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C Ionescu-Tîrgovişte

Publications and source records attributed to C Ionescu-Tîrgovişte.

At least 19 recordsLinked to original sources
PubMed2005

Meal testing and postprandial state of type 2 diabetic patients with metabolic syndrome.

BACKGROUND AND AIMS: C reactive protein (CRP), a non-specific acute phase reactant, has been associated with multiple patogenic mechanisms involved in chronic illnesses, but up to now the significance of CRP in the postprandial state in diabetes mellitus has not been addressed. MATERIAL AND METHODS: We evaluated 58 type 2 diabetic patients (33F/25 M) with associated metabolic syndrome. The main characteristics of the patients were: age 58.1+/-9.15 years, duration of diabetes 3.9+/-3.07 years, BMI 26.2+/-3.26 kg/m2, waist circumference 97.7+/-9.88 cm and HbA1c 7.2+/-1.2%. Men and women were matched for age, duration of diabetes, BMI and HbA1c. The patients had a 330 kcal standard meal, blood samples were taken in fasting condition and 2 and 4 hours postprandial and the following parameters were obtained: glycemia, total cholesterol, HDL-cholesterol, triglycerides, apolipoprotein A1 and B and also CRP levels. The patients were also evaluated through duplex scan 2D ultrasound for intima-media thickness (IMT) of common carotid artery bilaterally. Data were analysed with Epi Info, SPSS and Statistica Software. RESULTS: Fasting CRP correlated to BMI and waist circumference (p=0.0068 and p=0.038 respectively). At two hours postprandial, we found a significant nonparametric correlation between CRP level and total cholesterol (p=0.01), which remained significant even after adjusting for age, BMI, HbA1c and blood pressure values (adjusted p=0.018). Patients in the lowest quartile for CRP level compared to those in the highest quartile had lower fasting apolipoprotein B levels (146 vs 197 mg/dl, p=0.042), lower postprandial blood glucose levels (188 vs 241 mg/dl, p=0.035) and lower nonHDL-cholesterol levels (148 vs 192 mg/dl, p=0.005). Common carotid artery IMT correlated with the duration of diabetes (p=0.026) and systolic blood pressure values both in clino and orthostatism (p=0.007 and p=0.006 respectively). CONCLUSION: The results confirm that C reactive protein and apolipoprotein B have close relationships with other components of the metabolic syndrome in type 2 diabetic patients. High CRP and apolipoprotein B levels could be a marker for an excessive postprandial response, leading to an increased risk for chronic vascular complications and atherogenesis.

Aged↗
PubMed2005

Intradermal reactions to purified protein derivative in patients with diabetes mellitus.

Diabetes mellitus is known to adversely affect the immune system. Immune dysfunction is also associated with the etiology of diabetes mellitus. Immune dysfunction is associated with diminished chemotactic, phagocytic and monocyte activity. There is also increased T-cell activity. All these are associated with acute hyperglycemia. We investigated the cellular arm of the immune system of patients with diabetes mellitus using intradermal reactions (IDR) to purified protein derivative (PPD). Both groups high blood glucose [HBG] vs. low blood glucose [LBG]) were homogeneous in terms of size and sex and average age (24. vs. 22.; 21 F vs 25 M; 56.5yrs. vs. 54.5 yrs.). The LBG had a greater average duration of diabetes (13.6 yrs vs. 9.3 yrs), which suggests an increased tendency to complications of diabetes mellitus. The results showed an average blood glucose and IDR (HBG vs. LBG) of 235.8 +/- 46.5 mg/dl vs. 144.3 +/- 26.7 mg/dl and 18.5 +/- 8.5 mm vs. 12.2 +/- 7.0 mm respectively. These results showed that IDR is significantly affected by hyperglycemia. This increased IDR may be a consequence of the synergy between interferon-gamma and tumor necrosis factor alpha which is a significant factor in diabetes. Also, there is an accentuation of this synergy following injection of PPD. It appears to be clear that IDR to PPD may be influenced by the diabetic state, especially acute hyperglycemia. However, it also appears that IDR to PPD may not be an adequate method for assessing cutaneous cell-mediated immunity.

Blood Glucose↗
PubMed2004

Cost-effective analysis of candidate genes using htSNPs: a staged approach.

