Regulation of plasma vasopressin in insulin-dependent diabetes mellitus

1985 ◽  
Vol 249 (3) ◽  
pp. E317-E325 ◽  
Author(s):  
R. L. Zerbe ◽  
F. Vinicor ◽  
G. L. Robertson
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Osmolality ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Plasma Sodium ◽  
Diabetic Patients ◽  
Plasma Vasopressin ◽  
Insulin Dependent ◽  
Vasopressin Secretion

Patients with uncontrolled insulin-dependent diabetes mellitus have elevations in plasma vasopressin that cannot be accounted for totally by recognized osmotic or nonosmotic stimuli. To investigate the possibility that regulation of vasopressin secretion is abnormal in this disease, we characterized the vasopressin response to osmotic and hemodynamic stimuli in five uncomplicated, well-controlled insulin-dependent diabetics, and compared the results with those found in nondiabetic volunteers. During osmotic stimulation with hypertonic saline, plasma vasopressin increased in close linear correlation with plasma osmolality or sodium in both groups. However, in the diabetics, the lines describing the relationships between plasma sodium and vasopressin were shifted significantly to the left of normal, suggesting resetting of the osmostat. This shift was not due to abnormal stimulation by hyperglycemia, because increasing plasma glucose and osmolality by intravenous infusion of hypertonic dextrose produced no increase in plasma vasopressin in diabetics or normals. Tilt tests produced a slightly exaggerated increase in plasma vasopressin in diabetics, but their basal and upright pulse rate, blood pressure, plasma renin activity, norepinephrine, and hematocrit were all normal. The results indicate that in diabetic patients the osmoreceptor for osmotic regulation of vasopressin secretion is reset in such a way that higher plasma vasopressin levels are observed at comparable levels of plasma sodium. The exact cause and consequence of this abnormality remain to be determined.

Effect of insulin on osmoregulation of vasopressin

1987 ◽  
Vol 252 (4) ◽  
pp. E538-E548 ◽  
Author(s):  
T. P. Vokes ◽  
P. R. Aycinena ◽  
G. L. Robertson
Keyword(s):  
Plasma Osmolality ◽  
Insulin Dependent Diabetes Mellitus ◽  
Dependent Diabetes Mellitus ◽  
Plasma Sodium ◽  
Diabetic Patients ◽  
Intravenous Insulin ◽  
Plasma Vasopressin ◽  
Insulin Dependent ◽  
Vasopressin Secretion ◽  
Hypertonic Dextrose

Patients with uncontrolled insulin-dependent diabetes mellitus have elevations in plasma vasopressin that cannot be completely accounted for by recognized stimuli. To determine whether insulin deficiency per se increases plasma vasopressin, we investigated the effect of acute insulin depletion on the osmoregulation of plasma vasopressin in insulin-dependent diabetics. When intravenous insulin infusion was stopped, plasma vasopressin, osmolality, and glucose increased over the ensuing 5 h, whereas plasma sodium decreased, and blood volume and pressure did not change. This increase in vasopressin was not due to a loss of osmoregulation, because changes in plasma osmolality and sodium, induced by infusion of hypertonic saline or water loading, induced appropriate vasopressin responses under insulin deplete as well as replete conditions. However, when plasma osmolality and glucose were raised by infusion of hypertonic dextrose, plasma vasopressin increased significantly in diabetic patients under insulin-deplete but not under insulin-replete conditions and actually decreased in healthy controls. These results indicate that acute insulin depletion increases vasopressin secretion by sensitizing the osmoreceptor to stimulation by hyperglycemia. This change in osmoreceptor specificity may be explained by postulating that glucose transport by osmoreceptor neurons as insulin dependent.

Effect of blood glucose concentration on osmoregulation in diabetes mellitus

1989 ◽  
Vol 256 (3) ◽  
pp. R597-R604 ◽  
Author(s):  
C. J. Thompson ◽  
S. N. Davis ◽  
P. H. Baylis
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Concentration ◽  
Insulin Dependent Diabetes Mellitus ◽  
Dependent Diabetes Mellitus ◽  
Plasma Sodium ◽  
Vasopressin Release ◽  
Plasma Vasopressin ◽  
Insulin Dependent ◽  
Vasopressin Secretion

Poorly controlled insulin-dependent diabetes mellitus is associated with considerable elevations of plasma vasopressin concentrations, although well-controlled diabetics have normal osmoregulated thirst and vasopressin release. We studied the effect of blood glucose concentration on osmoregulated thirst and vasopressin secretion in insulin-dependent diabetes mellitus. Blood glucose was maintained overnight, and for the duration of the study, in either the euglycemic (4-5 mmol/l) or hyperglycemic (10-12 mmol/l) range, and patients underwent infusion of hypertonic (855 mmol/l) sodium chloride solution. Plasma sodium was lower during the hyperglycemic study, but elevation in plasma sodium concentration by infusion of saline caused progressive linear increases in both thirst and plasma vasopressin concentrations in both studies. Linear regression analysis defined lowered plasma sodium thresholds for both thirst appreciation and vasopressin release during the hyperglycemic study, although the sensitivity of the osmoreceptors remained unchanged. Analysis of the data in terms of plasma osmolality, corrected for the increase in blood glucose in the hyperglycemic study, revealed no differences in the osmotic thresholds for thirst or vasopressin release; sensitivity of the osmoreceptors also remained the same. Drinking abolished thirst and lowered plasma vasopressin concentrations before major changes in plasma sodium were observed. These results show that insulin-dependent diabetic patients osmoregulate appropriately when moderately hyperglycemic but that the threshold plasma sodium for vasopressin secretion and thirst appreciation is lowered by an unknown mechanism.

