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Biomedical subjects

B Gonen

Publications and source records attributed to B Gonen.

At least 55 records · Page 3Linked to original sources

Hemoglobin A1 and diabetic retinopathy.

The levels of the minor hemoglobin A1 components were measured in a consecutive series of 102 diabetic patients who were extensively studied for signs of diabetic retinopathy. We found a statistically significant relationship between metabolic control, as reflected by the hemoglobin A1 level, and the severity of diabetic retinopathy in patients with diabetes diagnosed before 30 years of age (P less than or equal to .001). We did not demonstrate a significant correlation between metabolic control and the severity of retinopathy in patients with diabetes diagnosed after the age of 30 years. We found significantly more severe retinopathy among patients with longer duration of the disease, in men, in whites, in diabetics diagnosted before 30 years of age who were treated with lower insulin doses, and in obses patients with the onset of diabetes after the age of 30 years.

Adult↗

Metabolic control in diabetic patients: assessment by hemoglobin A1 values.

Hemoglobin A1 concentrations were measured in 230 patients with diabetes mellitus. Diabetic patients controlled by diet alone had significantly lower HbA1 levels compared to the insulin or oral hypoglycemic treated groups. Only 13% of insulin-treated patients had HbA1 levels below 10%, while 26% of the oral agent treated group and 70% of the diet treated group fell into this range. The HbA1 levels correlated with fasting and nonfasting plasma glucose concentrations. However, in certain patients, discrepant results between these two variables were found. Hemoglobin A1 was measured on three or more occasions in 60 patients over a 1-yr period. An improvement was noted in 40%, no change in 38%, and a deterioration in 22%. Hemoglobin A1 measurements have proved to be useful in the follow-up and treatment of diabetic patients.

Adolescent↗

Familial nesidioblastosis: severe neonatal hypoglycemia in two families.

Severe neonatal hypoglycemia with pathologic findings of diffuse nesidoblastosis of the pancreas is described in five children of both sexes from two families with unaffected parents. This appears to represent an autosomal recessive disorder of pancreatic development. Despite extensive testing, the diagnosis of hyperinsulinism was difficult in the index case of each family and delayed definitive treatment. Medical therapy with steroids and diazoxide was unsuccessful; pancreatectomy was required to treat persistent hypoglycemia. An abnormality of circulating glucagon found in one child with this disorder suggested that hyperinsulinism may not be the sole hormonal imbalance present, but rather that this disease is one of generalized disturbance of islet cell function. The history of severe, persistent neonatal hypoglycemia in an older sibling should lead the physician to investigate subsequent children for the presence of asymptomatic hypoglycemia.

Chromosome Aberrations↗

An 'artificial beta cell' for control of diabetes mellitus: effect on plasma glucagon levels.

We have investigated the use of a glucose-controlled insulin infusion system, or artificial beta cell. On the feedback day, mean plasma glucose was significantly effect of improved control on plasma glucagon levels. Five insulin-requiring diabetic subjects in stable control were hospitalized for two 24 h periods. During one, they were given their usual dose(s) of subcutaneous insulin. In the other, the 'feedback' day, insulin administration was under feedback control by the artificial beta cell. One the feedback day, mean plasma glucose was significantly-lower in all subjects. Variability in plasma glucose throughout the day was also significantly less on the feedback day. All five subjects showed a significant fall in serum immunoreactive glucagon levels on the feedback day, suggesting that the glucagon abnormalities of diabetes may be secondary to the insulin deficiency, rather than a second primary defect of diabetes.

Adult↗

Metabolic control in diabetic patients. Effect of insulin-secretory reserve (measured by plasma C-peptide levels) and circulating insulin antibodies.

We measured circulating hemoglobin A1 (HbA1) and fasting plasma C-peptide concentrations in 100 diabetic patients. Pancreatic insulin reserve showed a negative correlation with HbA1 concentrations in nonobese, insulin-treated patients but not in obese patients, whether they were treated with insulin, oral agent, or diet alone. Patients with fasting C-peptide concentrations above 0.1 pmol/ml had significantly better metabolic control than did those with lower values. Anti-insulin antibodies were measured in 37 patients. There was no correlation between metabolic control and the affinity constants or binding capacities of these antibodies.

Adult↗

3H-thymidine, 3H-uridine and 3H-leucine uptake in erythroblasts of patients with chronic renal failure.

The in vitro incorporation of 3H-thymidine, 3H-uridine and 3H-leucine, reflecting the synthetic capacity for DNA, RNA and protein, respectively, was detected by radioautography in the erythroid precursors of 10 patients with chronic renal failure. The results were compared with the uptake of the isotopes in the erythroid precursors of healthy subjects. The pattern of incorporation for all three isotopes in the patients' cells was similar to that of control cells, but significantly lower. The possible causes of this difference are discussed.

Adult↗

Haemoglobin A1: An indicator of the metabolic control of diabetic patients.

The level of the minor glycosylated haemoglobins (HbA1) in ambulatory diabetic patients correlated closely with their physicians' ratings of the degree of control and their fasting plasma-glucose levels. In patients admitted to hospital for more detailed study, HbA1 correlated significantly with the mean fasting glucose, mean daily glucose, and highest daily glucose values. HbA1 measurement is a simple, rapid, and objective procedure to assess diabetic control and may serve both as a screening test for uncontrolled diabetes and as an indicator of the efficacy of various therapeutic regimens.

Adolescent↗