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Biomedical subjects

C D Saudek

Publications and source records attributed to C D Saudek.

At least 73 records · Page 4Linked to original sources
PubMed1978

Salicylate-induced hypoglycemia and ketoacidosis in a nondiabetic adult.

A 78-year-old nondiabetic woman was admitted to the hospital with salicylate-induced hypoglycemia. Ketosis was present with a moderate metabolic acidosis and primary respiratory alkalosis. The patient's mental status improved immediately following intravenous administration of glucose. The case illustrates salicylate's hypoglycemic activity, and that the metabolic acidosis may have exacerbated symptoms of cerebral glucopenia.

Acidosis↗
PubMed1978

Plasma squalene: lipoprotein distribution and kinetic analysis.

Plasma squalene concentration is increased in hypertriglyceridemia. In 24 normotriglyceridemic and 12 hypertriglyceridemic subjects, whole plasma squalene correlated strongly with plasma triglyceride (r = 0.973, P < 0.001) in the latter. In normal postabsorptive plasma, squalene was found in each lipoprotein fraction, 50.8% in very low density lipoprotein, 25.6% in low density lipoprotein, and 23.6% in high density lipoprotein. When plasma triglyceride was increased by dietary intake in humans or by experimental diabetes in rats, plasma squalene increased correspondingly. Conversion of [(14)C]mevalonic acid into [(14)C]squalene and kinetic analysis of [(14)C]squalene die-away curves were studied in 17 subjects. Hypertriglyceridemia significantly increased the estimated metabolically active plasma squalene pool. This together with an increase in radioactivity of squalene (dpm/ml plasma) in hypertriglyceridemia suggested that squalene production was increased. Squalene specific activity curves in lipoprotein fractions from four chylomicronemic subjects demonstrated that each fraction had newly synthesized squalene and that total plasma squalene kinetics represent the composite of several individual die-away curves. We conclude that squalene in whole plasma and in lipoprotein fractions varies directly with triglyceride content. Hypertriglyceridemia expands the plasma pool of metabolically active squalene, and each lipoprotein fraction contains squalene that is metabolically active in cholesterol synthesis.

Adult↗
PubMed1977

Phenytoin in the treatment of diabetic symmetrical polyneuropathy.

The efficacy of phenytoin in the treatment of the symptoms of diabetic symmetrical polyneuropathy has been tested in a double-blind, crossover study. Symptoms were evaluated daily by linear analogue self-assessment, while control of blood glucose and plasma phenytoin level were monitored on a weekly basis. There was no significant improvement in symptoms on phenytoin, whether analyzed in aggregate, as pain alone, or on the last 3 days of each treatment week. Blood glucose, however, was elevated in diabetic patients taking phenytoin, and the incidence of undesirable side effects was increased. It is concluded that phenytoin has no role in the treatment of diabetic symmetrical polyneuropathy.

Adult↗
PubMed1977

The effect of hepatitis B on plasma cholesterol and sterol balance.

A patient with hepatitis B was studied by cholesterol balance technics throughout 29 days of the incubation period, the entire preicteric phase (49 days) and 15 days into the icteric phase. As hepatic inflammation developed, the plasma cholesterol concentration declined, reaching 56 per cent of its base line level before the onset of jaundice. Fecal bile acids diminished slightly whereas fecal neutral steroids were unchanged. As jaundice developed, the plasma cholesterol level rose abruptly and fecal bile acid excretion decreased markedly. This report suggests that plasma cholesterol is diminished by hepatitis prior to the development of icterus. Cholesterol synthesis is probably decreased.

Aspartate Aminotransferases↗
PubMed1977

Abnormal glucose tolerance in beta-thalassemia major.

The question of whether iron overload causes glucose intolerance was studied in a group of 26 multiply transfused homozygous beta thalassemics. Of the 26, 13 (50%) had some abnormality in their oral glucose tolerance test, 5 fitting criteria for definite diabetes. Glucose intolerance correlated significantly with number of transfusions received and with age of the subjects, while a positive family history for diabetes was more common in the subjects with glucose intolerance. These data and a chart review of four deceased thalassemics with overt diabetes are consistent with the following conclusions: (1) glucose intolerance is common in multiply transfused thalassemics; (2) the incidence of abnormal glucose tolerance correlates with the number of transfusions received and the age of the subject; (3) a family history of diabetes may predisose multiply transfused thalassemics to glucose intolerance.

Adolescent↗
PubMed1977

Correlation of serum triglyceride levels and hemoglobin AIc concentrations in diabetes mellitus.

Studies in 10 nonketotic diabetic subjects (five juvenile- and five adult-onset) before and after control of carbohydrate metabolism showed a high degree of correlation between hemoglobin AIc (HbAIc) concentrations and serum triglyceride levels. Serum triglyceride levels were found to correlate more closely with Hb AIc (r = 0.91, p less than 0.001) than did serum cholesterol (r = 0.47, p greater than 0.05), thus indicating a more direct relationship to carbohydrate metabolism.

Adult↗
PubMed1975

Plasma glucagon and insulin in rat pregnancy. Roles in glucose homeostasis.

