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Biomedical subjects

B Willms

Publications and source records attributed to B Willms.

At least 19 recordsLinked to original sources
PubMed1991

[Alcohol-induced hypoglycemia in type I diabetic patients].

The hypoglycemic effect of alcohol, probably caused by inhibition of gluconeogenesis in the liver, is well known. However, accurate data on the effect of usual amounts of alcohol on the blood sugar in type 1 diabetics are not available. We therefore investigated the effect of an evening dose of alcohol on the blood sugar in 23 male type 1 diabetics (age 32.8 [20 to 64] years, duration of diabetes 11.5 [0.5 to 38] years, Broca index 0.98 [0.83 to 1.34] HbAlc 8.4 [5.8 to 12.2]%). On one day, the diabetics were given 0.56 g ethanol per kg body weight to drink in the evening, corresponding to about one liter of diabetic beer, on another day, the same volume of mineral water. In addition, eleven of the 23 patients received half the amount of alcohol on a third evening. Between 7 and 11 o'clock in the morning after alcohol consumption, blood glucose levels were significantly lower. The number of hypoglycemic episodes in the morning of the day following alcohol administration was appreciably greater. Usual amounts of alcohol consumed after the evening meal thus increase the risk of hypoglycemia the following morning. Diabetics should be instructed accordingly.

Adult↗
PubMed1991

[Delayed absorption of carbohydrates in the therapy of Type II diabetes: comparison between dietary (Muesli) and pharmacological (Alpha-glucosidase inhibition) modification].

Slowly resorbable carbohydrates are preferred in the dietetic therapy of patients with type 2 diabetes. In this study we compared the efficacy of a "müsli" with the alpha-glucosidase inhibitor miglitol in delaying the resorption of carbohydrates. 24 patients with NIDDM took, in randomized order, four different breakfasts with equal amounts of carbohydrate: a standard breakfast with bread and marmelade, a müsli, and both breakfasts with 100 mg miglitol. We calculated the maximal blood glucose concentration, the postprandial difference, the time of the maximum and the area under the curve (AUC). The postprandial blood glucose increase after the müsli breakfast was significantly lower compared with the standard breakfast (maximal blood glucose 12.3 vs. 13.9 mmol/l, postprandial difference 3.6 vs. 5.1 mml/l, AUC 360 vs, 468 mmol/l x min). The blood glucose increase after the standard breakfast with miglitol was even lower (maximum 11.6 mmol/l, postprandial difference 2.9 mmol/l, AUC 241 mmol/l x min). Miglitol also lowered the blood glucose values after the müsli breakfast. This study shows that the alpha-glucosidase inhibitor miglitol in a dose of 100 mg is more effective in lowering the postprandial blood glucose increase than a müsli. In cases of non-acceptance of a modern diet with slowly resorbable carbohydrates, alpha-glucosidase inhibitors may be a therapeutic alternative.

1-Deoxynojirimycin↗
PubMed1990

[A new fructosamine test--as a routine parameter in the control of diabetes].

Measurement of protein glycation (fructosamine) has become an accepted tool in diabetes diagnostics. Among different methods available, the serum fructosamine test published by Johnson and Baker in 1983 has gained wide acceptance due to a simple and easily automated assay procedure providing clinically meaningful results. A recent modification of the Nitroblue Tetrazolium (NBT) reagent, improved by addition of tensides and uricase, exhibits lower interference by lipaemia and urate. It is also less affected by the sample matrix and yields results closer to the physiological range of glycated proteins. Furthermore, a completely new standardization protocol was used in the preparation of calibration material. The new colorimetric method for the determination of fructosamine was evaluated in 12 European clinical laboratories.

Blood Glucose↗
PubMed1990

[Effect of a change in posture on the diurnal variations of fructosamine concentration in diabetic patients].

Daily profiles of blood glucose, HbA1c, total protein and fructosamine were measured in 10 diabetic patients and the factor fructosamine x 7/g total protein was calculated. Measurements were done at 4 a.m. to be sure that the patients were sleeping for some time, during the day and the following evening at 11 p.m., when the patients were lying again, so that the influence of orthostasis, the difference between bed rest and walking could be demonstrated. The blood glucose profile was typical whereas the HbA1c concentration was very stable and constant. Total protein and fructosamine increased significantly by orthostasis; the correction of fructosamine by total protein diminished the differences, but did not completely eliminate the effect of orthostasis. However, fructosamine should be corrected by the total protein concentration in order to increase the diagnostic value of the parameter.

Adolescent↗
PubMed1988

[Allergy to human insulin. Case reports on 3 patients].

Allergy against human insulin was demonstrated in three diabetics who had not previously been treated with animal-derived insulin. In all three patients the allergy developed within a few weeks or months of starting insulin treatment. The diagnosis was confirmed by intracutaneous tests and determination of insulin-specific IgE antibodies. Desensitisation was necessary in one patient, in the other two the allergic symptoms were successfully treated by local measures. Two of the patients are at present well controlled on human insulin, while the third is still undergoing desensitisation. Such cases of primary allergy against human insulin have not previously been reported in the German medical literature.

Aged↗
PubMed1988

Preferential release of proinsulin relative to insulin in non-insulin-dependent diabetes mellitus.

