scholarly journals HbA1 in the Diagnosis of Factitious Remission of Diabetes

1988 ◽  
Vol 25 (2) ◽  
pp. 150-154 ◽  
Author(s):  
A J Krentz ◽  
P J Hale ◽  
E C Albutt ◽  
M Nattrass
Keyword(s):  
Type I Diabetes ◽  
Insulin Dose ◽  
Type I ◽  
Self Administration ◽  
Glucose Levels ◽  
Endogenous Insulin ◽  
Blood Glucose Levels ◽  
Metabolite Profiles ◽  
Remission Of Diabetes ◽  
Endogenous Insulin Production

A case of factitious remission of type I diabetes in an adolescent girl is reported. The clue to diagnosis came from an inconsistency between clinic blood glucose levels and the corresponding values of glycosylated haemoglobin. Investigations of 24 h hormone and metabolite profiles demonstrated discrepancies between insulin dose, endogenous insulin production and free insulin levels which provided confirmatory evidence of surreptitious self-administration of insulin by the patient.

Urinary C-Peptide: A Useful Tool for Evaluating the Endogenous Insulin Reserve in Cohort and Longitudinal Studies of Diabetes in Childhood

1988 ◽  
Vol 25 (5) ◽  
pp. 552-559 ◽  
Author(s):  
C E de Beaufort ◽  
N C den Boer ◽  
G J Bruining ◽  
G A M Eilers ◽  
R van Strik ◽  
...  
Keyword(s):  
Linear Correlation ◽  
Type I Diabetes ◽  
Insulin Dose ◽  
Type I ◽  
Exogenous Insulin ◽  
Insulin Production ◽  
C Peptide ◽  
Endogenous Insulin ◽  
Diabetic Children ◽  
Endogenous Insulin Production

Increasing research into the remission phase of type I diabetes mellitus stresses the importance of a non-traumatic and reliable method for the evaluation of endogenous insulin production. We compared 24-h urinary C-peptide excretion (UCE) with plasma C-peptide values before and after stimulation with 1 mg glucagon in 24 type I diabetic children. Fasting plasma C-peptide values and stimulated plasma C-peptide values showed a linear correlation with 24 h UCE. Mean plasma C-peptide levels correlated inversely with the exogenous insulin dose. A slightly better correlation was found between the exogenous insulin dose and 24 h UCE. Control data of 24 h UCE were obtained from healthy siblings. A linear correlation with age was found up to 10 years of age above which UCE values seem to reach a plateau. This effect of age, as well as the frequency of sampling was taken into account in the derivation of 95% reference intervals for UCE. The measurement of 24 h UCE appears to be a useful parameter to assess endogenous insulin production in diabetic children, provided that age is taken into account.

Antidiabetic effect of Psychotria malayana Jack in induced type 1 diabetic rat

MEDISAINS ◽  
2020 ◽  
Vol 18 (1) ◽  
pp. 19
Author(s):  
Fairuz Fairuz ◽  
Hasna Dewi ◽  
Humaryanto Humaryanto
Keyword(s):  
Blood Glucose ◽  
Side Effects ◽  
Type I Diabetes ◽  
Langerhans Cell ◽  
Diabetic Rat ◽  
Type I ◽  
Antidiabetic Effect ◽  
Glucose Levels ◽  
Blood Glucose Levels

Background: Therapies for hyperglycemic treatment, including insulin and oral diabetes medications, have been confirmed to cause several side effects. Thus, finding new drugs with fewer side effects is of high importance. Salung leaf herb (Psychotria malayana Jack) reported used in traditional societies as a treatment for diabetes. However, the scientific proof of this plant for diabetes treatment is still lacking.Objective: To evaluate the antidiabetic effect of the P. malayana jack in induced type 1 diabetic rats by assessing blood glucose level and pancreatic cells in white rats.Methods: Alloxan used to induce type I diabetes. Rats randomly divided into six groups. A Group P1 received 250 mg/kg BW; group P2 received 500 mg/kg BW, group P3 received 1000 mg/kg BW. While group 4 basal received no treatment, group 5 received distilled water as a negative control, and group 6 received glibenclamide as a positive control. Medications are given for six days. Glucose levels were measured, and observation of pancreatic Langerhans cell damages.Results:  A decrease in blood glucose levels observed in all treatment groups. The most significant reduction (49.76%; 1000 mg/kg BW) occurred in the P3 group. Morphological features of pancreatic Langerhans cell damage were slightly high in the P1 group.Conclusion: P. malayana Jack can consider having an antidiabetic effect in a type 1 diabetic rat by reducing blood glucose levels.

