol was largely due to an increase in its HDL2 subclass. Similar changes were found in the healthy men although these were not as marked. A decrease in triglycerides was observed in both diabetics and normal controls. 4. Generally, diabetics showed greater changes in lipid concentrations which may suggest an altered metabolic response to w3 fatty acids. Therefore, the possible detrimental effect of the rise in total cholesterol and LDL cholesterol following fish oil administration may be offset by the increase in the protective HDL2 subclass.     

Similar treatment success rate after renal transplantation in diabetic and nondiabetic patients due to improved short- and long-term diabetic patient survival

In the early era of transplantation, it was common practice to exclude diabetic patients since the outcome in such cases was usually poor. At our center in Malmö, Sweden, diabetic nephropathy was never regarded as a contraindication. During the 22-year period from 1972 to 1993, 223 renal allografts were transplanted in 189 uremic diabetics, representing 24% of all renal transplant recipients (n=788). The two subgroups — patients with and without diabetes —did not differ significantly in graft survival rates for the 22-year period, which was characterized by a successive improvement in the success rate that was especially striking in the diabetic nephropathy subgroup. Among transplantations performed before 1988, the overall patient survival rate was significantly lower in the diabetic subgroup than in the remainder. After 1988 (when a series of new procedures had been adopted), the patient survival rate in the diabetic subgroup was similar to that in the nondiabetic subgroup, a similarity that persisted for at least 5 years. The 1 st year post-transplant mortality rate was reduced in diabetic patients from 24% before 1988 to 0% in those transplanted after 1988. In the 22-year period as a whole, cardiovascular or cerebrovascular events were the most common cause of death in both subgroups; the risk of cardiovascular or cerebrovascular death was reduced after 1988, and the rates were similar in both subgroups. The improved success rate of renal transplantation in patients with diabetic nephropathy supports continuation of the renal transplant program, which is based on careful management of the early stages of the disease.     

Some suspected periodontopathogens and serum antibody response in adult long-duration insulin-dependent diabetics

Abstract The subgingival microflora and serum antibody response were examined in long-duration insulin-dependent diabetics and age- and sex-matched non-diabetics. The material consisted of 9 diabetics aged 40–9 years and 19 aged 50–59 years, 13 non-diabetics aged 40–49 years and 21 aged 50–59 years. The bacterial species studied (Actinobacillus actinomycetemcomitans, Campylobacter rectus, Capnocytophaga spp, Eikenella corrodens, Fusobacterium nucleatum, Por-phyromonas gingivalis, Prevotella intermedia) were recovered in diabetics as well as in non-diabetics. Significantly more diabetics in both age groups harboured P. gingivalis compared to non-diabetics. Prevalence of P. gingivalis was associated with deepened periodontal pockets among non-diabetics but not among diabetics. In diabetics and non-diabetics, the serum antibody litres for most antigens were similar.     

Effects of various hypoglycaemic sulphonylureas on the cardiotoxicity of glycosides

Summary In diabetic patients it has been shown that tolbutamide and carbutamide enhanced and glibenclamide did not influence the incidence of digitalis intoxication, or that of multifocal ectopic beats or coupling due to premature ectopic ventricular beats during digitalis therapy. In rabbits glibenclamide decreased and tolbutamide and carbutamide increased strophanthidin toxicity in a dose dependent manner. It was concluded that glibenclamide should be preferred to tolbutamide or carbutamide in digitalistreated diabetics, when satisfactorily metabolic control is not achieved with a dietary regime alone.     

Failure of indomethacin to affect arginine-induced C-peptide and glucagon release in insulin-treated diabetics

Summary Fourteen insulin-treated diabetics were submitted to an arginine infusion test performed with either 11.7 or 5.85mg kg^-1 min^-1 arginine monohydrochloride infused during 40 min with or without previous oral administration of a low (75+50 mg) or a high (75 mg + 3 mg/kg) dose of indomethacin. Blood glucose, plasma non-esterified fatty acids, insulin, C-peptide and glucagon were determined at regular intervals before, during and after the arginine infusion. These parameters were totally unaffected by the two doses of indomethacin both in the basal state and during the arginine infusions at the two loads tested. Eight subjects had a basal C-peptide level above 0.07 pmol/ml and a mean (± SEM) maximal rise of 0.21±0.04 pmol/ml during the arginine infusion, whereas the remaining six patients had virtually zero values throughout the tests. The arginine-induced plasma glucagon rise was similar for the two rates of arginine infusion; the sum of the increments in plasma glucagon averaged 877±120 and 647±92 pg/ml (p>0.1) for the high and low rates of arginine infusion, respectively. The magnitude of the blood glucose rise appeared independent of the amount of arginine infused. Confirming previous reports, we found that the blood glucose rise after arginine was three to four times higher in subjects without C-peptide than in subjects with C-peptide. The mean glucagon response did not differ significantly between subjects with or without C-peptide. Thus, residual B cell function determines the magnitude of the blood glucose rise but not the glucagon response after intravenous arginine.     

