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Biomedical subjects

D Fedele

Publications and source records attributed to D Fedele.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Ganglioside treatment in diabetic peripheral neuropathy: a multicenter trial.

Ganglioside treatment was evaluated with a multicenter, randomized, double-blind, controlled, cross-over vs placebo trial in 140 insulin-treated diabetic subjects with peripheral neuropathy. The patients entered the study when they showed an impairment in at least two of the electroneurographic parameters, and were assigned to two protocols according to the presence and severity of their neurological symptoms. Ninety-seven diabetic subjects with no or mild symptoms were assigned to protocol I, whereas 43 symptomatic patients were assigned to protocol II. the treatment periods lasted 6 weeks with an intermediate washout period of 4 weeks. The treatment consisted in the daily i.m. administration of 20 mg gangliosides or of placebo. Electroneurographic parameters were recorded at the beginning and at the end of each treatment period, whereas clinical and metabolic data (mean daily plasma glucose, glycosuria and glycosylated hemoglobin) were evaluated every three weeks in protocol I and every two weeks in protocol II. No change in the metabolic parameters was observed throughout the trial period. However, the treatment induced a statistically significant improvement of paresthesias (protocol II) and of some electrophysiological parameters; in particular, ganglioside treatment improved MCV of peroneal nerve (p less than 0.03) in patients of protocol I, MCV o ulnar nerve (p less than 0.002) and SCV of median nerve (p less than 0.06) in patients of protocol II. Furthermore, 22 subjects of protocol II showed a 'drug preference' while 10 preferred placebo and 9 had no preference. In conclusion, ganglioside treatment seems to have a positive effect on diabetic peripheral neuropathy, improving both some symptoms and some electrophysiological parameters.

Adolescent↗
PubMedDate not supplied

Red cell sorbitol concentration in relation to short- and medium-term variation of plasma glucose.

To evaluate the time course of changes in red cell sorbitol (RCS) concentration in relation to variations of plasma glucose levels, RCS was determined in 7 normal subjects during i.v. glucose infusion (IVGTT); in 6 hyperglycemic insulin-dependent diabetic subjects while glycemia was normalized with Biostator GC 115 and in 4 diabetic patients in previously poor metabolic control, in whom normal glycemia was obtained in 8-10 days by intensive insulin therapy. During IVGTT, plasma glucose levels increased with significant differences from baseline at 5, 10, 16, 25, 60, 100 and 160 min and returned to basal levels after 3h; RCS concentration showed small and insignificant increases. During i.v. insulin infusion, plasma glucose fell to almost normal levels within roughly 3h; RCS levels showed a gradual reduction becoming significant at 180 min. In the third study, decrease in plasma glucose was always associated with a fall in RCS level which became significant between the 2nd and the 3rd day of the study. Thus, RCS levels were not affected by very short-term variations of glycemia but by a previous hyperglycemic crisis that lasted a few hours. There were therefore medium-term variations of RCS level. In conclusion, RCS determination is not useful as an index of metabolic control in diabetes.

Activity Cycles↗
PubMedDate not supplied

Plasma and red cell sorbitol assay in diabetic subjects.

Plasma and red cell sorbitol concentrations, fasting plasma glucose, glycosylated hemoglobin (GHb) were evaluated in 30 diabetic patients and 42 normal subjects. Red cell sorbitol levels were evaluated in hemolysate and non-hemolyzed samples. Mean red cell sorbitol concentrations evaluated after hemolysis were 21.5 +/- 5 nmol/ml in diabetics and 12.2 +/- 4 nmol/ml in controls (p less than 0.001). Mean values of red cell sorbitol determined in non-hemolyzed samples were 13.9 +/- 3 nmol/ml in diabetics and 8.1 +/- 3 nmol/ml in controls (p less than 0.001). Mean plasma sorbitol concentrations were 8.4 +/- 3 nmol/ml in diabetics and 5.2 +/- 1 nmol/ml in controls (p less than 0.001). The within and between run reproducibilities evaluated in plasma, hemolysate and non-hemolyzed red cells gave the lowest values for hemolyzed red cell samples. The studies on stability showed that samples neutralized and stored at -20 degrees C gave reproducible values if assayed within 3 days. A positive correlation was found between red cell hemolysate sorbitol concentrations and fasting plasma levels in both diabetics (r = 0.56; p less than 0.001) and controls (r = 0.62; p less than 0.001). Red cell hemolysate sorbitol concentrations were also positively correlated to GHb in both diabetics (r = 0.64; p less than 0.001) and controls (r = 0.36; p less than 0.05). We believe the most effective sorbitol assay to be that obtained in hemolyzed red cells and that these values related to glycemic levels could be a useful index of metabolic control and an indicator of tissue sorbitol levels in humans.

Adult↗
PubMedDate not supplied

Does ethanol intake interfere with the evaluation of glycated hemoglobins?