We have previously shown that the selection of haplotype tag single nucleotide polymorphisms (htSNPs) and their statistical analysis in a multi-locus transmission/disequilibrium test (TDT) results in a more cost-effective genotyping strategy in disease association studies of genes by minimising redundancy due to linkage disequilibrium between SNPs. Further savings can be achieved by the use of a two-stage genotyping strategy. This approach is illustrated here in conjunction with the multi-locus TDT in determining whether common alleles of the immune regulatory genes RANK and its ligand TRANCE (RANKL) are associated with type 1 diabetes (T1D). A saving of approximately 75% of potential genotyping reactions could be made with minimal loss of power. There was little evidence from our analysis for association between the TRANCE and RANK genes and T1D in the populations tested.

Carrier Proteins↗
PubMed2004

An increasing trend in the incidence of type 1 diabetes mellitus in children aged 0-14 years in Romania--ten years (1988-1997) EURODIAB study experience.

AIM: To assess the incidence of type 1 diabetes mellitus (DM1) in Romanian children aged 0-14 years using EURODIAB Study methodology. METHODS: Data were collected for a 10-year interval (1988-1997) for the whole country, using the capture-recapture method. RESULTS: We registered 1,418 newly diagnosed patients. The mean total incidence rate was 3.051/100,000/year. There was a wide geographic variation (6.71-fold) between the highest and the lowest incidence rates in different districts. We noticed a progressive increase of age-specific incidence rates from 1.43/100,000/year for the 0-4 year age subgroup to 4.37/100,000/year (10-14 years). The annual mean incidence rate rose from 1.91/100,000/year (1988) to 3.94/100,000/year (1996). CONCLUSIONS: Romania is one of the European countries with the lowest incidence rates (3.051/100,000/year) for DM1 in children. There was an evident increasing trend of DM1 incidence in children between 1988 and 1997, with an annual increase of 7.57%.

Adolescent↗
PubMed2004

Strong association of insulin gene INS-VNTR polymorphisms with type 1 diabetes in the Romanian population.

Type 1 diabetes (T1DM) is a common, chronic disease with autoimmune pathogeny, conditioned by genetic factors. Class II HLA DR and DQ and insulin gene polymorphisms encode for most of the T1DM genetic susceptibility. We have previously shown that class I alleles of the insulin gene INS-VNTR locus are strongly associated with T1DM in the Romanian population. The aim of our study was to confirm the contribution of INS-VNTR to T1DM genetic susceptibility in Romania. For this we typed the insulin gene -23HphI A/T polymorphism (an accurate marker for the INS-VNTR alleles) on 219 Romanian T1DM families using Taqman. Allele transmission to diabetics and unaffected siblings was assessed using the Transmission Disequilibrium Test (TDT). We found a significantly increased transmission of -23HphI A allele to diabetics (78.31% transmission, pTDT = 2.4 e-07) which confirms our previous findings. Combined with the data from the first 204 Romanian T1DM families, the transmission of -23HphI A allele to diabetics is almost 80% (79.78%, pTDT = 2.8 e-15). This percentage indicates the same level of predisposition as for the most diabetogenic HLA's. In conclusion, our results indicate an exceptionally strong association of the class I INS-VNTR alleles with T1DM for the Romanian population.

Adolescent↗
PubMed2004

Continuous glucose monitoring: physiologic and pathophysiologic significance.

Diabetes mellitus is a complex disorder of the energy metabolism. In the present paper, we have tried to illustrate the changes in the regulation of blood glucose levels encountered in the two main types of diabetes: Type 2 (T2DM) and Type 1 (T1DM) diabetes mellitus, compared with healthy, non-diabetic subjects. For this we used the MiniMed CGMS (Continuous Glucose Monitoring System) which allows the continuous in vivo blood glucose measurement over a 3-day period. The study group comprised 19 diabetic patients (14 T1DM and 5 T2DM cases) and 4 non-diabetic controls. The recording in normal subjects showed a glycemic variation between 46 and 118 mg/dl, suggesting the existence of a strong and efficient glycemic control mechanism. In T2DM patients, both on diet only or on oral antidiabetic treatment, the oscillation of blood glucose levels was significantly higher compared to that recorded in non-diabetic subjects. In T1DM patients with stable metabolic control blood glucose fluctuations were comparable with those recorded in long-term type 2 diabetic patients but the "mean" values of blood glucose over 72 hours were lower. The CGMS is a valuable tool in the detection of unrecognized hypoglycemic episodes and hyperglycemic postprandial peaks and allows the patient and the health care team to adjust the treatment regimen in order to improve glycemic control. From our point of view, the CGMS could offer valuable information for the knowledge of glycemic regulation in normal people and for the diabetogenic mechanisms in prediabetic IGT and IFG patients.

