Protein C Deficiency in Insulin-Dependent Diabetes: A Hyperglycemia-Related Phenomenon

1990 ◽  
Vol 64 (01) ◽  
pp. 104-107 ◽  
Author(s):  
Antonio Ceriello ◽  
Antonio Quatraro ◽  
Patrizia Dello Russo ◽  
Egidio Marchi ◽  
Miriam Barbanti ◽  
...  
Keyword(s):  
Protein C ◽  
Insulin Infusion ◽  
Inverse Correlation ◽  
Normal Subjects ◽  
Diabetic Patients ◽  
Related Phenomenon ◽  
Protein C Deficiency ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

SummaryIn 30 insulin-dependent diabetic patients protein C (PC) antigen and PC activity were significantly lower than those of matched control healthy subjects. An inverse correlation between fasting plasma glucose and both PC concentration and activity was present in diabetics, while a direct correlation between PC concentration and PC activity was observed. Induced hyperglycemia in diabetic and normal subjects was able to decrease both PC antigen levels and PC activity, and heparin reversed in part this effect.In diabetic patients euglycemia obtained by insulin infusion restored to normal the depressed PC levels. Heparin did not alter both the basal PC concentration and activity in healthy controls.These data stress the major role of hyperglycemia in determining PC decrease in diabetics, and suggest that PC reduction is probably associated to hyperglycemia-enhanced thrombin formation.

Impaired renal response to a meat meal in insulin-dependent diabetes: role of glucagon and prostaglandins

1990 ◽  
Vol 258 (3) ◽  
pp. F675-F683 ◽  
Author(s):  
P. Fioretto ◽  
R. Trevisan ◽  
A. Valerio ◽  
A. Avogaro ◽  
M. Borsato ◽  
...  
Keyword(s):  
Normal Subjects ◽  
Diabetic Patients ◽  
Base Line ◽  
Renal Response ◽  
Meat Meal ◽  
Insulin Dependent ◽  
Albumin Clearance ◽  
Insulin Dependent Diabetic ◽  
Protein Load

The renal response to 100 g/1.73 m2 protein load in the form of a meat meal was studied in 19 normal subjects and 35 normoalbuminuric insulin-dependent diabetic patients (IDDs) under conditions of sustained euglycemia. The area under the glomerular filtration rate (GFR) curve rose above base line by 1,904 +/- 292 in normals and 502 +/- 237 ml/1.73 m2 in IDDs (P less than 0.01). The meat meal induced a greater increment in the area under the glucagon curve in normals (14,930 +/- 186 pg.ml-1.min-1) than in IDDs (7,227 +/- 67, P less than 0.01); similarly urinary excretion of prostaglandin E2 and 6-ketoprostaglandin F1 alpha rose by 119 and 98%, respectively, in normals but only by 2% (P less than 0.01 vs. normals) and 10% (P less than 0.01 vs. normals) in IDDs. The fractional albumin clearance rose by 102 and 251% in normals and IDDs, respectively. In five normal subjects indomethacin administration abolished the GFR, glucagon, prostaglandin, and albuminuric response to meat ingestion. Glucagon replacement under indomethacin treatment failed to restore these responses. In five diabetic patients, selected for having a flat glucagon and GFR response to a meat meal, replacement of glucagon to postprandial levels increased urinary vasodilatory prostaglandins and restored a normal GFR response. Thus in normal subjects renal vasodilatory prostaglandins appear to be the final effector of the renal hemodynamic and albuminuric response to a meat meal. The prostaglandin increase is likely to be mediated under physiological conditions by a glucagon rise, which, however, has no effect per se on renal hemodynamics.(ABSTRACT TRUNCATED AT 250 WORDS)

Platelet function during continuous insulin infusion treatment in insulin-dependent diabetic patients

Diabetes ◽  
1985 ◽  
Vol 34 (11) ◽  
pp. 1127-1133 ◽  
Author(s):  
R. K. Mayfield ◽  
P. V. Halushka ◽  
H. J. Wohltmann ◽  
M. Lopes-Virella ◽  
J. K. Chambers ◽  
...  
Keyword(s):  
Platelet Function ◽  
Insulin Infusion ◽  
Diabetic Patients ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Continuous Insulin Infusion

Decreased distensibility of resistance vessels of the skin in type 1 (insulin-dependent) diabetic patients with microangiopathy

1987 ◽  
Vol 72 (1) ◽  
pp. 123-130 ◽  
Author(s):  
J. Kastrup ◽  
T. Nørgaard ◽  
H.-H. Parving ◽  
N. A. Lassen
Keyword(s):  
Blood Flow ◽  
Inverse Correlation ◽  
Diabetic Patients ◽  
Resistance Vessels ◽  
Head Up Tilt ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Type 1 Diabetic Patients ◽  
Term Type