Predicting Blood Glucose Levels Around Meals for Patients With Type I Diabetes

2010 ◽  
Author(s):  
Fraser Cameron ◽  
Gu¨nter Niemeyer
Keyword(s):  
Blood Glucose ◽  
Type I Diabetes ◽  
Type I ◽  
Start Time ◽  
Predictive Algorithm ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Multiple Hypothesis ◽  
Continuous Glucose Monitors

Insulin pumps and continuous glucose monitors enable automatic control of blood glucose (BG) levels for patients with type 1 diabetes. Such controllers should carefully assess the likely future BG levels before injecting insulin, since the effects of insulin are prolonged, potentially deadly, and irreversible. Meals pose a strong challenge to this assessment as they create large, fast disturbances. Fortunately, meals have consistent and predictable effects, if their size and start time are known. We present a predictive algorithm that embeds meal detection and estimation into BG prediction. It uses a multiple hypothesis fault detector to identify meal occurrences, and linear Kalman filters to estimate meal sizes. It extrapolates and combines the state and state covariance estimates to form a prediction of BG values and uncertainties. These inputs enable controllers to assess and trade off the acute risks of low and chronic risks of high BG levels. We evaluate the predictor on simulated and clinical data.

Current Approaches in Diabetes Treatment and Other Strategies to Reach Normoglycemia

2020 ◽  
Vol 20 (32) ◽  
pp. 2922-2944
Author(s):  
Worood Sirhan ◽  
Ron Piran
Keyword(s):  
Blood Glucose ◽  
Current Knowledge ◽  
Type I Diabetes ◽  
Current Status ◽  
Control Individual ◽  
Diabetic Patients ◽  
Regulation Mechanism ◽  
Type I ◽  
Glucose Levels ◽  
Blood Glucose Levels

: Cells are mainly dependent on glucose as their energy source. Multicellular organisms need to adequately control individual glucose uptake by the cells, and the insulin-glucagon endocrine system serves as the key glucose regulation mechanism. Insulin allows for effective glucose entry into the cells when blood glucose levels are high, and glucagon acts as its opponent, balancing low blood glucose levels. A lack of insulin will prevent glucose entry to the cells, resulting in glucose accumulation in the bloodstream. Diabetes is a disease which is characterized by elevated blood glucose levels. All diabetes types are characterized by an inefficient insulin signaling mechanism. This could be the result of insufficient insulin secretion, as in the case of type I diabetes and progressive incidents of type II diabetes or due to insufficient response to insulin (known as insulin resistance). We emphasize here, that Diabetes is actually a disease of starved tissues, unable to absorb glucose (and other nutrients), and not a disease of high glucose levels. Indeed, diabetic patients, prior to insulin discovery, suffered from glucose malabsorption. : In this mini-review, we will define diabetes, discuss the current status of diabetes treatments, review the current knowledge of the different hormones that participate in glucose homeostasis and the employment of different modulators of these hormones. As this issue deals with peptide therapeutics, special attention will be given to synthetic peptide analogs, peptide agonists as well as antagonists.

The effect of pirenzepine on growth hormone and blood glucose levels in Type I diabetes mellitus

1988 ◽  
Vol 117 (3) ◽  
pp. 315-319 ◽  
Author(s):  
P. Pietschmann ◽  
G. Schernthaner
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Type I Diabetes ◽  
Anticholinergic Drug ◽  
Serum Levels ◽  
Type I Diabetes Mellitus ◽  
Diabetic Patients ◽  
Type I ◽  
Glucose Levels ◽  
Blood Glucose Levels

Abstract. Increased GH levels in Type I diabetes mellitus have been implicated in the pathogenesis of metabolic complications such as the so-called dawn phenomenon. GH secretion is under control of cholinergic mechanisms. In 21 Type I diabetic patients the effect of oral administration of the anticholinergic drug pirenzepine in addition to intensive insulin therapy on GH and blood glucose levels was studied. At 21.30, 08.00 and 12.00 h, all patients received in random order 50 mg of pirenzepine or placebo po. Blood for determination of GH, blood glucose, cortisol and Cpeptide levels were obtained at 3-h intervals. Serum levels of plasma glucose and GH were significantly lower under pirenzepine than under placebo (P < 0.05 and P < 0.01, respectively). Serum levels of cortisol, free insulin and C-peptide were comparable on the test and the control day. Our data indicate that in Type I diabetes mellitus the anticholinergic drug pirenzepine is effective in decreasing both GH and blood glucose levels.

