Anti-Platelet Therapy In Diabetic Patients With Retinopathy

1981 ◽  
Author(s):  
H Tindall ◽  
R C Paton ◽  
G P McNicol
Keyword(s):  
Microvascular Complications ◽  
Latin Square ◽  
Dosage Level ◽  
Normal Subjects ◽  
Diabetic Patients ◽  
Double Blind ◽  
Regeneration Time ◽  
Platelet Survival ◽  
Insulin Dependent Diabetic ◽  
Diabetes Mellitus Treatment

The effect of a combination of aspirin at 2 dosage levels (330mg/day and 1gm/day) and dipyridamole 225mg/day on platelet lifespan and some haemostatic variables was investigated in 30 insulin-dependent diabetic patients with retinopathy. Platelet regeneration time using a modification of the Stuart technique was measured in 40 normal controls and all patients before therapy commenced. Treatment was then allocated in a double-blind manner using a Latin square design and haemostatic variables were measured at the end of each treatment period. Platelet survival by the standard Na51Cr radioisotopic technique was performed twice during treatment. The post-aspirin platelet regeneration time in normal subjects was 9.98 ± 0.22 days (mean ± SEM) and in diabetic patients was significantly (p<0.001) shorter at 7.16 ± 0.18 days. A similar result of 7.37 ± 0.20 days was obtained in the diabetic patients by Na51cr platelet survival (analysed by γ function). The aspirin/dipyridamole combination (330mg/75mg tds) resulted in significant (p<0.001) lengthening of platelet survival to 8.46 ± 0.13 days (as estimated by Na51Cr method). The postaspirin platelet regeneration time was significantly prolonged (p<0.01) in this group (9.75 ± 0.52 days).Although the lower dose aspirin - dipyridamole combination (110mg/75mg tds) caused a prolongation in regeneration time (8.29 ± 0.45 days) this time was not significantly different from placebo, and was significantly (p<0.01) shorter than the time taken on the higher aspirin dosage. No significant changes in haemostatic function were observed. These results support the hypothesis that platelets may be involved in the microvascular complications of diabetes mellitus. Treatment with Igm aspirin +225mg dipyridamole/day significantly lengthened platelet survival suggesting that long term trials at this aspirin dosage level are justified.

Aspirin, Dipyridamole and Platelet Survival in Patients with Diabetes Mellitus

1982 ◽  
Vol 63 (2) ◽  
pp. 205-209 ◽  
Author(s):  
Hilary Tindall ◽  
R. Colin Paton ◽  
George P. McNicol
Keyword(s):  
Diabetic Patients ◽  
High Dose ◽  
Double Blind ◽  
Regeneration Time ◽  
Dose Aspirin ◽  
Platelet Survival ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
High Dose Aspirin

1. Platelet survival in 27 insulin-dependent diabetic patients with severe retinopathy was studied in a double-blind cross-over trial using placebo, aspirin (990 mg/day) and a combination of dipyridamole (225 mg/day) with aspirin at two dosage levels (330 mg and 990 mg/day). 2. Twenty patients (group I) had 51Cr-labelled-platelet survival after treatment with placebo and the high-dose-aspirin/dipyridamole combination. The remaining seven patients (group II) had platelet-regeneration times measured after each of the four treatment periods. 3. Treatment of group I patients with the high-dose-aspirin/dipyridamole combination resulted in significant (P < 0·001) prolongation of platelet survival from 7·3 ± 0·2 (mean ± sem) days to 8·4 ± 0·1 days. 4. In group II patients, when compared with the mean placebo result of 7·2 ± 0·2 days, the mean aspirin-labelled-platelet-regeneration time was significantly (P < 0·01) longer only after high-dose-aspirin/dipyridamole (9·8 ± 0·5 days) but not after low-dose-aspirin/dipyridamole (8·3 ± 0·5 days) or aspirin alone (7·3 ± 0·3 days). 5. These results suggest that it may be premature to consider reducing the dose of aspirin in aspirin/dipyridamole combinations below 1 g/day when used as antithrombotic therapy.

Platelet Regeneration Time In Diabetics With And Without Retinopathy

1981 ◽  
Author(s):  
H Tindall ◽  
R C Paton ◽  
M Zuzel ◽  
G P McNicol
Keyword(s):  
Plasma Glucose ◽  
Microvascular Complications ◽  
Normal Subjects ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Regeneration Time ◽  
Insulin Dependent

Platelet regeneration time was measured by a modification of the Stuart technique which depends on progressive reappearance of the capacity to synthesize malondial- dehyde (MDA) in response to thrombin stimulation following aspirin ingestion. The subjects of the study were 40 normal subjects and 40 patients with insulin-dependent diabetes mellitus for more than 10 years. The presence or absence of retinopathy was independently assessed in a diabetic eye clinic and severe retinopathy was found in 20 patients. The mean platelet regeneration time in normal subjects was 9.98 ±0.22 days (mean ± SEM). In diabetic patients without retinopathy the platelet regeneration time was significantly (p<0.001) shortened (7.38 ± 0.14 days) and a further shortening occurred in those patients with retinopathy (6.80 ± 0.18 days), but with the number of subjects studied the difference between these two groups was not statistically significant. MDA produced in response to thrombin-stimulation of platelets was 235.5 ± 12.8 pmole/108 platelets in controls with significantly (p<0.001) less in diabetics with retinopathy at 156.7 ± 17.5 pmole/108 platelets. In 10 diabetic patients a standard oral glucose tolerance test was performed with blood taken for MDA at the same time as plasma glucose levels. There was no correlation between plasma glucose and the concentration of MDA produced. These results show that patients with longstanding insulin-dependent diabetes have an accelerated platelet regeneration time even in the absence of overt retinal microvascular complications.

