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Biomedical subjects

A Teuscher

Publications and source records attributed to A Teuscher.

At least 19 recordsLinked to original sources
PubMed2006

QTc interval and resting heart rate as long-term predictors of mortality in type 1 and type 2 diabetes mellitus: a 23-year follow-up.

AIMS/HYPOTHESIS: We evaluated the association of QT interval corrected for heart rate (QT(c)) and resting heart rate (rHR) with mortality (all-causes, cardiovascular, cardiac, and ischaemic heart disease) in subjects with type 1 and type 2 diabetes. METHODS: We followed 523 diabetic patients (221 with type 1 diabetes, 302 with type 2 diabetes) who were recruited between 1974 and 1977 in Switzerland for the WHO Multinational Study of Vascular Disease in Diabetes. Duration of follow-up was 22.6 +/- 0.6 years. Causes of death were obtained from death certificates, hospital records, post-mortem reports, and additional information given by treating physicians. RESULTS: In subjects with type 1 diabetes QT(c), but not rHR, was associated with an increased risk of: (1) all-cause mortality (hazard ratio [HR] 1.10 per 10 ms increase in QT(c), 95% CI 1.02-1.20, p = 0.011); (2) mortality due to cardiovascular (HR 1.15, 1.02-1.31, p = 0.024); and (3) mortality due to cardiac disease (HR 1.19, 1.03-1.36, p = 0.016). Findings for subjects with type 2 diabetes were different: rHR, but not QT(c) was associated with mortality due to: (1) all causes (HR 1.31 per 10 beats per min, 95% CI 1.15-1.50, p < 0.001); (2) cardiovascular disease (HR 1.43, 1.18-1.73, p < 0.001); (3) cardiac disease (HR 1.45, 1.19-1.76, p < 0.001); and (4) ischaemic heart disease (HR 1.52, 1.21-1.90, p < 0.001). Effect modification of QT(c) by type 1 and rHR by type 2 diabetes was statistically significant (p < 0.05 for all terms of interaction). CONCLUSIONS/INTERPRETATION: QT(c) is associated with long-term mortality in subjects with type 1 diabetes, whereas rHR is related to increased mortality risk in subjects with type 2 diabetes.

Adult↗
PubMed2003

Effects of alcohol consumption on mortality in patients with Type 2 diabetes mellitus.

AIMS/HYPOTHESIS: Moderate alcohol intake has been associated with increased life expectancy due to reduced mortality from cardiovascular disease. We prospectively examined the effects of alcohol consumption on mortality in Type 2 diabetic patients in Switzerland. METHODS: A total of 287 patients with Type 2 diabetes mellitus (125 women, 162 men), recruited in Switzerland for the WHO Multinational Study of Vascular Disease in Diabetes, were included in this study. After a follow-up period of 12.6+/-0.6 years (means +/- SD), mortality from CHD and from all causes was assessed. RESULTS: During the follow-up, 70 deaths occurred (21 from CHD, 49 from other causes). Compared with non-drinkers, alcohol consumers who drank alcohol 1 to 15 g, 16 to 30 g and 30 g or more per day had the following risk rates of death from CHD: 0.87 (95% CI: 0.25 to 2.51, NS), 0.00 (95% CI: 0.00 to 0.92, p less than 0.05) and 0.37 (95% CI, 0.01 to 2.42, NS), respectively. The corresponding risk rates of death from all causes were 1.27 (95% CI: 0.68 to 2.28, NS), 0.36 (95% CI: 0.09 to 0.99, p less than 0.05) and 1.66 (95% CI: 0.76 to 3.33, NS). CONCLUSIONS/INTERPRETATION: In Swiss Type 2 diabetic patients moderate alcohol consumption of 16 to 30 g per day was associated with reduced mortality from CHD and from all causes. Alcohol intake above 30 g per day was associated with a tendency towards increased all-cause mortality.

Adult↗
PubMed2001

Glycaemia and insulinaemia in elderly European subjects (70-75 years).