To determine if pancreatic glucoregulatory hormones can be implicated in the glucose fall of pregnancy, we have measured plasma immunoreactive insulin and glucagon (IRI and IRG) in rats. Fed rats in midgestation show a rise in IRI without a corresponding increase in IRG. In late gestation, IRG rises significantly, but only enough to keep pace with a further rise in IRI. On a molar basis, IRI remains the predominant hormone despite a marked fall in blood glucose. After a 48-h fast IRI falls to comparably low levels in pregnant and virgin rats. A small rise in IRG is seen in virgin but not in pregnant rats despite frank hypoglycemia in the latter. Thus, IRG secretion in pregnancy is diminished relative to IRI in the fed state and fails to increase in the fasted state despite the stimulus of a lower glucose in both instances. To evaluate IRG secretory reserve, the IRG response to i.v. alanine was assessed in late gestation. In fed rats a greater IRG increase is seen in pregnancy; after fasting no difference is seen between pregnant and virgin rats. These results preclude an absolute deficiency in glucagon secretion. Pancreas hormone stores were alos measured in an effort to explain the altered secretory state. We find reciprocal changes in IRI and IRG content favoring IRG in midgestation and IRI in late gestation. Thus, pancreas hormone storage is altered in pregnancy but does not account for the changes in hormone secretion. Rather, pregnancy exerts an effect on the islet secretory process itself. Release of IRI is enhanced relative to IRG regardless of the blood sugar level. These observations suggest that in the pregnant rat circulating levels of insulin and glucagon may act to limit hepatic glucose output. Available evidence from the literature supports the concept of restrained glucose production. It is proposed that a lower blood glucose production. It is proposed that a lower blood glucose in rat pregnancy may be a lesser liability teleologically than would be the obligate nitrogen wasting which accompanies gluconeogenesis.

Alanine↗
PubMed1973

Abnormal lipoprotein lipase in familial exogenous hypertriglyceridemia.

A 5-yr old male proband and his sister have had hypertriglyceridemia and hepatosplenomegaly since birth. When studied on a metabolic ward, they demonstrated rapid decreases in serum triglycerides on 3 g fat/day diets. Oral glucose tolerance tests were normal. Postheparin lipolytic activity (PHLA) against chylomicrons was virtually absent in both children whereas the mother and a normolipemic sister had levels approximately 50% normal. However, all four had a normal PHLA against commercial triglyceride emulsion (Intralipid). Two unrelated children from different kindreds of typical type 1 hyperlipoproteinemia and two patients with acquired type V hyperlipoproteinemia had deficient PHLA against both substrates. No inhibitors of PHLA could be demonstrated in the proband's plasma, and his own PHLA could not be enhanced by either normal concentrated plasma or pooled d > 1.063 lipoprotein fraction. The proband's postheparin plasma required almost 20 times the normal chylomicron-triglyceride concentration to reach one-half maximal lipase velocity. Both affected siblings showed heavy pre-beta lipoprotein electrophoretic bands plus chylomicrons in their fasting plasmas while ingesting a 33% carbohydrate, 30% fat diet. Incubation of their postheparin plasma with S(f) > 400 chylomicrons in vitro produced a smaller S(f) 20-400 "remnant" with pre-beta electrophoretic mobility that was not seen under the same conditions when normal postheparin plasma was used. Postheparin monoglyceridase and phospholipase activities were either normal or only moderately decreased when determined with appropriate artificial substrates. These data are consistent with either (a) a mutant gene producing a lipoprotein lipase with unusual substrate specificities or (b) an absolute deficiency of normal lipoprotein lipase with a compensatory increase in some other postheparin triglyceridase.

Blood Protein Disorders↗
PubMedDate not supplied

Non-ophthalmologic findings of the Diabetes Control and Complications Trial.

The Diabetes Control and Complications Trial (DCCT) was a large and rigorously conducted trial which definitively established that longterm hyperglycemia causes longterm diabetic complications. In this review the author considers the non-ophthalmologic results of the DCCT and the applications of these findings to current and future care of diabetic patients. It is concluded that people with diabetes do not need to anticipate a future of diabetic complications, and that improved glycemic control can be achieved through the education and cooperation of physicians, patients, and health care payers.

Clinical Trials as Topic↗
PubMedDate not supplied

Implantable insulin infusion pumps: a case presentation.

A case is presented of a young woman implanted with a programmable implantable medication system (PIMS). Implanted insulin pumps have been the subject of research for over a decade but have encountered a series of obstacles ranging from design problems to insulin aggregation to catheter blocking from omental tissue. Many of these problems, but not all, have been overcome. Implanted insulin pumps are still in a developmental phase. Glucose sensing is not yet available. Nevertheless, PIMS has demonstrated in this case that it can safely and effectively control insulin-dependent diabetes for over 1.5 years.

Adult↗
PubMedDate not supplied

Assessment of glycosylated hemoglobin measurement with sample collection papers.

It would be advantageous to be able to measure glycosylated hemoglobin (GHb) from a sample of blood dried on paper and sent to the physician by the patient. Indeed, such a technique has been introduced by Isolab (Akron, OH). We tested the validity of the method to determine whether applying the blood to paper and immediately assaying it correlates with the same sample assayed by the usual whole-blood technique, the size of sample applied to paper affects apparent GHb results, time and temperature of storage of the sample paper affect apparent GHb results, and plasma glucose concentration of the sample affects GHb results. The GHb of samples assayed immediately after application to sample paper versus those assayed as whole blood showed very good correlation (r = .93, P less than .001). Volume of the drop of blood applied to paper (25-100 microliters) did not affect results. However, there was a dramatic, temperature-dependent increase in apparent GHb when samples were stored on sample paper, averaging 12.5, 16.3, and 19.5% when stored at room temperature for 3, 6, and 9 days, respectively. Overall, apparent GHb rose from 1.3-fold in 3 days at 4 degrees C to 3.8-fold in 9 days at 37 degrees C. The rate of GHb formation was proportional to plasma glucose concentration, but removal of free glucose by ethanol or glucose oxidase did not yield consistent results for this method. We conclude that these sample papers are not useful as an approach to collecting blood samples for GHb measurement.

Blood Glucose↗