PubMed Health⌕ Search

Biomedical subjects

C Kühl

Publications and source records attributed to C Kühl.

At least 73 records · Page 4Linked to original sources
PubMed1985

Insulin appearance of subcutaneously infused insulin: influence of the basal rate pulse interval of the infusion pump.

To compare the metabolic control and the pharmacokinetics of infused insulin using an insulin pump (Auto-Syringe AS 6C) which provides the basal rate in pulses every 2-10 min with a pump (Medix Syringe Driver 209) providing the basal rate in pulses every 15-60 min, 6 C-peptide negative diabetic patients received, in random order, identical, but individual, insulin treatment during one 4-day period using the Auto-Syringe pump and another 4-day period using the Medix pump. On the fourth day of each period, blood glucose and plasma-free insulin were estimated every 30 min for 7 hr and every 5 min for the next hour. Plasma-free insulin was significantly higher on 3 time points out of the 26 possible when using the Medix pump, but this was not reflected in the blood glucose concentrations which were similar in the 2 periods. The results indicate that, from a metabolic and pharmacokinetic point of view, insulin pumps working with larger intervals between the basal rate pulses are just as good as the more technically advanced and hence often more expensive pumps which provide the basal rate in more and smaller pulses.

Adult↗
PubMed1985

A screening procedure for diabetes in pregnancy.

A screening system for detection of diabetes in pregnancy was carried out in a geographically well-defined unselected population of 2 457 pregnant women all living in the community of Copenhagen. The screening was based on clinical criteria for potential diabetes consisting of previous delivery of a large baby, a family history of diabetes and obesity combined with examination of glucosuria and determination of the fasting blood glucose concentration. It was possible to follow up 95% of all pregnancies. One hundred and ninety women had a positive screening determination and among these women, 24 (1%) were found to have diabetes in pregnancy. It was established that a fasting blood glucose concentration of 4.1 mmol/l was the ideal cut-off point for referring potential diabetics to an oral glucose tolerance test (OGTT). The screening procedure is easy to administer and acceptable for the pregnant woman. The screening OGTT should be performed in the second or third trimester as only one woman had diabetes detected in the first trimester in this study.

Adult↗
PubMed1984

Gastroenteropancreatic hormones in normal and gestational-diabetic pregnancy: response to oral lipid.

The effect of normal and gestational-diabetic pregnancy on the gastroenteropancreatic (GEP) hormone response to lipid ingestion was studied in 17 women, 8 normal and 9 with gestational diabetes, by determination of the plasma concentrations of gastric inhibitory polypeptide (GIP), gut glucagon-like immunoreactivity (gut GLI), insulin, glucagon, and pancreatic polypeptide (PP) following the ingestion of 67 g of triglyceride in late pregnancy and postpartum. Also, the plasma concentrations of free fatty acids (FFA), triglyceride, and glucose were determined. In both groups fasting plasma triglyceride and insulin were increased and PP was decreased. Fasting plasma glucose and gut GLI were decreased in normal pregnancy, but were unaltered in gestational-diabetic pregnancy. Fasting plasma glucagon were unaltered in normal but increased in gestational diabetic pregnancy. In both groups of women the GIP response to triglycerides was impaired in pregnancy. Postpartum, the GIP response was greater in the gestational diabetics than in normal women whereas no difference was found in pregnancy. The other hormones and metabolites responded similarly in pregnancy and postpartum and no difference between normal women and women with gestational diabetes was found. It is concluded that the GIP response to triglycerides is impaired in pregnancy.

Adult↗
PubMed1984

Cortisol and glucose tolerance in normal pregnancy.

The possible correlations between the increase in cortisol levels and the decrease in glucose tolerance and changes in insulin and glucagon secretion in normal pregnancy were studied in 17 normal pregnant women. Total and free plasma cortisol concentrations and urinary cortisol excretion rate were measured monthly from week 12 and the results were related to the changes in glucose tolerance in early, mid, and late pregnancy and finally compared to postpartum findings. In early pregnancy, total and free plasma cortisol concentrations and the urinary cortisol excretion rate were already higher than postpartum and the levels increased further throughout gestation, reaching maximum levels at term. Glucose tolerance deteriorated during pregnancy. When the increases during pregnancy in total and free plasma cortisol concentrations and urinary cortisol excretion rates on the one hand and the deterioration of glucose tolerance on the other hand were related, significant positive correlations were obtained (r-values between 0.55 and 0.63, p less than 0.05). No correlation was found between the increase in cortisol levels or excretion rates and the changes in the insulin and glucagon responses to glucose in pregnancy. It is concluded that the elevation of cortisol levels in pregnancy might possibly be associated with the diabetogenicity of pregnancy.