Adolescent↗
PubMed2004

NIDDM: new once-daily intervention for type 2 diabetes mellitus: Diaprel MR.

UNLABELLED: Pharmacological treatment of hyperglycemia should address to both abnormalities in T2DM treatment, that is reduction of insulin resistance and restoration of normal insulin secretion. Gliclazide is a sulfonylurea compound oral hypoglycemic drug that has a unique feature of restoring the first-phase insulin secretion, which is lost in T2DM being one of the early features of disease. MATERIAL AND METHOD: Laboratoires Servier conducted in Romania a an open non randomized surveillance on the efficacy and safety of Diaprel MR in type 2 diabetic patients. 199 patients in 14 treatment centers were enrolled. Eligibility criteria were as it follows: men and women with diabetes, previously on diet alone and not treated with other OAD, over 35 years old with FPG (mg/dl) at enrollment between 126 and 180. The clinical trial lasted for 16 weeks. During this period the doctors examined the patients 6 times. First visits were at a 2 weeks interval and the last two visits at a 4 weeks interval. At each visit the doctor renewed the prescription for the subsequent period according to the following protocol: the starting dose was 30 mg Diaprel MR/day, if the FPG (mg/dl) was over 140 (at the next visit) the dosage was increased with 30 mg Diaprel MR/day, if the FPG (mg/dl) was under 140 the dosage remained the same as the previous dosage. The maximum dosage was 120 mg Diaprel MR/day. The following parameters were measured on first and last (seventh) visit: blood pressure (systolic and diastolic), heart rate (bpm), body mass index-BMI (kg/m2), fasting plasma glucose FPG (mg/dl and mmol/l), glycated hemoglobin HbA1c (%) and Hb-Hct (mg/dl-%), creatinine (mg/dl), SGPT (UI/I), cholesterol (mg/dl) and triglycerides (mg/dl). Blood pressure (systolic and diastolic), heart rate, BMI and FPG were measured from the second to sixth visit also. On each visit there was registered other data such as: associated illnesses, concomitant medication and adverse events. RESULTS: Primary end points. The average values of end points HbA1c (%) and PFG (mg/dl) registered a significant decrease during the 16 weeks of medication, from the enrollment moment (S0) to the last week (S16). The decrease was significant on the total sample of the main analysis group but also on subsamples of age, gender and BMI. HbA1c (%) average values decreased in the main analysis group (S16 compared to S0): with 22% on the total sample (from 7.7 to 6.0); p < 0.05. FPG (mg/dl) average values decreased in the main analysis group (S16 compared to S0): with 21% on the total sample (from 159 to 126); p < 0.05. Secondary end points. There were no significant changes registered in the average level of cholesterol and triglycerides, BMI, diastolic blood pressure, heart rate, creatinine, SGPT. A significant decline of the average systolic blood pressure was registered. CONCLUSION: Diaprel MR can be used safely in diabetic patients newly diagnosed, uncontrolled on diet or other oral antidiabetic drugs, overweight, safely in those with cardio-vascular disease, or in patients with creatinine clearance 50-80 ml/min.

Adult↗
PubMed1994

Epidemiology of diabetes in Bucharest.

An analysis of the last 20,000 newly diagnosed diabetic patients consecutively registered from 1 January 1981 to 6 June 1991 in the Bucharest Registry of Diabetes showed the following: (1) primary insulin-dependence (Type 1 diabetes) was encountered in only 7% of cases: the rest were Type 2 diabetic patients (8745:43.7% treated with diet alone and 9856:49.3% treated with diet and oral drugs); (2) low body weight (BMI < 25) was encountered in 81.7% of patients in the age group 0-20 years, while obesity (BMI > 27) was encountered in 75.7% of cases in the age group 41-65 years; (3) the overall annual incidence of the Type 1 diabetes for all ages was 5.7/100,000, lowest (1.3/100,000) in the age group 0-4 years and the highest 10.1/100,000) in the age group 65-69 years; (4) the overall annual incidence for the Type 2 diabetes was 76.3/100,000, the lowest (2.4/100,000) in the age group 20-24 years and the highest (261.4/100,000) in the age group 60-64 years. Studying the relationship between the onset of Type 1 diabetes mellitus and age, we did not observe the previously reported strong relationship, so that the distribution of Type 1 diabetes can be considered relatively uniform, with the exception of extreme ages. In conclusion, each year, about 1 in 1000 inhabitants of Bucharest are registered as having diabetes, the majority (93%) had type 2 and only 7% had Type 1 diabetes, one of the lowest incidence rates in Europe.