Hepatic drug metabolism is increased in poorly controlled insulin-dependent diabetes mellitus

1990 ◽  
Vol 123 (5) ◽  
pp. 550-556 ◽  
Author(s):  
Steven Goldstein ◽  
Anna Simpson ◽  
Paul Saenger
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Dependent Diabetes Mellitus ◽  
Diabetic Control ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Patients ◽  
Hepatic Drug Metabolism ◽  
Hepatic Drug ◽  
Insulin Dependent ◽  
Cytochrome P 450

Abstract. In addition to increased glycosylation of hemoglobin, abnormalities of other heme proteins such as cytochrome P-450 might also occur in patients with insulin-dependent diabetes mellitus. Antipyrine is a useful marker drug for cytochrome P-450 dependent hepatic drug metabolism. Antipyrine kinetics and urinary excretion of antipyrine metabolites were measured in 14 patients with insulin-dependent diabetes mellitus in poor metabolic control. Improvement in diabetic control in 9 patients, as measured by more normal HbA1 values, led to normalization of plasma antipyrine half-time (t½) and metabolism: the mean antipyrine t½ slowed from 4.7±0.2 (sem) initially to 7.8±0.3 h in these 9 patients and was thus nearly identical to that of normal subjects 8.6±1.0. Antipyrine plasma clearance improved in the 9 diabetic patients whose diabetic control improved. The apparent volume of distribution was normal on both occasions in the diabetic patients. These findings provide a new argument for tight metabolic control in patients with insulin-dependent diabetes mellitus.

scholarly journals FTIR Spectroscopic Investigation of Mineral Structure of Streptozotocin Induced Diabetic Rat Femur and Tibia

2003 ◽  
Vol 17 (2-3) ◽  
pp. 627-633 ◽  
Author(s):  
Handan Boyar ◽  
Belma Turan ◽  
Feride Severcan
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Rat ◽  
Carbonate Content ◽  
Diabetic Patients ◽  
Type I ◽  
Mineral Density ◽  
Insulin Dependent

Diabetes mellitus (DM) can be accepted as a heterogenous multi organ disorder that can affect various systems of the human body. Disorders include retinopathy, neuropathy, cardiomyopathy, musculoskeletal abnormalities such as diminished bone formation and bone healing retardation. Low bone mineral density is often mentioned as a complication for patients with insulin dependent diabetes mellitus (type I DM). Streptozotocin (STZ) induced diabetic rats are good models for investigation of the complications of insulin dependent diabetes. In the present study, the effects of STZ induced diabetes on the mineral environment of rat bones namely femur and tibia were studied by Fourier transform infrared (FTIR) spectroscopic technique. The results revealed that mineral crystal sizes increased and carbonate content decreased for diabetic femur and tibia. These changes can be due to the formation of osteoporosis which is widely seen in diabetic patients.

Islet cell transplantation for insulin-dependent diabetes mellitus: perspectives from the present and prospects for the future

2000 ◽  
Vol 2 (6) ◽  
pp. 1-28 ◽  
Author(s):  
Derek W.R. Gray ◽  
Nicolas Titus ◽  
Lionel Badet
Keyword(s):  
Diabetes Mellitus ◽  
Immune Modulation ◽  
Insulin Dependent Diabetes Mellitus ◽  
Human Islet ◽  
Insulin Dependent Diabetes ◽  
Current Status ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Patients ◽  
Islet Cell Transplantation ◽  
Insulin Dependent

The long-term complications of insulin-dependent diabetes mellitus have become a major health care problem, and it is now clear that they arise from inadequate homeostatic control of blood glucose by injected replacement insulin. Transplantation of pancreatic islets is arguably the most logical approach to restoring metabolic homeostasis in people with diabetes. This review looks at the current status of human islet transplantation and the problems that remain. These include: (1) the limited supply of human islet tissue available for transplantation; (2) the adverse effects of current immunosuppressive protocols on diabetic patients; (3) the problems of primary nonfunction of the transplanted islets; (4) the rejection of islets; and (5) the recurrence of autoimmune diabetic disease. Some of the approaches that might solve these problems are then examined: (1) immune modulation to reduce or prevent immune attack by the recipient's immune system; (2) immunoisolation to prevent recognition of the islet graft; (3) induction of tolerance; (4) xenotransplantation using islets derived from animals; and (5) gene therapy.