Adult↗
PubMed1983

Endocrine pancreatic sensitivity to glucose in women with gestational diabetes.

To study whether gestational diabetes is the result of abnormal endocrine pancreatic adaptation to pregnancy, alpha- and beta-cell sensitivity to glucose was determined during pregnancy and post partum in seven women of normal weight who had gestational diabetes. Glucose was infused intravenously in quantities producing similar increases in plasma glucose in pregnancy and post partum, and the plasma glucose curves obtained closely resembled those found during an oral glucose tolerance test. The insulin response to the infusion was 3.5 times greater in pregnancy (P less than .02), whereas glucagon was suppressed similarly in pregnancy and post partum. These findings resemble previous ones in normal women. It is concluded that pancreatic alpha and beta cells adapt similarly to pregnancy in women with gestational diabetes and in normal women.

Adult↗
PubMed1982

Effect of intraduodenal and intravenous triglyceride infusions on plasma gastric inhibitory polypeptide and insulin in fetal and neonatal pigs.

The responses of gastric inhibitory polypeptide (GIP) and insulin to intraduodenal and IV triglyceride infusions were measured in 11 late fetal and 10 neonatal pigs. Basal plasma glucose, insulin, and GIP concentrations were lower in fetal than in neonatal pigs. In the fetal pigs, plasma glucose increased slightly during intraduodenal and IV triglyceride infusions, whereas plasma insulin remained unchanged during the tests. No significant changes were observed in plasma GIP concentration following intraduodenal triglyceride infusion in the fetal pigs, but plasma GIP fell during the IV infusion of triglyceride in these pigs (p less than 0.01). In the neonatal pigs, plasma glucose and insulin remained unaffected by intraduodenal and triglyceride infusions. Plasma GIP did not change during the IV triglyceride infusion, but exhibited a paradoxical decline after the intraduodenal triglyceride infusion (p less than 0.05). It is concluded that the GIP-cell response to an oral triglyceride load is suppressed in late fetal and neonatal pigs. The abolished GIP response to oral triglycerides could play a causal role in the inactivity of the enteroinsular axis which is seen in both human and animal neonates.

Animals↗
PubMed1982

Gastro-entero-pancreatic hormones in gestational diabetes: response to a protein rich meal.

The gastro-entero-pancreatic (GEP) hormone response to glucose ingestion is considerably altered in pregnancy in normal women and gestational diabetics. In normal women, also the GEP hormone response to protein is changed in pregnancy. In the present investigation, the gastrin, gastric inhibitory polypeptide (GIP), gut glucagon-like-immunoreactivity (gut GLI), insulin, pancreatic glucagon, and pancreatic polypeptide (PP) responses to a protein rich meal in pregnancy and postpartum were studied in 10 women with gestational diabetes. Five of the women were overweight and five were normal weight. Fasting and postprandial gut GLI and PP levels were reduced and insulin levels enhanced in pregnancy. No effect of pregnancy on fasting or postprandial gastrin, GIP, or glucagon levels was found. In pregnancy as well as postpartum, insulin levels were higher in the overweight than in the normal weight patients, whereas the concentrations of the other hormones were similar in the two subgroups of gestational diabetics. It is concluded that the GEP hormone response to a protein rich meal is influenced by late pregnancy in gestational diabetics in the same way as in normal women. The physiological consequences of the findings are not known in detail as yet but they may be important to carbohydrate metabolism and gastrointestinal physiology in pregnancy.

Adult↗
PubMed1982

Metabolic events in infants of diabetic mothers during first 24 hours after birth. I. Changes in plasma glucose, insulin and glucagon.