Adolescent↗
PubMed1989

Measurement of perception threshold to an electric stimulus using a phase-sensitive technique in normal and diabetic subjects.

To evaluate the functional state of peripheral sensitivity we measured the perception threshold to an electrical stimulus applied deeply at the level of the lower limbs in both diabetic and nondiabetic patients. The data were obtained using a phase-sensitive technique with a sinusoidal applied voltage at 1592 Hz. The test signal applied through needle electrodes was monitored using a current-to-voltage convertor, the current being considered to have two components, one resistive (IR) in phase with the voltage V across the electrodes, and the other capacitive (IC) 90 degrees out of phase. A significantly (p less than 0.001) higher perception threshold was found in diabetic patients than in nondiabetic subjects with all three electrical variables measured: IR, IC and V.

Adolescent↗
PubMed1987

Evaluation of an intensified insulin treatment and teaching programme as routine management of type 1 (insulin-dependent) diabetes. The Bucharest-Düsseldorf Study.

It has been questioned whether aiming at near-normoglycaemia by intensified insulin treatment regimens is feasible and safe for the majority of patients with insulin-dependent diabetes. In this study, intensified insulin injection therapy (including blood glucose self-monitoring and multiple insulin injections) based upon a 5-day inpatient group teaching programme was evaluated in Type 1 (insulin-dependent) diabetes mellitus in the centralised health care system of Bucharest. One hundred patients (group A, initial HbA1 12.5%) were followed for 1 year on their standard therapy (individual teaching, no metabolic self-monitoring), and thereafter for 1 year on intensified therapy. Another 100 patients (group B, HbA1 12.3%) were followed for 2 years on intensified therapy. A third 100 patients (group C, HbA1 11.7%) were assigned to a basic 4-day inpatient group teaching programme with conventional insulin therapy (including self-monitoring of glucosuria and acetonuria) and followed for 1 year. Mean HbA1 remained unchanged after standard treatment (group A: 12.8% at 12 months), but decreased during intensified therapy (group A: 10.1% at 24 months; group B: 9.3% at 12 months, 9.5% at 24 months; p less than 0.0001). In group C, no change was found compared to standard treatment (i.e. group A at 12 months). Incidence rates of ketoacidosis were 0.16 episodes per patient per year during standard treatment, 0.01 during intensified treatment (p less than 0.01) and 0.04 in group C (p less than 0.025). Hospitalisation rates were reduced by 60% during intensified therapy and by 40% in group C. Frequency of severe hypoglycaemia was not significantly different between the three treatment regimens. Thus, under the condition that insulin treatment is based upon a structured and comprehensive training of the patient, intensified insulin injection therapy performed as routine treatment of Type 1 diabetes significantly lowers HbA1 levels without increasing the risk of severe hypoglycaemia.

Adolescent↗
PubMed1984

Disappearance rate of insulin antibodies after discontinuing insulin treatment in 42 type 2 (non-insulin-dependent) diabetic patients.

The disappearance rate of insulin antibodies was studied after cessation of insulin treatment which had been given for 3 months to 6 years in 42 Type 2 (non-insulin-dependent) diabetic patients. Insulin antibodies were measured before and 15 days after interruption of insulin treatment, and every 30 days until the disappearance of insulin antibodies. The mean +/- SD value of insulin binding in the entire group before the interruption of insulin treatment was 32 +/- 14%. There was no relationship between the antibody level at that time and the duration of insulin treatment. However, the insulin antibody level was significantly higher in 17 diabetic patients on an insulin dose of greater than 20 U/day (p less than 0.02) than in 25 on an insulin dose of less than 20 U/day (39 +/- 13% versus 28 +/- 12%). A positive correlation was found between initial insulin binding and the time required for it to fall below 10% (r = 0.74). Antibodies were absent 60 days after discontinuing insulin treatment in eight of ten subjects presenting with initial binding of less than 20%. In contrast, in only two of 12 patients with an initial binding of greater than 40% were insulin antibodies detectable 150 days after discontinuation of insulin therapy. Disappearance of insulin antibodies sometimes took up to 1 year and occasionally even more than 2 years.