AIMS: To determine glycaemia and insulinaemia in elderly subjects aged 70-75 years, living across Europe, who participated in the EURONUT-SENECA (Survey in Europe on Nutrition and the Elderly, a Concerted Action) study. METHODS: Fasting plasma glucose (FPG) and fasting insulin concentrations were measured in 1830 subjects aged 70-75 years living in 15 traditional towns in 11 European countries. For the diagnosis of diabetes, the recommendations of the 1997 report of the American Diabetes Association 'Expert Committee on the diagnosis and classification of diabetes mellitus' were used. RESULTS: A total of 31.6% of the study subjects had either diabetes (17.5%) or impaired fasting plasma glucose (FPG) (14.1%). Fifty-one per cent of the subjects with diabetes were unaware of the disease. No difference in diabetes prevalence was found for sex, but male subjects were more likely to have impaired FPG than female subjects (16.8 vs. 11.5%, P = 0.001). Hyperinsulinaemia (fasting insulin levels in the highest quartile) was associated with increased FPG, body mass index, and waist-to-hip ratio. CONCLUSIONS: It was found that a substantial number of elderly Europeans have impaired glucose homeostasis, with diabetes and impaired FPG being present in almost a third of European subjects aged 70-75 years.

Aged↗
PubMed1998

Human versus porcine insulin in patients with insulin-dependent diabetes mellitus: differences in sleep and the sleep EEG during near-normoglycemia.

To investigate whether porcine insulin (PI) and human insulin (HI) have different effects on brain functions outside of hypoglycemia, sleep and the sleep EEG were recorded in eight insulin-dependent diabetes mellitus (IDDM) patients in three separate sessions of 2 consecutive nights. Near-normoglycemia was confirmed by measurements of capillary blood glucose before and after sleep and at 0145 hours. The treatment effect (PI compared to HI) consisted of a change in the NREM sleep EEG in the spindle frequency range. Spectral power density in the 14-Hz bin was reduced upon transfer from PI (session 1) to HI (session 2) in all subjects, and increased upon reversal to PI (session 3) in all but one subject. There were no significant treatment effects on any other sleep EEG variable or on sleep stages. The subjects rated their sleep as more sound and their state in the morning as more relaxed during PI treatment. They were, however, not blinded to the type of insulin they were using. Porcine insulin and human insulin may exert differential effects on spindle-generating mechanisms in the thalamocortical system. The results indicate that human insulin may affect brain functions differently compared to animal insulin under near-normoglycemic conditions.

Adult↗
PubMed1995

[Incidence of insulin-dependent diabetes mellitus in Switzerland (1972-1993) in 19-year-old men].

There is current debate whether prevalence of insulin-dependent diabetes mellitus is increasing in western countries. In Switzerland every male at age 19 years is legally obligated to appear before the Military Conscript Board, where health status is determined by physicians. We analyzed prevalence data concerning the diagnosis of diabetes mellitus in four full surveys (1972, 1982, 1987, 1993). The study included data from 162,607 Swiss males at age 19 years. Case numbers of birth cohorts and prevalence rates per 1000 are the following: [table: see text] Although the number of years surveyed is limited, trend analysis showed no evidence of an increase in the diabetes rates (total chi 2 = 4.953, DF = 3, 0.1 < p 0.2; chi 2 due to linear regression = 3.013, DF = 1, 0.05 < p < 0.1; chi 2 due to departure from linear regression = 1.940, DF = 2, 0.3 < p < 0.5). Overall cumulative incidence of diabetes mellitus was 1.30/1000 conscripts (95% confidence interval: 1.13-1.48/1000). We conclude that, in contrast to reports from other European countries, the cumulative incidence of insulin dependent diabetes mellitus has not increased among cohorts of Swiss males at age 19 years.

Adult↗
PubMed1993

[Prevalence of diabetes in Switzerland: calculation based on drug sales].

Data on prevalence of diabetes mellitus in Switzerland are scarce. In connection with a EURODIAB project the prevalence of diabetes was assessed in a standardized form, based on sales data for antidiabetic drugs. The prevalence of diabetes treated by specific drugs was calculated on the basis of Swiss sales data for antidiabetic drugs (corrected for combination therapies), the average prescribed daily dosages of insulin and oral antidiabetic drugs (OAD) defined by an inquiry in 38 pharmacies, and the mean annual population of Switzerland. The following prevalence rates were obtained (patients per 1000 inhabitants): [table: see text] Prevalence data obtained by the same, standardized method are higher in France (1.3%), Belgium (1.64%), Sweden (1.7%), and much higher in Italy (2.2%). Calculation based on drug sales data is an easy method of obtaining prevalence rates of diabetes mellitus. In comparison with field studies, discompliance and non-inclusion of diabetics treated only with diet do admittedly lead to low prevalence rates. Nevertheless, the chosen method is very useful for longitudinal observations and for international comparisons.

