Serumglykoproteine beim Diabetes mellitus; quantitative immunologische Bestimmung von saurem α1-Glykoprotein,Gc, α2-Makroglobulin und Hämopexin bei Diabetikern mit und ohne Angiopathien

Zusammenfassung 1. Bei Diabetikern mit und ohne Gefäßkomplikationen wurden die Serumkonzentrationen des sauren ₁-Glykoproteins, der gruppen-spezifischen Komponente (Gc), des ₂-Makroglobulins und des Hämopexins mit der Immuno-Diffusions-Methode nachMancini und Mitarb. quantitativ bestimmt. — 2. Das ₂- Makroglobulin ist bei Diabetikern vermehrt, bei 276 Patienten fand sich ein Mittelwert von 242 mg% gegenüber einem Mittelwert von 186 mg% bei 98 nicht-diabetischen Blutspendern. Diese Differenz ist statistisch hochsignifikant. Der Konzentrationsanstieg ist bei jugendlichen Diabetikern stärker ausgeprägt als bei Altersdiabetikern. Bei Patienten mit Retinopathie findet sich eine deutlichere Vermehrung als bei Patienten ohne Retinopathie. Auch geht der Anstieg des ₂-Makroglobulins mit dem Schweregrad arteriosklerotischer Veränderungen der peripheren Gefäße parallel. — 3. Die Konzentrationen des sauren ₂-Glykoproteins und der gruppen-spezifischen Komponente sind in Seren von Diabetikern gegenüber gesunden Blutspendern nur unwesentlich vermehrt. — 4. Die Hämopexin Konzentration ist bei Diabetikern mit einem Mittelwert von 92 mg% gegenüber gesunden Blutspendern mit einem Mittelwert von 77 mg% gering erhöht; dieser geringe Unterschied ist statistisch hochsignifikant.

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Serum, glycoproteins in diabetes mellitus; quantitative immunological determination of acid ₁-glycoprotein, Gc, ₂-macroglobulin and haemopexin in diabetics with and without angiopathy

Summary 1. Serum concentrations of acid ₁-glycoprotein, Gc, ₂-macroglobulin and haemopexin were determined in diabetics with and without vascular complications by the immunological assay method ofMancint and co-workers. — 2. ₂-macroglobulin concentrations were increased in sera of diabetics. The mean value was 242 mg% in 276 patients compared with the mean value of 186 mg% in a sample of 98 healthy blood-donors. This difference is statistically highly significant. The increase was more pronounced in juvenile diabetes than in late-onset diabetes. The increase was also more pronounced in patients with retinopathy than in patients without retinopathy. There was also an increase of ₂- macroglobulin concentrations in relation to the degree of arteriosclerotic changes of the peripheral vessels. — 3. Serum concentrations of acid ₁-glycoprotein and Gc were only slightly increased in diabetics compared with blood-donors. — 4. There was a small, but statistically highly significant increase of haemopexin concentrations in sera of diabetics. The mean value in 243 diabetics was 92 mg%, in 15 healthy blood-donors a mean value of only 77 mg% was found.

Mit Unterstützung durch die Deutsche Forschungsgemeinschaft     

Pancreatic B-cell response to a test-meal in lean and obese diabetic patients: Relation to metabolic control

Summary We have measured fasting C-peptide reactivity (CPR) as well as CPR responses to a test meal in 83 diabetic patients and 41 non diabetic controls. In comparison to controls, basal CPR was decreased in lean insulin-treated diabetics with stable or brittle diabetes and in obese patients with brittle diabetes. Lean and obese maturity-onset diabetics had increased CPR levels and so had obese insulin-treated patients. Nevertheless, the CPR response to the test meal was clearly inadequate in all diabetics. In control patients, there was a positive correlation between fasting blood glucose and CPR levels. On the contrary, lean diabetics demonstrated a negative correlation between these parameters. Hemoglobin A₁ levels were negatively correlated to fasting CPR levels in lean diabetics, indicating the importance of residual B-cell function for diabetes control. These correlations were obscured in obese diabetics. In our patients, circulating insulin antibodies had apparently no deleterious effect on metabolic control.     

No Relationship Between Serum Cholesterol and Suicidal Ideation and Depression in African-American Diabetics

ABSTRACT

Low serum cholesterol has been associated with suicidal behavior. Depression has been postulated to be a mediating factor between low serum cholesterol and suicidal behavior. Therefore, this possibility was examined in a large group of 459 diabetic patients that had blood drawn for serum cholesterol levels on the same day that they completed the Beck Depression Inventory. The results failed to show any significant relationship between serum cholesterol levels and either total Beck Depression Inventory (BDI) scores or BDI scores on the item measuring current suicidal ideation. The limitations of the study are discussed.     

Accuracy of Narcotrend Index in Monitoring Depth of Anesthesia in Diabetics：a Case Report

NARCOTREND index （NI） is based on studies ofnormal human brain electrical data. It uses anordinary electrode to collect and analysis brainelectrical signals immediately at any positionof the head, to display the state of consciousness and depthof anesthesia of patients on the touch screen afterautomatic analysis and classification, so as to guide doseadjustment of anesthetics. NI may make the consciousnessand depth of anesthesia monitoring safe, simple, accurate,and economic. It is important that NI is more accurate thanclassical electroencephalographic variables.^1 Weber et al2believed that the NI was an objective and true index in theevaluation of propofol sedation in children.     