Aged↗
PubMed1983

Blood glucose and plasma insulin responses to various carbohydrates in type 2 (non-insulin-dependent) diabetes.

The blood glucose and plasma insulin responses to some simple carbohydrates (glucose, fructose, lactose) and some complex ones (apples, potatoes, bread, rice, carrots and honey) were studied in 32 Type 2 (non-insulin-dependent) diabetic patients. Blood glucose and plasma insulin were measured at zero time and then at 15, 30, 60, 90 and 120 min after ingestion of 25 g glucose, fructose or lactose, or 30 g honey, 50 g white bread, 125 g white rice or potatoes, 150 g apples or 260 g carrots. Maximum blood glucose and plasma insulin responses were recorded 60 min after ingestion of each test meal. At this time the increases in blood glucose and in plasma insulin were significantly higher after the more refined carbohydrates (glucose, fructose and lactose) than after the more complex ones (apples, potatoes, rice, carrots and honey, -p less than 0.01). Counting the blood glucose increase after glucose as 100%, the corresponding increases in glycaemia for other carbohydrates were: fructose, 81.3%; lactose, 68.6%; apples, 46.9%; potatoes, 41.4%; bread, 36.3%; rice, 33.8%; honey, 32.4% and carrots, 16.1%.

Aged↗
PubMed1981

Insulin antibodies.

Explore the source record for details and available documents.

Diabetes Mellitus↗
PubMed1980

Relationship between the concentration of H+-ions and the efficiency of insulin in the treatment of diabetic ketoacidosis.

The efficiency of insulin (decrease of the blood glucose per unit of insulin administered) was assessed in 610 cases of diabetic ketoacidosis (316 females, 274 males, aged 3 to 72 years) in terms of the degree of plasma acidemia. The 610 cases were grouped into 4 ketoacidosis stages, defined according to pH values as incipient, pH > 7.35 (77 cases); moderate, pH 7.31-7.35 (163 cases); advanced, 7.21-7.30 (160 cases); severe, pH < 7.20 (210 cases). The mean [H+]-ion concentration recorded on admission in the 4 stages of ketoacidosis was 41 nEq/1, 46 nEq/1, 53 nEq/1, and 91 nEq/1, respectively. The efficiency of insulin for the first 2 hours of treatment (interval during which acidemia was only partly corrected) was comparable in the four ketoacidosis stages, i.e. 31.1 mg/l, 32.9 mg/l, 29.5 mg/l and, respectively 28.9 mg/l per unit of insulin injected as a bolus. The somewhat lower efficiency of insulin in the advanced and severe cases of ketoacidosis appears to be due to vascular collapse encountered in 38 cases (6 advanced ketoacidosis and 32 severe ketoacidosis), since in these patients the fall in blood glucose per unit insulin was only 15.8 mg/l.

Adolescent↗
PubMed1975

Classification of diabetic ketoacidosis.

An analysis of 1000 cases of diabetic ketoacidosis has suggested to the authors their classification into four evolutive stages: incipient ketoacidosis (normal pH, decrease of total CO2, between 20--26 mMol/l and of excess bases between -2 and -5 mMol/l), moderate ketoacidosis (pH 7.31-7.35, total CO2, between 15--19.9 mMol/l, excess bases between -5 and -10 mMol/l); advanced ketoacidosis, "diabetic precoma" (pH 7.21-7.30 total CO2 between 11 and 14.9 mMol/l, excess bases between -10 and -15 mMol/l, and severe diabetic ketoacidosis or "diabetic coma" (pH less than or equal to 7.20, total CO2 less than or equal to 10 mMol/l, excess bases greater than -15 mMol/l). The follow up of the four therapeutical parameters (number of hours, amount of fluids, insulin and KCl necessary for equilibration) showed that this classification of ketoacidosis reflects the degree of metabolic and hydroelectrolytic disorders, suggesting at the same time the intensity of the treatment to be administered in view of correcting them.

Diabetic Coma↗