Ethanol and/or its metabolites interfere with the chromatographic assay of glycated hemoglobins. Fasting plasma glucose, blood ethanol, HbA(1), HbA(1c), HbA(1a+b), MCV and GGT were determined in 22 control subjects; 22 alcoholics, 22 diabetic patients and 22 alcoholic diabetic patients. Fasting plasma glucose and all hemoglobin fractions were lower in alcoholic subjects and, except for HbA(1a+b), higher in diabetic patients and in alcoholic diabetic patients. HbA(1), and HbA(1c) correlated well with plasma glucose but not with blood ethanol, MCV and GGT. Glycated hemoglobin was not found to be a useful marker for alcohol abuse. With the chromatographic method we used, the evaluation of glycated hemoglobin fractions, chiefly HbA(1c), confirms its usefulness in monitoring the metabolic control of diabetic subjects, even in case of ethanol abuse.

Alcohol Drinking↗
PubMedDate not supplied

Diabetes and coronary risk factors, relative risk for single factors and aggregation of more factors in a general population sample from northern Italy.

In the course of a general population survey in Mirano (Venice), Northern Italy, a random sample of 1,903 subjects (50.1% men) aged 20-59 was examined. Fifty-five were diabetic (fasting plasma glucose greater than or equal to 140 mg/dl or diagnosed by a physician) and 1,670 non-diabetic subjects (fasting plasma glucose below 110 mg/dl). In this paper an assessment was made on the more frequent occurrence of coronary risk factors (serum cholesterol and triglycerides, body mass index (BMI), systolic blood pressure, cigarette smoking) and, in particular, of their aggregation in diabetic patients as compared to non-diabetic controls. The occurrence of any one of the coronary risk factors studied was more frequent in diabetic subjects and significantly so for triglyceridemia in both sexes and for systolic blood pressure and BMI in men. The aggregation of two or more risk factors was also more frequent in diabetic subjects than controls. Finally, the combined score of coronary risk as calculated by multiple logistic function showed higher values for diabetic subjects. These results confirm the need for a systematic search for coronary risk factors in diabetic subjects in order to prevent cardiovascular complications.

Adult↗
PubMedDate not supplied

Glycated serum protein determination: comparison between thiobarbituric acid and fructosamine assays.

Glycated serum proteins were evaluated with fructosamine (GSP-fructosamine) and thiobarbituric acid (GSP) assays in 60 normal and 60 diabetic subjects. Higher levels of GSP-fructosamine and GSP were found in diabetics in comparison to controls. GSP-fructosamine levels were positively related to GSP values and the other metabolic control parameters. Moreover, the fructosamine assay is sensitive, reproducible, rapid and easy to perform. Thus, fructosamine assay could be a useful method for glycated serum protein evaluation in diabetic patients.

Adult↗
PubMedDate not supplied

Bromocriptine acute effect on insulin, glucagon and growth hormone levels in acromegalic patients.

It has been shown that L-dopa or dopamine administration influences glucose metabolism, as well as insulin and glucagon release in man. In the present study, the effect of bromocriptine (CB-154), a long-acting dopamine agonist, on insulin, glucagon and growth hormone secretion in 32 acromegalic patients was investigated. Glucose, insulin and plasma glucagon levels were not modified following administration of bromocriptine or placebo. Moreover, plasma GH levels were decreased by more than 50% in 18 of the 32 acromegalics. Mean GH levels were significantly lower with respect to levels observed following placebo at 60 min to the end of the test (p less than 0.001). Administration of a double dose of CB-154 (5 mg po) one hour before arginine test did not affect insulin or glucagon secretion with respect to levels observed during arginine alone. In addition, there was a fall in GH levels similar to that observed following administration of bromocriptine alone. These findings suggest that bromocriptine in itself does not exert a direct action on insulin and glucagon release. Improvement in glucose tolerance and reduction in insulin secretion observed following prolonged CB-154 treatment in acromegalic patients are probably due to a simultaneous inhibition of GH secretion or to other peripheral effects of bromocriptine.

Acromegaly↗
PubMedDate not supplied

Growth hormone response to insulin and to arginine in patients with familial hypercholesterolaemia.

Human growth hormone (HGH) response to i.v. insulin (0.1 U/kg body weight) and arginine infusion (25 g of L-arginine for 30 min) was studied in 9 patients (5 males and 4 females) with primary familial hypercholesterolaemia and belonging to 4 families. Mean age was 28 +/- 2 years (range 18-36) and body weight was less than 105% of ideal body weight. Glucose tolerance and insulin response to oral glucose were normal in all patients. HGH release after insulin and after arginine was slightly increased as compared to 21 normal controls, but the differences were not significant. Insulin and glucagon response to arginine in these patients was within the normal range. Plasma glucose and free fatty acids were normal after both insulin and arginine. Moreover, no significant correlation was found between fasting cholesterol and HGH peaks after insulin and after arginine, nor between cholesterol and insulin and glucagon responses. Despite marked hyperlipidaemia, HGH-deficient patients examined by other authors never present signs of atherosclerotic disease. Our data suggest that HGH, in the presence of elevated cholesterol levels, might play an important role in the development of atherosclerotic lesions.