Electron microscopy analysis of degenerating pancreatic ß cells in transgenic mice expressing the MHC Class I antigen Dd

1990 ◽  
Vol 48 (3) ◽  
pp. 548-549
Author(s):  
T. A. Stewart ◽  
D. Liggitt ◽  
S. Pitts ◽  
L. Martin ◽  
M. Siegel ◽  
...  
Keyword(s):  
Type I Diabetes ◽  
Disease Process ◽  
Class Ii ◽  
Class I ◽  
Type I ◽  
Aberrant Expression ◽  
Mhc Molecules ◽  
Endogenous Insulin ◽  
Class Ii Mhc ◽  
Ifn Γ

Insulin-dependant (Type I) diabetes mellitus (IDDM) is a metabolic disorder resulting from the lack of endogenous insulin secretion. The disease is thought to result from the autoimmune mediated destruction of the insulin producing ß cells within the islets of Langerhans. The disease process is probably triggered by environmental agents, e.g. virus or chemical toxins on a background of genetic susceptibility associated with particular alleles within the major histocompatiblity complex (MHC). The relation between IDDM and the MHC locus has been reinforced by the demonstration of both class I and class II MHC proteins on the surface of ß cells from newly diagnosed patients as well as mounting evidence that IDDM has an autoimmune pathogenesis. In 1984, a series of observations were used to advance a hypothesis, in which it was suggested that aberrant expression of class II MHC molecules, perhaps induced by gamma-interferon (IFN γ) could present self antigens and initiate an autoimmune disease. We have tested some aspects of this model and demonstrated that expression of IFN γ by pancreatic ß cells can initiate an inflammatory destruction of both the islets and pancreas and does lead to IDDM.

scholarly journals Intraperitoneal insulin administration in pigs: effect on circulating insulin and glucose levels

2021 ◽  
Vol 9 (1) ◽  
pp. e001929
Author(s):  
Ilze Dirnena-Fusini ◽  
Marte Kierulf Åm ◽  
Anders Lyngvi Fougner ◽  
Sven Magnus Carlsen ◽  
Sverre Christian Christiansen
Keyword(s):  
Systemic Circulation ◽  
Subcutaneous Insulin ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Endogenous Insulin ◽  
Blood Glucose Levels ◽  
Intraperitoneal Insulin ◽  
A Minor ◽  
Design And Methods ◽  
Mean Blood Glucose

IntroductionThe effect of intraperitoneal insulin infusion has limited evidence in the literature. Therefore, the aim of the study was to investigate the pharmacokinetics and pharmacodynamics of different intraperitoneal insulin boluses. There is a lack of studies comparing the insulin appearance in the systemic circulation after intraperitoneal compared with subcutaneous insulin delivery. Thus, we also aimed for a comparison with the subcutaneous route.Research design and methodsEight anesthetized, non-diabetic pigs were given three different intraperitoneal insulin boluses (2, 5 and 10 U). The order of boluses for the last six pigs was randomized. Endogenous insulin and glucagon release were suppressed by repeated somatostatin analog injections. The first pig was used to identify the infusion rate of glucose to maintain stable glucose values throughout the experiment. The estimated difference between insulin boluses was compared using two-way analysis of variance (GraphPad Prism V.8).In addition, a trial of three pigs which received subcutaneous insulin boluses was included for comparison with intraperitoneal insulin boluses.ResultsDecreased mean blood glucose levels were observed after 5 and 10 U intraperitoneal insulin boluses compared with the 2 U boluses. No changes in circulating insulin levels were observed after the 2 and 5 U intraperitoneal boluses, while increased circulating insulin levels were observed after the 10 U intraperitoneal boluses. Subcutaneously injected insulin resulted in higher values of circulating insulin compared with the corresponding intraperitoneal boluses.ConclusionsSmaller intraperitoneal boluses of insulin have an effect on circulating glucose levels without increasing insulin levels in the systemic circulation. By increasing the insulin bolus, a major increase in circulating insulin was observed, with a minor additive effect on circulating glucose levels. This is compatible with a close to 100% first-pass effect in the liver after smaller intraperitoneal boluses. Subcutaneous insulin boluses markedly increased circulating insulin levels.

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