PubMed Health⌕ Search

Biomedical subjects

D A Pyke

Publications and source records attributed to D A Pyke.

At least 73 records · Page 4Linked to original sources
PubMed1981

Circulating prostanoid levels, both basal and during the chlorpropamide alcohol flush, in non-insulin dependent diabetes.

Circulating basal levels of prostanoids were measured in non-insulin dependent diabetics (NIDDs) who showed chlorpropamide alcohol flushing (CPAF), with and without diabetic complications, and in non-diabetic controls. Prostanoids were also measured during CPAF in those diabetics in whom CPAF is or is not blocked by indomethacin and also in CPAF-negative patients. There was no significant difference in circulating prostanoids between diabetics with and without severe vascular disease. The level of prostaglandin F, however, was significantly higher in the diabetic than in the non-diabetic subjects (mean +/- SEM PGFM 521 +/- 23 v. 414 +/- 18 pmol/l respectively P less than 0.01). In the group in whom CPAF could be blocked by indomethacin there was a significant rise in thromboxane during CPAF when compared with basal values (mean +/- SEM 905 +/- 48 v. 688 +/- 46 pmol/l respectively P less than 0.01) which was abolished by prior administration of indomethacin. There was no significant rise in prostacyclin or PGF. The group in which CPAF could not be blocked by indomethacin and the CPAF negative group showed no rise in any of the prostanoids measured. These findings support the concept of at least two different groups of CPAF positive NIDDs, one in which prostanoids are involved in CPAF and one in which they are not. It is the group in which prostanoids are involved in CPAF who seem to be highly protected against vascular disease.

6-Ketoprostaglandin F1 alpha↗
PubMed1980

Computerisation of diabetic clinic records.

A simple system for putting diabetic records on a computer file is achieved by using stationery that combines the usual handwritten records (not computerised) with the minimum of essential data suitable for punching on to computer tape. The record may be brought up to date at a selected time time interval. This simple, cheap system has been in use in a busy clinic for six years. The information on about 8000 diabetics now held in the computer file is used chiefly to help research by creating registers of patients with specified characteristics, such as treatment, heredity complications, and pregnancy. A complete up-to-date index of the entire clinic population is always available, and routine clinic statistics are returned every six months.

Computers↗
PubMed1980

Diabetes and ECT.

Explore the source record for details and available documents.

Diabetes Mellitus↗
PubMed1980

Blockade of chlorpropamide-alcohol flushing by indomethacin suggests an association between prostaglandins and diabetic vascular complications.

Chlorpropamide/alcohol flushing (CPAF), found in many patients with non-insulin-dependent diabetes (NIDD), can be blocked by indomethacin in most patients who are free of vascular complications but not in those with such complications. Since indomethacin is a prostaglandin inhibitor this finding suggests that prostaglandins may be involved in the aetiology of vascular diseases in NIDD. All 6 pairs of identical twins with CPAF, of whom 2 pairs were disocrdant for diabetes, were concordant for indomethacin blocking, which suggests that the block has a genetic basis. The difference in the response of CPAF to indomethacin in diabetic patients with and without vascular complications is probably the first indication of a metabolic difference between these two types of patient.

Blood Vessels↗
PubMed1980

Chlorpropamide-alcohol flushing and large-vessel disease in non-insulin-dependent diabetes.

A total of 220 non-insulin-dependent diabetics aged over 45 (139 with a history of chlorpropamide-alcohol flushing and 81 without such a history) were examined for the prevalence of large-vessel disease. Large-vessel disease was significantly more common in the group without a history of flushing (41% v 24% of the two groups respectively; p < 0.05). A history of myocardial infarction was found in 14 (17%) of the patients without flushing but in only 10 (7%) patients with flushing. Similar differences were detected in the prevalences of angina, intermittent claudication, and absent foot pulses. There were, however, no significant differences in the prevalence of cerebrovascular disease or hypertension between the two groups. These results suggest that patients with non-insulin-dependent diabetes who flush in response to chlorpropamide and alcohol are significantly less likely to develop large-vessel disease than those who do not. Hence such flushing is probably related to the pathogenesis not only of small-vessel but also of large-vessel disease.

Cardiovascular Diseases↗
PubMed1980

Management of the pregnant diabetic: home or hospital, with or without glucose meters?

