Comparison of Intraperitoneal and Subcutaneous Insulin Administration on Insulin Sensitivity and Serum Lipids in Type I Diabetic Patients on Continuous Ambulatory Peritoneal Dialysis Treatment

1995 ◽  
Vol 88 (4) ◽  
pp. 427-432 ◽  
Author(s):  
Jorma T. Lahtela ◽  
Jukka Mustonen ◽  
Amos Pasternack

1. The metabolic effects of intraperitoneal and subcutaneous insulin delivery were compared in a crossover manner in six C-peptide-negative diabetic patients with end-stage renal disease on continuous ambulatory peritoneal dialysis. Each treatment period lasted at least 3 months. Hyperinsulinaemic euglycaemic clamp was performed and glucose turnover assessed using [3-3H]glucose as a tracer. 2. During intraperitoneal delivery the daily insulin dose was 2.4 times higher than during subcutaneous administration and glycaemic control was significantly better (HbA1c 7.63% ± 0.46% and 9.52% ± 0.51% during intraperitoneal and subcutaneous insulin respectively, P < 0.01). The number of hypoglycaemic episodes was lower during intraperitoneal insulin than during subcutaneous therapy. 3. Intraperitoneal insulin resulted in an enhanced glucose disposal rate (P < 0.01) and reduced fasting hepatic glucose production (P < 0.01). High-density lipoprotein-cholesterol decreased and the ratio of low-density lipoprotein/high-density lipoprotein-cholesterol increased significantly (P < 0.05) during intraperitoneal insulin delivery. 4. The results suggest that intraperitoneal insulin, while resulting in better glycaemic control and improved insulin sensitivity than subcutaneous insulin, increases serum triacylglycerol and total cholesterol and reduces high-density lipoprotein-cholesterol, possibly via a direct effect on the liver.

Author(s):  
Smita V Patil ◽  
Anita P Mandare ◽  
Gaikwad B Pandurang

Objective: There are probably 100 million people in the world with diabetes mellitus (DM), and incidences of diabetes are on the rise. Dyslipidemia is one of the common disorders which are seen in most of the diabetes patients, which causes cardiovascular disorders. The aim of this study is to investigate the total cholesterol (TC), triacylglycerols (TGs), high-density lipoprotein cholesterol (HDL-C) in Type 2 DM, and healthy controls.Methods: The study was conducted on 50 controls and 50 Type 2 diabetic subjects between age group of 30 and 60 years. Serum TC was determined by an enzymatic (cholesterol oxidase/phenol-aminophenazone [PAP]) colorimetric method and TGs were determined by an enzymatic (glycerol phosphate oxidase-PAP) method, and HDL-C was estimated by a precipitant method. Statistical analysis was done using unpaired t-test.Results: The mean value of TC, TGs, and HDL-C in normal subjects is 165.5±24.24, 118.7±41.58, 28.38±7.85 mg/dl, respectively, and the value of TC, TGs, and HDL-C in diabetic patients is 179±31.69, 164.35±27.93, 25.4±6.86 mg/dl, respectively. The observed difference in the means of TC, TGs, and HDL-C in normal and diabetic are statistically significant (p<0.05).Conclusion: From the present study, it is concluded that TC, TGs, and HDL-C levels for all persons with Type 2 DM should be done as a routine test. Furthermore, early diagnosis and treatment of dyslipidemia can be used as a preventive measure for the development of cardiovascular disease in Type 2 diabetes.Keywords: Diabetes mellitus, Dyslipidemia, Lipid profile, Total cholesterol, Triglycerides, High-density lipoprotein cholesterol.


2008 ◽  
Vol 28 (6) ◽  
pp. 611-616 ◽  
Author(s):  
Ryota Ikee ◽  
Yoshifumi Hamasaki ◽  
Machiko Oka ◽  
Kyoko Maesato ◽  
Tsutomu Mano ◽  
...  

