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Biomedical subjects

C B Kahn

Publications and source records attributed to C B Kahn.

36 records · Page 2Linked to original sources
PubMed1978

Haemoglobin Aic (glycohaemoglobin) in diabetic pregnancy: an indicator of glucose control and fetal size.

Haemoglobin AIc (Hb AIc), a glycohaemoglobin present in normal human blood, is elevated in glucose intolerant individuals. In non-pregnant diabetic subjects, a direct relationship has been established between per cent Hb AIc and blood and urinary glucose levels over weeks and months. In this study, Hb AIc level and mean random blood glucose concentration in the third trimester of pregnancy were found to correlate directly in 12 diabetic women without vascular disease (P less than 0.001). In this same group of women, third trimester Hb AIc levels also correlated significantly with infant birth weight (P less than 0.05) and birth weight adjusted for gestational are (P less than 0.01). Finally, third trimester mean blood glucose concentrations also correlated directly with birth weight (P less than 0.05) and adjusted birth weight (P less than 0.001). In pregnancies complicated by diabetes, rigid glucose control has been recommended to achieve optimal fetal and maternal outcomes. Hb AIc is a new tool with which to assess blood glucose control during diabetic pregnancy.

Birth Weight↗
PubMed1978

A model of glucose-insulin homeostasis in man that incorporates the heterogeneous fast pool theory of pancreatic insulin release.

Current physiologic knowledge about glucose-insulin homeostasis in liver, brain, pancreas, kidney, peripheral tissues, and central vascular organs has been synthesized to form a whole-system mathematical model of glucose metabolism in normal, ideal man. In addition to data of other workers, results from more than 100 intravenous glucose tolerance tests, including variable dosage, variable duration of infusion, and double pulse studies, were used to determine model structure and parameters. Model and clinical testing have focused particularly on the fast phase of insulin response to vascular glucose. The model incorporates blood circulation and equilibration of substances between vascular and interstitial spaces, and it assumes constant fractional clearance of insulin by liver and kidney. Studies using a double pulse of glucose suggest that the time derivative of glucose level is not the sole or predominant influence on fast phase insulin release, but that preinfusion glucose level and/or previous glucose exposure of the pancreas are also important. Variable dosage glucose studies suggest that the amount of insulin released during the fast phase rather than the insulin release rate is regulated by the glucose level. A two-pool, heterogeneous threshold mechanism for beta cell response to glucose is presented that is compatible with the clinical results.

Computers↗
PubMed1976

[The effect of caffeine on the serum insulin level during intravenous glucose tolerance test in patients with chemical diabetes].

Nine mild male diabetic patients were studied by intravenous glucose tolerance tests with and without pretreatment with caffeine. The dose of caffeine was 90 mg given as 195 mg of caffeine citrate. The parameters measured were blood glucose and serum insulin. Caffeine given 2 hours previously did not affect the mean glucose disappearance rate of the group, however, those with the highest rates did show a reduced rate after caffeine. Insulin levels showed a decrease particularly during the first five minutes after glucose. This finding was present particularly in those patients who exhibited the larger first peak. It is possible that a relationship exists between the magnitude of the caffeine effect upon early insulin secretion and the glucose disappearance rate.

Adult↗
PubMed1975

Dynamics of tolbutamide, glucose, and insulin interrelationships following varying doses of intravenous tolbutamide in normal subjects.

Four healthy adult subjects received intravenous tolbutamide (TOL) at six different doses (twenty-four tests): 0.0625 gm., 0.125 gm., 0.25 gm., 0.5 gm., 1.0 gm. and 1.5 gm. Blood glucose (BG), serum immunoreacctive insulin (IRI) and serum TOL levels were determined before and for 180 minutes after TOL. There was a highly significant correlation of the dose of TOL with the peak IRI (p less than .01), zero to ten minute IRI area (p less than .001), and zero to sixty minute IRI area (p less than .001) and with the decline in BG expressed as zero to sixty minute BG area (p less than .001). Similar significant correlations were observed between levels of TOL and both IRI and BG. At each dose level the IRI response correlated significantly with the BG fall. An additional eighteen subjects received the 1.0 gm. dose. In these, serum TOL levels did not correlate with either BG or IRI. These subjects also received intravenous glucose (0.5 gm. per kilogram body weight). BG levels did not correlate with IRI. However, there were striking correlations between TOL and glucose-stimulated peak IRI (p less than .001), zero to ten minute IRI area (p less than .05). The mean (plus or minus SEM) space of distribution for glucose (G.S.) and tolbutamide (TLS.) was found to be 13.45 plus or minus 0.71 and 6.34 plus or minus 0.31 L., respectively. There was a significant dose-response relationship exists between TOL and IRI. TOL- and glucose-induced IRI secretion dynamics suggest strong similarities between mechanisms of rapid IRI release and/or size of available IRI storage pools.

Adult↗
PubMedDate not supplied

Effect of premixed nph and regular insulin on glucose control and health-related quality of life in patients with type 2 diabetes mellitus.

OBJECTIVE: To compare the effect of the addition of regular insulin as a premixed 70/30 insulin to the treatment regimen of patients with type 2 diabetes who had used NPH insulin alone relative to overall glycemic control (postprandial blood glucose), patient satisfaction, and health-related quality of life. METHODS: We studied 90 patients with type 2 diabetes in a 10-week, randomized, double-blind, crossover trial involving 9 clinical investigators. Patients previously treated with NPH insulin alone were transferred to 30% regular insulin added to 70% NPH as a premixed insulin (70/30) administered twice daily. Patients in one sequence group received NPH insulin twice daily for 4 weeks followed by 70/30 insulin for 4 weeks; in the second sequence group, the order was reversed. RESULTS: The magnitude of the 1.5- and 2-hour postprandial glucose excursion was reduced with 70/30 insulin in comparison with NPH insulin, and patients treated with 70/30 insulin experienced fewer hypoglycemic events than with NPH insulin. With regard to health-related quality of life, patients treated with 70/30 insulin rated their physical functioning as better; rated their ability to be spontaneous, follow the meal plan, and interact socially to be less difficult; and had less fear of hypoglycemia and perceived their diabetes to be better controlled than when treated with NPH insulin alone. CONCLUSION: In patients with type 2 diabetes mellitus, premixed 70/30 insulin improved postprandial glycemic control and health-related quality of life without increasing the frequency of hypoglycemic events and without any additional cost.

Clinical Trial↗