彩色多普勒超声分析早期糖尿病视网膜病变患者中央动脉的血流动力学

目的研究糖尿病患者视网膜中央动脉（CRA）在早期视网膜病变时血流动力学的变化及CRA血流参数与血糖水平的相关性。方法利用彩色多普勒超声技术,对临床已确诊糖尿病、但经眼底检查未见视网膜异常的糖尿病患者进行CRA彩色多普勒超声检测,先根据血糖水平控制良好与否分为A、B两组,其中A组为血糖控制不良患者,B组为血糖控制良好患者。然后将A组患者通过各种措施使血糖水平在4个月内均控制良好者重组为C组。结果A组CRA的血流动力学改变比B组更明显;C组CRA的血流动力学各项指标均有明显改善（P < 0.05）。结论糖尿病患者CRA血流动力学改变先于临床病理改变;CRA血流参数与血糖水平有密切相关;早期糖尿病视网膜病变是可逆的功能性改变。     

互动式教育在规范社区老年糖尿病患者胰岛素注射中的研究

目的　评价互动式教育在规范社区老年糖尿病患者胰岛素注射中的应用效果。方法 采用便利抽样法选取上海市某社区行笔型胰岛素注射的老年糖尿病患者150例,随机分为对照组和干预组各80例。对照组给予常规教育指导;观察组在对照组基础上组成的互动式健康教育团队。两组患者分别于教育前、教育6个月后采用胰岛素规范注射的知信行问卷调查,评价两组患者胰岛素注射相关知识、技能的掌握程度。评估其干预后糖代谢水平和低血糖的发生率,观察这种服务模式的可行性。 结果 干预前两组患者胰岛素知识和技能、糖化血红蛋白值、低血糖的发生率差异无统计学意义(P＞0.05)。干预6月观察组较对照组糖化血红蛋白值下降更为显著(P<0.05),观察组胰岛素知识和技能提高更为显著(P<0.05)。观察组低血糖发生率较对照组明显下降(P<0.05)。结论 互动式教育规范社区2型糖尿病患者胰岛素注射,改变传统单纯糖尿病知识教育方式,通过患者技能培训和改善生活质量,提高患者自我管理技能。     

N-Acetylation and hydroxylation polymorphisms in type II diabetics with microvascular disturbances

The N-acetylation and hydroxylation (CYP2D6) genetic polymorphisms were assessed in 43 healthy subjects and in 84 type II (non-insulin-dependent) diabetics. The proportions of slow and fast acetylators as well as poor and extensive metabolisers in a group of diabetics suffering from microvascular disturbances (nephropathy, retinopathy and neuropathy) were compared with the ocntrol group and with diabetics without such ocmplications. Sulphadimidine was used as a probe for polymorphic acetylation and debrisoqine for CYP2D6. Debrisoquine and its 4-OH metabolite were assayed by means of HPLC, and sulphadimidine using a modified Bratton-Marshall proceedure. The frequency of the slow phenotype (63%) was significantly higher in diabetics with microvascular disturbances than in patiens without diabetic complica tions (P < 0.005). In patients with type II diabetes (84), only the extensive phenotype of hydroxylation was observed. Received: 18 March 1996 / Accepted in revised form: 11 July 1996     

Balloon occlusion femoral angiography prior to in-situ saphenous vein bypass

The advent of thein situ saphenous vein bypass procedure for peripheral lower extremity ischemic disease has placed new demands on the angiographer. It is imperative that the small runoff arteries of the calf be seen beyond the level of the ankle to include evaluation of the patency of the plantar arch. Balloon occlusion femoral angiography (BOFA) has been used in 45 consecutive lower extremities in 40 patients referred for proposedin situ saphenous vein bypass; excellent visualization of the plantar arch on the first run was obtained in 40 of 45 extremities (88.9%). The patients included 35 (87.5%) insulin-dependent diabetics with severe proximal arterial disease. Initially,in situ candidates were studied using conventional “runoff” methods; it was rarely possible to visualize the upper trifurcation vessels let alone the plantar arch by this conventional method. The BOFA method was used to provide excellent visualization of the plantar arch and foot arteries. It permits use of smaller contrast medium volumes, provides all the arteriographic anatomy on one 51 inch long film, and is safe.     

Young Diabetics: Memories,Current Lifestyles and Attitudes

Eighty-six subjects aged 22.3 ± 2.3 years (mean ± S.D.), who attended one clinic as diabetic children, filled in a questionnaire designed to evaluate their present health and lifestyles, as well as discover their childhood memories. About two-thirds (66.3%) had unhappy recollections particularly of such irritating routines as urine testing, injections, and special food programmes. Only 6% complained that future complications were not discussed with the child at the appropriate time, but with the exception of blindness, childhood knowledge of diabetic complications was poor. Around two-thirds (66.4%) left school with some examination result; 44.2% went into further education, while 19.8% entered into a trade. These attainments were comparable to those of local school leavers. As young diabetic adults, 62.8% were employed; 22.1% were students or housewives with no other occupations.