Objective The prevalence of left ventricular hypertrophy (LVH) reaches 75% in patients with end-stage renal disease. In patients on peritoneal dialysis (PD), some factors, such as hypertension, volume overload, serum albumin, and residual renal function, have been reported to be related to LVH. Dyslipidemia often occurs in PD but it remains unclear whether dyslipidemia is related to LVH. We investigated the relationship between clinical parameters, including lipid profile, and left ventricular mass index (LVMI). Methods In this cross-sectional study, 34 patients undergoing PD for more than 1 year without combined therapy with hemodialysis were included. We recorded the patients’ clinical data and related those parameters with LVMI as evaluated by echocardiography. Results The patients included 23 males and 11 females (age 62.2 ± 12.1 years, duration on PD 31.6 ± 15.6 months). Mean LVMI was 142 ± 37 g/m2. In univariate analysis, urine volume ( r = -0.493, p = 0.003), total cholesterol ( r = -0.418, p = 0.01), high-density lipoprotein cholesterol (HDL-C; r = -0.374, p = 0.02), and human atrial natriuretic peptide (hANP; r = 0.600, p < 0.001) significantly correlated with LVMI. Stepwise multiple regression analysis showed that hANP (β= 0.524, p = 0.001) and HDL-C (β= -0.422, p = 0.007) were independently associated with LVMI ( r2 = 0.32). Conclusion Strict volume control and salt restriction is essential for prevention of LVH. The role of HDL-C in the development of LVH in PD patients remains to be determined.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xixiang Tang ◽  
Ying Tan ◽  
Yi Yang ◽  
Mei Li ◽  
Xuemin He ◽  
...  

Background: Chronic inflammation in type 2 diabetes mellitus (T2DM) is an essential contributor to the development of diabetic retinopathy (DR). The monocyte–to–high-density lipoprotein cholesterol (HDL-C) ratio (MHR) is a novel and simple measure related to inflammatory and oxidative stress status. However, little is known regarding the role of the MHR in evaluating the development of DR.Methods: A total of 771 patients with T2DM and 607 healthy controls were enrolled in this cross-sectional study. MHR determination and eye examination were performed. The association of MHR with the prevalence of DR in T2DM patients was analyzed.Results: The MHR in patients with DR was significantly higher than that in both non-DR diabetic patients (P &lt; 0.05) and healthy controls (P &lt; 0.01). No significance was observed in the MHR of different DR severity grades. Moreover, the MHR was similar between patients with non-macular oedema and those with macular oedema. Logistic regression analysis demonstrated that MHR was independently associated with the prevalence of DR in diabetic patients [odds ratio (OR) = 1.438, 95% confidence interval (CI): 1.249–1.655, P &lt; 0.01]. After additional stratification by HbA1c level and diabetic duration, the MHR was still independently associated with the prevalence of DR.Conclusions: Our study suggests that the MHR can be used as a marker to indicate the prevalence of DR in patients with T2DM.


2022 ◽  
Author(s):  
Rui Zhang ◽  
Xing Zhang ◽  
Xingming Tang ◽  
Liwen Tang ◽  
Sijia Shang ◽  
...  

Abstract BackgroundLow levels of high-density lipoprotein-cholesterol (HDL-C) and diabetes are common in patients undergoing peritoneal dialysis (PD). The aim of this study was to investigate the association between diabetes coexisting with a low level of HDL-C and the first episode of peritoneal dialysis-related peritonitis (PDRP) in patients with PD.MethodsWe retrospectively investigated patients with PD from January 1, 2003, to May 31, 2020 in four PD centers. Patients with PD were divided into four groups: no comorbidity, low HDL-C only, diabetes only, and diabetes plus low HDL-C. The clinical and laboratory baseline data of the four groups were collected and compared. The association between diabetes coexisting with low HDL-C levels and the first episode of PDRP was analysed by multivariate Cox regression analysis. ResultsA total of 1013 patients with PD were recorded in our study. The mean age was 49.94±14.32 years, and 597 (58.99%) were males. A total of 301 (29.7%) patients had their first episodes of PDRP, and low HDL-C levels existed with diabetes in 72 patients with PD. After adjusting for confounding factors, a low level of HDL-C coexisting with diabetes was significantly associated with the first episode of PDRP in our study (hazard ratio: 1.93, 95% CI: 1.03-3.61, p<0.05). The associations between HDL-C, diabetes and PDRP were consistent in the following subgroups: sex, age, pre-existing CVD (all P interaction > 0.05).ConclusionsLow levels of HDL-C alone or diabetes alone were not independent risk factors for PDRP. Patients with both diabetes and low HDL-C levels were at high risk for PDRP.


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