Thirteen pregnant insulin-dependent diabetic patients were allocated to blood-glucose self-monitoring (meter) or conventionally treated (non-meter) groups at 30--31 weeks. A day-profile of blood-glucose and intermediary metabolite levels was obtained 2 weeks later at home and after routine admission to hospital at 35--36 weeks. Metabolic profiles were also obtained in eight normal pregnant women of equivalent gestational ages admitted to hospital for study. The mean blood-glucose and metabolite concentrations in both the meter and non-meter groups were similar to those obtained in the non-diabetic pregnant women (mean diurnal blood-glucose 4.6 +/- 1.1 mmol/l, meter group; 5.3 +/- 1.5 non-meter group; 4.8 +/- 0.8 controls). The diabetic control achieved at home was not improved by the use of a meter or admission to hospital (mean glucose at home 5.0 +/- 1.3 and 6.3 +/- 1.6 mmol/l in hospital). Both the use of a meter and admission to hospital may be valuable in some patients. Neither, however, is essential for the good control of blood-glucose in all pregnant diabetics.

Adolescent↗
PubMed1980

Asthma induced by enkephalin.

A total of 291 diabetics were studied to see whether an asthmatic reaction was associated with facial flushing induced by chlorpropamide and alcohol. Of these patients, 191 reported facial flushing, of whom 12 reported breathlessness as well. Of these 12, five also described wheezing, and respiratory function tests showed them to have asthma. Three of these five patients underwent further tests, which showed that the asthmatic reaction could be prevented by giving disodium cromoglycate and the specific opiate antagonist naloxone. One patient developed wheezing when given an enkephalin analogue with opiate-like activity. Asthma induced by chlorpropamide and alcohol was concluded to be mediated by endogenous peptides with opiate-like activity such as enkephalin.

Asthma↗
PubMed1980

Effect of enkephalins and morphine on insulin secretion from isolated rat islets.

The direct effects of an enkephalin analogue, (D-Ala2/MePhe4/Met/(O)-o1) enkephalin (DAMME), on insulin release from isolated islets of Langerhans of the rat have been investigated. DAMME had a dose-dependent effect on insulin secretion: low concentrations (10(-10) to 10(-8) mol/l) were stimulatory while high concentrations (10(-5) mol/l) were inhibitory in the presence of 8 mmol/l glucose. Similar effects were found with met-enkephalin, and with the longer acting alanine substituted met-enkephalin. Morphine sulphate (5 X 10(-7) mol/l) also stimulated insulin release. The effects of enkephalin and morphine were blocked by the specific opiate antagonist naloxone hydrochloride (1.2 X 10(-6) mol/l). The insulin secretory response of perifused islets to enkephalins and morphine was rapid, corresponding to the first phase of glucose induced insulin release. These observations suggest that there may be opiate receptors in islets, and that opioid peptides could modulate insulin release.

Animals↗
PubMed1979

Chlorpropamide alcohol flushing and diabetic retinopathy.

"Mason-type" diabetics (mild diabetes which is dominantly inherited) are relatively free of retinopathy. Alcohol almost invariably causes facial flushing in these patients when they are given chlorpropamide (chlorpropamide alcohol flush, C.P.A.F.). 291 non-insulin-dependent diabetics were examined to see whether there was a difference in frequency of retinopathy between C.P.A.F. positive and negative cases who were of comparable age and duration of diabetes. Retinopathy was commoner and often severe in CPAF negative patients. Blindness from retinopathy was almost confined to C.P.A.F.-negative cases. Lens opacities, on the other hand, were equally common in both groups. Since C.P.A.F. is an inherited trait, retinopathy in non-insulin-dependent diabetics is to a considerable extent, although not entirely, determined by genetic factors.

Cataract↗
PubMed1979

C-peptide response to glucagon in diabetics with and without complications.

Beta cell function has been studied by measurement of C-peptide responses to intravenous glucagon in 11 diabetics with advanced complications and compared with nine long-term diabetics without complications. The majority had no C-peptide responses, but there was evidence of beta cell function in one patient from each group. These observations suggest that some factor other than continuing beta cell function is involved in the complications of insulin-requiring diabetics.

Adult↗
PubMed1979

Sensitivity to enkephalin as a cause of non-insulin dependent diabetes.

Non-insulin-dependent diabetes is associated with facial flushing after alcohol in patients on chlorpropamide (chlorpropamide alcohol flushing, C.P.A.F.) especially when there is a family history of diabetes. C.P.A.F. in three subjects (two diabetics, one non-diabetic) was blocked by the specific opiate antagonist naloxone. In nine subjects (six diabetics) C.P.A.F. was reproduced by the enkephalin analogue with opiate-like activity [D-Ala2, MePhe4, Met (O)-ol] enkephalin (DAMME). C.P.A.F. thus may be due to increased sensitivity to endogenous opiates. DAMME and other substances with opiate-like activity, such as morphine and beta-endorphin, affect carbohydrate metabolism and insulin secretion. Increased sensitivity to endogenous opiates such as enkephalin may thus give rise to non-insulin-dependent diabetes associated with C.P.A.F.

Alcoholic Beverages↗