Diabetes Mellitus↗
PubMed1993

Fetal haemoglobin levels in adult type 1 (insulin-dependent) diabetic patients.

Glycated haemoglobin levels (HbA1 and HbA1c) are established parameters of long-term glycaemic control in diabetic patients. Depending on the method used, fetal haemoglobin interferes with the assays for glycated haemoglobin. If present in high amounts, fetal haemoglobin may lead to overestimation of glycated haemoglobin levels, and therefore, of average blood glucose concentration in diabetic patients. Glycated (HbA1c) and fetal haemoglobin levels were measured by high pressure liquid chromatography in 60 (30 female) adult Type 1 (insulin-dependent) diabetic patients of Swiss descent, and were compared with levels obtained from 60 normal, non-diabetic control subjects matched for age and sex. Fetal haemoglobin levels were significantly higher in the diabetic patients (0.6 +/- 0.1%, mean +/- SEM; range: 0-3.6%) than in the control subjects (0.4 +/- 0.1%, p < 0.001). Elevated fetal haemoglobin levels (> or = 0.6%) were found in 23 of 60 diabetic patients (38%) compared to 9 of 60 control subjects (15%; chi 2 = 8.35, p < 0.01). In addition, fetal haemoglobin levels in diabetic patients are weakly correlated with glycated haemoglobin (HbA1c) (r = 0.38, p < 0.01). Fetal haemoglobin results were confirmed with the alkali denaturation procedure, and by immunocytochemistry using a polyclonal rabbit anti-fetal haemoglobin antibody. A significant proportion of adult patients with Type 1 diabetes has elevated fetal haemoglobin levels. In certain patients this may lead to a substantial over-estimation of glycated haemoglobin levels, and consequently of estimated, average blood glucose levels. The reason for this increased prevalence of elevated fetal haemoglobin remains unclear, but it may be associated with poor glycaemic control.

Adolescent↗
PubMed1991

Risk of severe hypoglycaemia in insulin treated diabetic patients transferred to human insulin: a case control study.

OBJECTIVE: To examine whether transfer from animal insulin to human insulin is associated with an increased risk of severe hypoglycaemia. DESIGN: Matched case-control study of insulin treated diabetic patients admitted to hospital because of hypoglycaemia during 1984-7, the period when human insulin was introduced into treatment. SETTING: Case admissions and control admissions were obtained from eight public hospitals within the Swiss canton of Berne and a second control group comprised members of the Bernese section of the Swiss Diabetes Association. SUBJECTS: 94 patients with insulin treated diabetes with a total of 112 admissions for hypoglycaemia during 1984-7 (case admissions), 182 patients with insulin treated diabetes seen in the same hospitals for reasons other than hypoglycaemia with a total of 225 admissions (control admissions), and 86 insulin treated diabetic patients who were members of the Bernese section of the Swiss Diabetes Association. MAIN OUTCOME MEASURES: Type of insulin used at time of admission, glycaemic control as measured by amount of glycated haemoglobin or glucose concentration; severity of hypoglycaemia. RESULTS: Treatment with human insulin at admission was more common in cases than controls (52/112 (46%) admissions v 77/225 (34%); p = 0.003). 116 out of 129 (90%) of admissions taking human insulin had been transferred from animal insulin, mainly because of non-availability of porcine insulins. The ratio of rate of hypoglycaemia in those taking human insulin to the rate in those taking animal insulin was 2.4 (95% confidence interval 1.3 to 4.4). Other risk factors for hypoglycaemia were a history of hypoglycaemic coma (rate ratio of history to no history 3.8, 2.3 to 6.4) and good glycaemic control (rate ratio of good to poor control 3.9, 1.4 to 7.5). With multivariate analysis the increase in rate ratio associated with use of human insulin rose to 3.0 (1.4 to 6.4). Comparison with the diabetes association controls also showed an increased risk associated with use of human insulin (2.2; 1.1 to 4.8). CONCLUSIONS: Transfer of treatment from animal insulin to human insulin was associated with an increased risk of severe hypoglycaemia. Caution should be exercised when transferring diabetic patients to human insulin. Further studies are required to elucidate why this effect occurs.

Adolescent↗