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Biomedical subjects

A M Roussell

Publications and source records attributed to A M Roussell.

5 recordsLinked to original sources
PubMed1986

Plasma level of 13,14-dihydro-15-keto-PGE2 in patients with diabetic ketoacidosis and in normal fasting subjects.

Plasma levels of 13,14-dihydro-15-keto-PGE2, a stable derivative of PGE2, are elevated in rats with diabetic ketoacidosis (DKA) and decrease in response to insulin therapy. In patients with insulin-dependent diabetes mellitus type I (IDDM) the plasma levels of this derivative also rise in response to insulin withdrawal and then fall in response to insulin replacement. We wished to determine whether the level of this substance is elevated acutely when patients present with DKA and to determine whether the levels fall during treatment. We also wished to identify the origin of the circulating 13,14-dihydro-15-keto-PGE2 in patients with DKA and in normal fasting subjects. We measured the plasma level of 13,14-dihydro-15-keto-PGE2 in five patients with DKA and in six normal subjects during a 24-h fast. In the patients with DKA before treatment, the plasma 13,14-dihydro-15-keto-PGE2 level was threefold above normal. During therapy, the 13,14-dihydro-15-keto-PGE2 level fell toward normal. There was a significant direct correlation between the plasma free fatty acid (FFA) level and the plasma 13,14-dihydro-15-keto-PGE2 level before and during treatment. In addition, the inverse correlation between the plasma free-insulin level and the plasma 13,14-dihydro-15-keto-PGE2 level approached significance (P = .06). In contrast, in the normal fasting subjects the plasma FFA level rose to values comparable to those observed in the patients with DKA, but there was no significant increase in the plasma 13,14-dihydro-15-keto-PGE2 level.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1985

Metabolic response to three years of continuous, basal rate intravenous insulin infusion in type II diabetic patients.

We studied two obese type II diabetic patients before, during, and after 3 yr of continuous iv insulin infusion, delivered by means of totally implanted insulin infusion pumps. Tolerance of the devices was excellent, and no side-effects or episodes of significant hypoglycemia occurred. Glycosuria was eliminated, and mean 24-h plasma glucose and hemoglobin A1c levels decreased in both patients and remained in or near the normal range for 3 yr. Improvements were also noted in serum triglyceride concentrations and vitreous fluorescein concentrations after iv fluorescein injection. Euglycemic insulin clamp studies showed that no significant change in glucose disposal rate occurred after 6 and 12 months of treatment. However, some improvement in insulin secretion during hyperglycemic insulin clamp studies occurred in both patients after 6 months of insulin infusion. Evaluation of the insulin-glycerol mixture used in the pump revealed that moderate degradation of insulin occurred in the pump during the 21-day flow cycle, resulting in 6-12% increases in fasting blood glucose levels; in addition, higher mol wt species of immunoreactive insulin were present in the patients' serum. We conclude that long term continuous iv infusion of insulin using a totally implantable infusion pump is practical in type II diabetic patients, is acceptable to patients, and is capable of providing near-normal glycemic control.

Blood Glucose↗
PubMedDate not supplied

Basal-rate intravenous insulin infusion compared to conventional insulin treatment in patients with type II diabetes. A prospective crossover trial.

We compared continuous basal-rate intravenous insulin infusion, delivered by means of a totally implantable pump, to two types of conventional insulin administration in patients with type II (non-insulin-dependent) diabetes in a prospective crossover trial. Ten patients entered the study, and 5 completed all three 8-mo study periods. When results from the infusion study period were compared with results from the period involving single daily injections of ultralente insulin, significant improvements were noted in the pump arm in glycosylated hemoglobin concentrations (which were nearly normal), M-component values, mean daily outpatient fasting blood glucose concentrations, mean fasting and 24-h blood glucose concentrations during an inpatient 24-h glycemic profile, and urinary glucose concentrations. When the pump arm was compared to a period of single daily injections of lente insulin, three of six monthly mean fasting blood glucose concentrations and overall means for the entire study period were significantly lower during the pump arm than during the lente arm; in addition, significantly fewer hypoglycemic reactions were noted during infusion therapy than during lente therapy. Finally, mealtime free-insulin and C-peptide excursions appeared to be greater during infusion treatment when compared with lente or ultralente treatment. In the 50% of patients who completed the study, it appeared that significant improvements in glycemic control could be achieved by simple basal-rate intravenous insulin infusion compared with conventional treatment with single daily injections of ultralente or lente insulin without an increased incidence of symptomatic hypoglycemia.

Adult↗