Changes in plasma glucose, nonantibody-bound insulin and glucagon concentrations were studied in 32 newborn infants of diabetic mothers (IDM) during the first 24 hours after birth. Ten infants were born to White class A mothers and 22 to class B-F mothers. The infants were kept fasting during the investigative period and blood was sampled from an umbilical artery catheter. At birth, plasma glucose and glucagon levels were similar in the class A and B-F infants, whereas nonantibody-bound insulin levels were approximately 15-fold higher in the class B-F infants than in the class A infants (p less than 0.001). After birth, plasma glucose fell in all infants, the nadir being reached at two hours (p less than 0.01). Plasma glucose fell by approximately 35% in the class A infants and 63% in the class B-F infants (p less than 0.01). Eight IDM had asymptomatic hypoglycemia (plasma glucose less than 1.9 mmol/l) and four of these infants had glucose levels below 1.7 mmol/l and were withdrawn from further study. In the remaining four hypoglycemic IDM, plasma glucose was about 1.6-fold higher (p less than 0.01) and insulin about 11-fold higher (p less than 0.001) at birth compared to the 24 normoglycemic IDM. The hypoglycemia was attended by unchanged insulin levels in the class A infants, whereas insulin fell in the class B-F infants (p less than 0.01). However, during the whole investigative period, plasma insulin of the class B-F infants was higher than that of the class A infants (p less than 0.01). After birth, plasma glucagon increased slowly in all IDM and peak values were reached after 12 hours in the class A infants (p less than 0.05) and 24 hours in the class B-F infants (p less than 0.01). Only those infants who became hypoglycemic after birth exhibited a significant increment in plasma glucagon from 0.2 hours (p less than 0.05). These results suggest that neonatal hypoglycemia of IDM results from high plasma levels of nonantibody-bound insulin together with a very retarded increment in plasma glucagon levels. The degree of neonatal hypoglycemia and hyperinsulinemia of an individual IDM seems to be positively correlated to the severity of the diabetes of the mother.

Adult↗
PubMed1982

Metabolic events in infants of diabetic mothers during first 24 hours after birth. II. Changes in plasma lipids.

Changes in plasma glycerol (FG), free fatty acids (FFA) and triglyceride (TG) were studied in 24 normo- and 8-hypoglycemic infants of diabetic mothers (IDM). In both groups a normal rise in plasma FG 2 hours after birth was found indicating unimpaired lipolysis. The rise in plasma FFA, however, was only about 50% of normal in normoglycemic IDM and about 25% of normal in hypoglycemic IDM. The rise in plasma TG was normal in normoglycemic and about 70% of normal in hypoglycemic IDM. The 2 hour rise in plasma FFA correlated with the 2 hour concentration of insulin and glucose, whereas the rise in plasma FG and TG did not. Maternal plasma FFA correlated with fetal FFA retention (umbilical vein minus artery (V-A) FFA concentrations). No correlations were found between maternal plasma FFA values and birth-weights nor between umbilical V-A FFA concentrations and birth-weights.

Adult↗
PubMed1982

Metabolic events in infants of diabetic mothers during first 24 hours after birth. III. Changes in plasma amino acids.

Plasma amino acid concentration (AAC) were studied in 31 diabetic mothers (10 of White class A, 10 of B-C and 11 of D-F) and their 32 infants during the first 24 hours after birth. Only minor differences between the 3 groups were found at birth and 2 hours, and none at 12 and 24 hours after birth. The individual AAC in umbilical vein plasma did not correlate with birthweight. All AAC except aspartic acid, asparagine, cystine and glutamic acid were higher in umbilical venous plasma than in maternal plasma. Umbilical venous-arterial differences of amino acids did not correlate with maternal or umbilical vein insulin concentrations except for threonine and valine. In general essential amino acids decreased after birth. In 8 infants with hypoglycemia and hyperinsulinism at 2 hours of age several plasma amino acids were lower than in the normoglycemic infants.

Adult↗
PubMed1982

Plasma noradrenaline and adrenaline in infants of diabetic mothers at birth and at two hours of age.

Plasma noradrenaline and adrenaline in the umbilical artery were very high in many infants of both diabetic mothers (IDM) and non-diabetic mothers (controls) compared to values obtained in adults. Blood pH was slightly but significantly lower in IDM than in controls at delivery. There was a significant negative correlation between plasma noradrenaline and blood pH in IDM at birth, but no correlation between plasma noradrenaline and blood glucose, birth weight and Apgar scores. Plasma noradrenaline decreased significantly from birth to two hours of age both in IDM and controls. At two hours of age plasma noradrenaline and adrenaline were significantly greater in IDM compared to controls whereas blood glucose concentration was lower in the former group. There was a close inverse correlation between plasma noradrenaline and adrenaline, respectively, and blood glucose in IDM at two hours of age but not in controls. The elevated plasma noradrenaline at delivery in IDM may be explained by clinically undetectable acidosis whereas elevated plasma catecholamines at two hours are probably due to hypoglycaemia.

Blood Glucose↗
PubMed1982

Minor physiological relevance of oral glucose tolerance test.