“中气法”针刺治疗糖尿病胃轻瘫

中气法是指将补益中气的组穴通过现代数学的对角线原理和中线原理分成两组穴位交替使用以加强治疗效果的治疗方法。中气法I由巨阙、中脘、下脘、梁门组成。中气法II由中脘、不容、太乙组成。无论是中气法I还是中气法II都是在胃的投影区,可交替使用。两组穴中中脘穴为主穴。中脘乃属任脉,既是胃募,又是八会穴之腑会,是治疗各种胃肠疾病的中坚。文献引用：吴名,徐海环,张蒙,等.“中气法”针刺治疗糖尿病胃轻瘫[ J].中医学报,2015,30（4）：493-494.     

心脏-脚踝血管指数预测老年冠状动脉狭窄程度的价值

目的 观察老年2型糖尿病患者心脏-脚踝血管指数(CAVI)与冠状动脉狭窄程度的相关性,评价CAVI对冠状动脉狭窄程度的预测价值.方法 对60岁以上行冠状动脉造影异常患者,连续人选后进行CAVI测量、病史采集及血液化验检查,并分为A组(CAVI值≥9)及B组(CAVI值<9),观察动脉硬化相关危险因素与CAVI的关系.入选患者分为糖尿病组及非糖尿病组,了解CAVI与血糖增高及冠状动脉病变程度的相关性.结果共入选298例冠心病患者,其中合并糖尿病者135例,无糖尿病者163例.CAVI≥9.0者患糖尿病,多支病变者显著增多,并受年龄、体重指数、低密度脂蛋白等因素的影响.结论 CAVI增高与冠状动脉硬化程度有一定的相关性.CAVI有助于预测冠状动脉硬化程度.     

30例糖尿病酮症酸中毒治疗体会

目的探讨糖尿病酮症酸中毒（DKA）急救的简便治法。方法所有患者均采用两条静脉通道,一条静脉通道采用微量注射泵持续小剂量输注普通胰岛素0.1IU/（h.kg）,另一条静脉通道大量补液、补钾、纠正酸中毒等。结果 30例患者血糖、血清β-羟丁酸、电解质均降至正常,尿酮体转为阴性。结论微量输注泵方便操作、利于控制胰岛素小剂量输注速度,分步降糖利于把握病情;快速有效扩容、恢复组织灌注是治疗的关键。     

Gastric emptying in diabetic patients by the 13C-octanoic acid breath test: role of insulin in gastric motility

Background Impairment of gastric emptying is well recognized in patients with diabetes mellitus (DM), especially long-standing insulin-dependent diabetes mellitus (IDDM). The aim of this study was to evaluate the cause of delayed gastric emptying in DM patients. Methods In 16 controls, 16 non-insulin-dependent diabetes mellitus (NIDDM) patients and 23 IDDM patients, gastric emptying was studied using the ¹³C octanoic acid breath test. Breath samples were taken before a test meal labeled with 100 mg of ¹³C octanoic acid, and at 15-min intervals over a 300-min period postprandially. Results In all DM patients, the gastric emptying coefficient was lower than that in the controls (P < 0.05), and lag time and half-emptying time were significantly longer (P < 0.05). Both NIDDM and IDDM patients showed delayed ¹³CO₂ excretion compared with the controls, but IDDM patients showed more delayed gastric emptying than NIDDM patients (P < 0.05). There were no significant differences in sex, HbA1c level, or the rate of neuropathy between the two groups. Conclusions IDDM patients showed delayed gastric emptying compared with NIDDM patients, and the ¹³C octanoic acid breath test is useful for evaluating DM patients with delayed gastric emptying.