Assessing Daily Problems with Diabetes: A Subject-Oriented Approach to Compliance

1995 ◽  
Vol 76 (2) ◽  
pp. 515-521 ◽  
Author(s):  
Gabriele Duran ◽  
Peter Herschbach ◽  
Sabine Waadt ◽  
Friedrich Strian ◽  
Angela Zettler
Keyword(s):  
Diabetes Mellitus ◽  
Psychosocial Stress ◽  
Discriminant Validity ◽  
Reliability And Validity ◽  
Insulin Dependent Diabetes Mellitus ◽  
Self Report ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Patients ◽  
Insulin Dependent

The reliability, construct validity, and discriminant validity of a new self-report questionnaire, the Questionnaire on Stress in Diabetic Patients, were assessed in a sample of 617 patients with insulin-dependent diabetes mellitus and non-insulin-dependent diabetes mellitus. The 90-item inventory is designed to assess psychosocial stress associated with problems in daily living with diabetes. One of the intended uses is to identify psychosocial factors hampering patient compliance with the necessary treatment regimen. Values of Cronbach alpha ranged from 0.63 to 0.88. The results provide initial evidence for the reliability and validity of the instrument.

Abstract P348: Prognostic Value of Exercise Capacity in Patients With Diabetes Mellitus

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Waqas T Qureshi ◽  
Mohammad Zaidan ◽  
Mohammad Alqarqaz ◽  
David Lanfear ◽  
Fatima Khalid ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Exercise Capacity ◽  
Prognostic Value ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Patients ◽  
Social Security Death Index ◽  
Insulin Dependent

Background: Exercise capacity has been shown to predict outcomes in the general population. However, the prognostic value of Exercise capacity in patients with insulin dependent diabetes mellitus (IDDM) and non insulin dependent diabetes mellitus (NIDDM) has not been extensively evaluated. Methods: We included 10768 consecutive diabetic patients (3600 (33%) IDDM and 7168 NIDDM (67%)) who underwent exercise testing between 1991 and 2008. Baseline characteristics and exercise data were collected prospectively at the time of testing including Metabolic Equivalents (METS). The primary endpoint is all cause mortality confirmed by the social security death index. Results: Patents with IDDM were older, more often females (46% vs. 41%) with higher prevalence of hypertension (83% vs. 77%) and prior coronary disease (21% vs. 17%). Patients with NIDDM achieved more than 10 METS more often (36% vs. 30%, p<0.0001). After a median follow-up duration of 6.4 years (Range 1-18 years), 2143 patients (20%) died. Kaplan Meier survival curves are shown below. Using Multivariable Cox Hazard Proportional Analysis, IDDM (Hazard ratio 1.45, 95% CI 1.3 -1.6, p<0.0001 (in comaprison to NIDDM)) and METS achieved (HR 0.82, 95% CI 0.80-0.83, p<0.0001 per METS achieved) were associated with decreased survival. Conclusions: In this large cohort of diabetic patients, decreased Exercise capacity is independently associated with decreased survival over long follow-up duration.

Combination of Low-Dose Niacin and Pravastatin Improves the Lipid Profile in Diabetic Patients without Compromising Glycemic Control

1997 ◽  
Vol 31 (6) ◽  
pp. 677-682 ◽  
Author(s):  
Stephanie F Gardner ◽  
Michael A Marx ◽  
Laura M White ◽  
Mark C Granberry ◽  
David R Skelton ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Lipid Profile ◽  
Low Dose ◽  
Ldl Cholesterol ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Patients ◽  
Insulin Dependent

OBJECTIVE: To determine the efficacy and tolerability of the addition of low-dose niacin (1.5 g/d) in a diabetic hypercholesterolemic population who were unable to attain desired lipid control with low-dose (20 mg) pravastatin monotherapy. RESEARCH DESIGN AND METHODS: This was a prospective, open-label study conducted over a 14-week period. Twenty-three diabetic patients with low-density lipoprotein (LDL) cholesterol concentrations of at least 150 mg/dL after dietary therapy were recruited from the outpatient diabetes clinic of a university teaching hospital. After 4 weeks of dietary stabilization and baseline determination of the lipid profile and glycemic control, patients received pravastatin 20 mg once daily for 4 weeks. Laboratory parameters were reassessed and niacin was added to the regimen in qualifying patients. Over 2 weeks, patients' regimens were titrated to a maximal dosage of 500 mg tid. Patients continued to receive the combination regimen for 4 weeks and were reassessed. MEASUREMENTS AND MAIN RESULTS: Sixteen patients (14 non-insulin-dependent diabetes mellitus, 2 insulin-dependent diabetes mellitus) completed the study. Mean fasting blood sugar and fructosamine concentrations were unchanged throughout the study. Five patients required minor alterations (3 increased, 2 decreased) in their hypoglycemic regimens during the study. The addition of low-dose niacin to pravastatin therapy resulted in a significant lowering of LDL cholesterol compared with pravastatin monotherapy. CONCLUSIONS: Low-dose niacin is a promising addition to hydroxymethylglutaryl-coenzyme A reductase inhibitor therapy in the treatment of hypercholesterolemia in patients with diabetes mellitus.

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