A radioimmunoassay, using an antiserum that is specific for human proinsulin, has been used to study the response of serum proinsulin to low (25 g) and high (75 g) oral glucose loads in non-obese patients with non-insulin-dependent diabetes mellitus (NIDDM). Diabetic patients were treated by diet only (N = 8) or were receiving oral anti-hyperglycemic agents (N = 8) and therapy was not interrupted during the study. In the fasted state, proinsulin concentrations were higher (P less than 0.05) in the drug-treated patients (31 +/- 3 pmol/l (SEM)) compared with age- and weight-matched healthy subjects (22 +/- 2 pmol/l; N = 10), but concentrations in the diet-treated patients 25 +/- 3 pmol/l) were not significantly different. Following 25 g and 75 g glucose loads, the rises in serum immunoreactive insulin and C-peptide concentrations in both groups of diabetic patients were impaired and delayed relative to those in the control subjects. The responses of serum proinsulin, however, were not significantly different in the NIDDM patients compared with controls at any time point up to 180 min except in the case of drug-treated patients receiving 25 g of glucose who had elevated (P less than 0.05) proinsulin concentrations at 150 min and 180 min after ingestion. It is concluded that NIDDM is not associated with an exaggerated release of proinsulin in response to glucose compared with healthy subjects, but the islets have maintained the ability to release proinsulin better than the ability to release insulin.

Adult↗
PubMed1987

Physical factors influencing the blood glucose response to different breads in type II diabetic patients.

Blood glucose responses to test meals containing 75 g of different breads were compared in 103 type II diabetic patients under sulfonyl urea treatment. Nine breads differing in type of cereal, physical structure, and dietary fiber content were studied using pairwise intraindividual comparisons. It could be shown that the type of cereal and the fiber content had no significant influence upon the maximal or mean postprandial blood glucose increase. Coarse-grained breads, however, resulted in significantly lower blood glucose responses than breads that were finer grained or were produced from flour. Physical properties determining the access of intestinal hydrolytic enzymes to ingested carbohydrates seem to be major factors that influence postprandial blood glucose responses.

Adult↗
PubMed1985

[Hypoglycemia with loss of consciousness during insulin therapy as an initial symptom of Addison's disease. Report of 2 cases].

Within a six-month period, two type-I diabetics were admitted because of labile metabolic state with recurrent severe hypoglycaemia and unconsciousness. In both patients electrolytes were normal on admission. There were at first only few pointers to Addison's disease. But in both primary adrenocortical insufficiency was demonstrated to be the cause of the symptoms. Serological tests suggested an autoimmune genesis. Recurrent severe hypoglycaemia and unconsciousness in insulin-treated diabetics indicates that adrenocortical insufficiency should be excluded.

Addison Disease↗
PubMed1979

[Clinical implication of serum insulin determination. Diagnosis and prognosis in patients with apparent secondary failure of treatment with sulfonylureas (author's transl)].

Serum insulin was measured after maximal stimulation in 213 patients with apparent secondary failure of treatment with sulfonylureas. The maximal increase of serum insulin was 327% of baseline in patients treated with oral drugs alone and 175% in patients switched to insulin. The control of diabetes in the patients treated with oral drugs alone was investigated 2 to 3 years later by a questionnaire and correlated to the insulin values measured earlier. Following conclusions were drawn: Sulfonylurea treatment is indicated if the increase of serum insulin is more than 300%. If the increase of serum insulin is below 200%, insulin treatment is necessary now or in the near future. The determination of serum insulin after maximal stimulation in patients with apparent secondary failure of sulfonylurea treatment has a diagnostic as well as a prognostic value.

Blood Glucose↗
PubMed1979

[Diabetic neuropathic cachexia (author's transl)].

Marked weight loss with cachexia together with severe depression and pain from symmetrical peripheral neuropathy were noted in a 66-year-old man, known to have had diabetes for six years, which required insulin on admission to hospital. The patient died of bronchopneumonia after one year. The severe neuropathy was proven both neurophysiologically and at necropsy. There was no diabetic retinopathy and no histological evidence of renal glomerulosclerosis. There was no evidence of a malignant tumour either clinically or at necropsy.

Aged↗
PubMed1979

[Interaction between naproxen and tolbutamide on metabolism in diabetics].

In a double blind study 16 maturity onset diabetics were treated with d-2-(6-methoxy-2-naphthyl)-propionic acid (naproxen) and tolbutamide with a view to possible interactions between both drugs. There were no significant differences between blood glucose levels after placebo and naproxen, respectively. The concentrations of tolbutamide were not significantly different, either. Thus diabetics on tolbutamide can be treated additionally with naproxen without any clinical side effect on carbohydrate metabolism.

Adult↗
PubMed1978

HLA-typing in juvenile diabetics with and without positive family history and in families with one and two diabetic siblings.

HLA-typing was performed in two groups of juvenile-onset diabetics, one with (n = 58) and one without (n = 109) a family history of the disease. The association of this type of diabetes with certain HLA antigens (excess of B8 and B15, shortage of B7) was confirmed. No heterogeneities could be established between the two groups. This suggests that the aetiologic basis in single and familial cases of juvenile diabetes is the same. The hypothesis, that the B8 associated gene is more penetrant than the B15 associated gene, cannot be confirmed. Haplotypes were determined in families with one and two diabetic siblings. The findings of high haplotype concordance among diabetic siblings was confirmed: concordance of 2, 1 and 0 haplotypes in 7, 5 and 3 pairs respectively. There was a low degree of haplotype concordance between diabetics and nonaffected siblings in the families with two diabetics: 2, 1, and 0 haplotypes in 2, 8 and 6 pairs respectively. This led to the hypothesis of negative selection against these HLA-linked "diabetogenic" genes. This tendency was not, however, observed in families with only one diabetic. The report of a high recombination rate in families with juvenile diabetics could not be confirmed.

Adolescent↗