Cardiac Hyperfunction in Insulin-Dependent Diabetic Patients Developing Microvascular Complications

Diabetes ◽  
1988 ◽  
Vol 37 (7) ◽  
pp. 851-856 ◽  
Author(s):  
L. Thuesen ◽  
J. S. Christiansen ◽  
C. E. Mogensen ◽  
P. Henningsen
Keyword(s):  
Microvascular Complications ◽  
Diabetic Patients ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

Iohexol and Metrizoate in Urography of Insulin Dependent Patients

1986 ◽  
Vol 27 (3) ◽  
pp. 265-267 ◽  
Author(s):  
J. Edgren ◽  
L. Laasonen ◽  
P.-H. Groop ◽  
L. Groop
Keyword(s):  
Creatinine Clearance ◽  
Contrast Medium ◽  
Adverse Reactions ◽  
Diabetic Patients ◽  
Double Blind ◽  
Ionic Medium ◽  
Ionic Contrast ◽  
Insulin Dependent ◽  
Ionic Contrast Medium ◽  
Insulin Dependent Diabetic

A double blind urographic study with the ionic contrast medium metrizoate or the non-ionic medium iohexol was perfomed on 69 insulin dependent diabetic patients. Metrizoate caused 24 per cent and iohexol 11 per cent mild adverse reactions and metrizoate a significant decrease in creatinine clearance values. Thus iohexol turned out to be better tolerated by these diabetic patients than metrizoate. References

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.

Acetoacetate and 3-hydroxybutyrate kinetics in obese and insulin-dependent diabetic humans

1985 ◽  
Vol 248 (5) ◽  
pp. R611-R620 ◽  
Author(s):  
R. Nosadini ◽  
A. Avogaro ◽  
R. Trevisan ◽  
E. Duner ◽  
C. Marescotti ◽  
...  
Keyword(s):  
Kinetic Data ◽  
Compartmental Model ◽  
De Novo ◽  
Normal Subjects ◽  
Diabetic Patients ◽  
De Novo Synthesis ◽  
Insulin Dependent ◽  
Tracer Kinetic ◽  
Obese Subjects ◽  
Insulin Dependent Diabetic

[3-14C]acetoacetate (AcAc) and beta-[3-14C]hydroxybutyrate (beta-OHB) administration, measurements of labeled AcAc and beta-OHB in blood, and kinetic modeling have been used to investigate ketone body (KB) metabolism in five normal, five obese, and eight insulin-withdrawn diabetic subjects. Diabetic subjects were divided in mildly ketotic (MKD) and highly ketotic (HKD) patients according to beta-OHB blood level. A four-compartmental model successfully described the tracer kinetic data in obese and normal subjects, whereas in diabetic patients a five-compartmental model was necessary. Obese subjects showed a significantly lower (P less than 0.05) KB de novo synthesis (R30 = 159 +/- 54 (SD) mumol X min-1 X m-2) in comparison with normal subjects (282 +/- 93), but the clearance rates of AcAc (PCR1) and beta-OHB (PCR2) were similar in the two groups. R30 was 596 +/- 534 in MKD and 1,278 +/- 445 (P less than 0.01) in HKD. PCR1 was not significantly different both in MKD and HKD in comparison with normal subjects. In contrast PCR2 was markedly reduced in HKD (0 +/- 0 ml X min-1 X m-2) in comparison with MKD (1,031 +/- 615) and normal subjects (782 +/- 278). The percentage distribution of KB among various tissues inside the organism of diabetic subjects is abnormal. Both AcAc and beta-OHB recycling and mean residence time are not normal in HKD. A significant correlation was found between C-peptide and KB production in diabetes. These results suggest that a selective defect of beta-OHB peripheral utilization is important in determining and maintaining severe diabetic ketoacidosis.

Oral Buflomedil in Diabetic Background Retinopathy: Results of a Preliminary Controlled Study

1984 ◽  
Vol 12 (3) ◽  
pp. 184-187 ◽  
Author(s):  
N Ducrey ◽  
B Curchod
Keyword(s):  
Placebo Group ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Double Blind Trial ◽  
Double Blind ◽  
Blind Trial ◽  
Background Retinopathy ◽  
Number Of Patients ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic

Twenty insulin-dependent diabetic patients with signs of background retinopathy were given Buflomedil 600 mg/day orally or placebo in a randomized double-blind trial for a 6-month period. A larger number of patients had their retinal condition deteriorating in the placebo group and this finding is an indication for pursuing investigations on a larger scale in this direction.

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.

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