The physiological relevance of the oral glucose tolerance test was evaluated in ten healthy nonobese subjects and nine subjects with slightly impaired glucose tolerance. In random order, all subjects received a 50 g oral glucose tolerance test or a standardized breakfast meal of equivalent carbohydrate content. Changes in plasma glucose, insulin, and pancreatic glucagon concentrations were measured. In both groups, plasma glucose increased significantly during the oral glucose tolerance test and the meal test but the incremental glucose area (0-60 min) of the oral glucose tolerance test was about 350% and 120% greater than that of the mean test (p less than 0.001) in the normals and the patients with impaired glucose tolerance, respectively. In both groups, insulin responded almost similarly to the oral glucose tolerance test and the meal test whereas plasma glucagon declined significantly during the oral glucose tolerance test only (p less than 0.001). Glucagon remained unchanged during the meal test in the normals and increased slightly (p less than 0.05) in the group with impaired glucose tolerance. These data show that the response of glucose, insulin and glucagon to an oral glucose tolerance test in various respects is different to that obtained by the more physiological stimulation with a breakfast meal.

Administration, Oral↗
PubMed1982

Low dosage oral contraception in women with previous gestational diabetes.

The carbohydrate metabolic status in 10 women with previous non-insulin-dependent diabetes in pregnancy and in 8 control subjects was evaluated prospectively during a 6-month treatment period with an oral contraceptive containing 30 micrograms ethinyl estradiol and 150 micrograms levonorgestrel. An oral glucose tolerance test was performed before treatment and after tablet intake for 2 and 6 months. At each test, plasma values of glucose, insulin, and glucagon were measured. Before treatment the non-insulin-dependent diabetic patients demonstrated significantly increased glucose values and decreased insulin values as compared with the values of the control subjects. During treatment they displayed a small but significant rise in plasma insulin values. The glucose tolerance, however, remained unaffected in both groups during the study period. No change in body weight or blood pressure was observed. The results indicate that hormonal contraception of the low dosage type may be administered to women with previously impaired glucose tolerance in pregnancy without any deterioration of the glucose metabolism post partum.

Adult↗
PubMed1982

Effect of maternal triglyceride ingestion on fetal respiratory movements.

The fetal breathing index is the time in which a fetus undertakes respiratory movements, expressed as a percentage of a 30-minute observation period. The fetal breathing index was studied following maternal ingestion of either a 100-ml triglyceride emulsion (Lipomul) plus 250 ml mineral water, or ingestion of 350 weeks' gestation were examined. The fetal breathing index increased similarly and significantly in both groups. As expected, maternal plasma triglyceride levels increased significantly in the triglyceride-stimulated group 180 minutes after ingestion of triglyceride emulsion plus water. The fetal breathing index for the triglyceride-stimulated group increased from 19.1 +/- 5.7% (SEM) to 38.8 +/- 10.5% at 90 minutes after ingestion, and to 44.4 +/- 14.1% after 180 minutes (P less than .05). In the control group (ingesting mineral water only), the fetal breathing index increased form 8.6 +/- 3.5% to 44.9 +/- 6.9% and 49.0 +/- 13.1% (P less than .05) after 90 and 180 minutes, respectively. Plasma triglyceride levels remained unchanged. No significant increase in maternal plasma free fatty acids, glucose, insulin, glucagon, total cortisol, or free cortisol levels was found. No increase in the fetal breathing index was found over a 180-minute period in 6 pregnant women who had not had oral intake of food or water (P = .17). The results suggest that oral intake of water, with or without added triglycerides, by fasting mothers might stimulate fetal respiratory movements.

Administration, Oral↗
PubMed1981

Hepatic insulin extraction in human pregnancy.

The hepatic degradation of insulin in late pregnancy has been estimated by determination of the molar C-peptide: Insulin (C/l) ratio under fasting conditions in 20 normal women in late pregnancy and again 4--8 weeks post-partum. Fasting plasma C-peptide and insulin concentrations were both significantly enhanced in pregnancy. However, since the relative gestational increments in plasma C-peptide and insulin concentrations were of almost the same magnitude, the C/l ratio remained unaffected by pregnancy (7.3 +/- 0.07 (mean +/- S.E.M) (pregnancy) vs. 7.4 +/- 0.8 (post-partum), N.S.). The results suggest that, in pregnancy, peripheral hyperinsulinaemia is due, in general, to pancreatic hypersecretion rather than to diminished hepatic extraction of insulin.

Adult↗