1. The distensibility of the resistance vessels of the skin at the dorsum of the foot was determined in 11 long-term type 1 (insulin-dependent) diabetic patients with nephropathy and retinopathy, nine short-term type 1 diabetic patients without clinical microangiopathy and in nine healthy non-diabetic subjects. 2. Blood flow was measured by the local 133Xexenon washout technique in a vascular bed locally paralysed by the injection of histamine. Blood flow was measured before, during and after a 40 mmHg increase of the vascular transmural pressure, induced by head-up tilt. 3. The mean increase in blood flow during headup tilt was only 24% in diabetic subjects with and 48% in diabetic patients without clinical microangiopathy, compared with 79% in normal non-diabetic subjects (P < 0.0005 and P < 0.05, respectively). 4. An inverse correlation between microvascular distensibility and degree of hyalinosis of the terminal arterioles in biopsies from the skin was demonstrated (r = − 0.57, P < 0.001). 5. Our results suggest that terminal arteriolar hyalinosis reduces the microvascular distensibility and probably increases the minimal vascular resistance, thereby impeding hyperaemic responses.

Relationship between the Basal Blood Alanine Concentration and the Removal of an Alanine Load in Various Clinical States in Man

1980 ◽  
Vol 58 (4) ◽  
pp. 301-309 ◽  
Author(s):  
M. Elia ◽  
Vera Ilic ◽  
Susan Bacon ◽  
D. H. Williamson ◽  
R. Smith
Keyword(s):  
Metabolic Response ◽  
Physiological State ◽  
Normal Subjects ◽  
The Body ◽  
Diabetic Patients ◽  
Adequate Diet ◽  
Insulin Dependent ◽  
Cirrhotic Patients ◽  
Lactate And Pyruvate ◽  
Insulin Dependent Diabetic

1. Blood alanine was measured in six patients undergoing total hip replacement and in four normal subjects starved for 4 days. Hypoalaninaemia occurred in both groups and persisted in the surgical patients despite an adequate diet. The blood alanine was also low in four insulin-dependent diabetic patients and in four patients with muscular dystrophy; it was normal in four patients with cirrhotic liver disease. 2. The removal of an intravenous l-alanine load (12 g; 133 mmol) was significantly increased after surgery and in the diabetic patients, unaltered by starvation, and decreased in the cirrhotic patients. 3. Increases in blood glucose were observed when alanine infusion was performed 6 h after surgery and after 3 days' starvation. Increases in blood lactate and pyruvate always occurred after alanine infusion but were most marked 6 h after surgery. 4. These results show that the metabolic response to an alanine load and the ability of the body to remove it alter with change in physiological state, and that the hypoalaninaemia after surgery and in diabetes is related to an increased removal of intravenous alanine, whereas that during starvation is not.

Nocturnal versus diurnal hormonal counterregulation to hypoglycemia in Type 1 (insulin-dependent) diabetic patients

1993 ◽  
Vol 128 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Inger Bendtson ◽  
Anne Mette Rosenfalck ◽  
Christian Binder
Keyword(s):  
Growth Hormone ◽  
Blood Glucose ◽  
Insulin Infusion ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Diabetic Patients ◽  
Hormonal Responses ◽  
Nocturnal Hypoglycemia ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

Asymptomatic hypoglycemia in IDDM patients seems to be more frequent during the night than during the day, with reported frequencies as high as 56%. Hormonal counterregulation to diurnal and nocturnal hypoglycemia was studied in 10 insulin-dependent diabetic patients without diabetic complications in order to test whether hormonal responses were lower at night than during daytime. A lower catecholamine response might imply less marked symptoms and therefore one reason why patients are not awakened by hypoglycemia. Blood glucose was stabilized to around 6 mmol/1 by iv insulin infusion and hypoglycemia was induced by increasing the insulin infusion rate—in the night studies at 01.30, in the day studies at 08.00. Blood glucose nadirs were 1.5±0.4 (1.2–1.9) mmol/1 at night and 1.9±0.3 (1.3–2.2) mmol/l during the day; in three patients the nadirs were identical during both the night and day. One patient had no adrenaline response to daytime hypoglycemia. In general, nocturnal hypoglycemia elicited greater catecholamine responses correlated to the duration of hypoglycemia. Glucagon responses showed a great heterogeneity independently of diabetes duration and hypoglycemic level. Growth hormone secretion was reduced during the night study; however, no refractory periods were found after sleep-related growth hormone secretion. In conclusion: counter-regulatory hormonal responses tend to be greater at night than during the day and do not explain why patients are not awakened by nocturnal hypoglycemia.

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