Adolescent↗
PubMedDate not supplied

Effects of clofibrate treatment on arginine-induced insulin secretion in endogenous hypertriglyceridemia.

Arginine-induced insulin secretion was evaluated in 13 patients with endogenous hypertriglyceridemia (Fredrickson's Type IV) before and after a two-month period of Clofibrate therapy. Clofibrate reduced triglyceride, cholesterol and FFA levels by 68, 28 and 15% respectively and provoked a significant reduction in arginine-induced insulin secretion without modifying glucose response. Arginine-induced insulin secretion was also studied in 11 normal subjects during saline and intralipid infusions. Glucose and insulin basal values, and glucose and insulin response to arginine infusion were not influenced by Intralipid infusion in these controls. These results confirm that clofibrate reduces insulin secretion thereby contributing to decreased serum triglyceride levels.

Adult↗
PubMedDate not supplied

Collisional spectroscopy as a screening procedure for the determination of FFI in complex natural matrices.

The build-up of brown products on long-lived proteins could be an important factor in determining long-term diabetic complications. A brown product 2-(2-furoyl)-4(5)-(2-furanyl)-1H-imidazole (FFI), present in the acid hydrolysate mixtures of beta-polylysine and beta-albumin has been identified by collisional spectroscopy, using a commercial double-focusing, reverse-geometry mass spectrometer. Using this approach the analyses were carried out without any sample derivatization or need for chromatographic separation procedures.

Albumins↗
PubMedDate not supplied

Pregnancy does not induce or worsen retinal and peripheral nerve dysfunction in insulin-dependent diabetic women.

In order to verify whether pregnancy induces or worsens diabetic retinopathy or somatic and autonomic neuropathy, 16 insulin-dependent diabetic (IDDM) pregnant women, 14 age-matched nondiabetic pregnant women, and 12 IDDM nonpregnant women matched for age and disease duration were studied. Plasma glucose, HbA1c, and fructosamine were repeatedly assayed during pregnancy. Retinopathic and neuropathic endpoints were evaluated through ophthalmoscopy, electrophysiology of left peroneal and sural nerves (motor and sensory conduction velocities), and cardiovascular autonomic tests (deep breathing, cough test, lying-to-standing). In the IDDM pregnant women, evaluations were performed three times during pregnancy and 6 months after delivery. Good metabolic control was achieved during pregnancy. At baseline, nine IDDM pregnant women did not show signs of retinopathy, and seven had nonproliferative retinopathy. Only one patient showed worsening during pregnancy, but she improved after delivery. Motor conduction velocity, significantly lower in IDDM pregnant women, progressively improved, and, in the third trimester, was not significantly different from that of nondiabetic pregnant women. At baseline, none of the IDDM pregnant women had abnormal responses to cardiovascular autonomic tests. During pregnancy, the response to deep breathing appeared temporarily reduced in all pregnant women, possibly due to lowered ventilatory excursion at the end of pregnancy. In IDDM women with minimal or no retinopathy, and subclinical or no peripheral neuropathy, pregnancy does not appear to induce or worsen these complications.

Adult↗
PubMedDate not supplied

An immunological evaluation of type II diabetic patients with periodontal disease.

Peridontal disease is a frequent complication of diabetes, and diabetic subjects often exhibit decreased immune response with increased susceptibility to infection. We evaluated the possible relationship between immune response and periodontal disease in 40 type II diabetic patients, mean (+/- SD) age 59 +/- 8 years and mean disease duration 17 +/- 4 years, with good metabolic control (mean fasting plasma glucose, 10.5 +/- 3.8 mM/L, mean HbA1c 8.1 +/- 1.66%), and in 40 age and gender-matched controls. Interproximal alveolar bone loss (ABL), as the percentage of bone loss from the cement enamel junction (CEJ) to the apex, was measured with a modified Schei ruler at the deepest point on the mesial/distal surface of the teeth, except third molars, on a panoramic radiograph. Immunological evaluation involved study of NADPH neutrophil superoxide production, neutrophil chemotaxis, lymphocyte subpopulations, immunoglobulins and complement. Diabetic patients showed significant differences compared with controls regarding ABL (30.6 +/- 14.7% versus 17.6 +/- 4.3%; p < 0.0001) and the T-helper/T-suppressor ratio (2.3 +/- 1.0% versus 1.8 +/- 0.8%; p < 0.05). Other parameters of cell-mediated immunity and humoral immune response did not show any significant variations. No correlation between immunological and radiographic analysis parameters were found. Further studies are needed to verify the exact role played by immunological factors in type II diabetic patients with periodontal disease.

Alveolar Bone Loss↗
PubMedDate not supplied

Standing to lying heart rate variation. A new simple test in the diagnosis of diabetic autonomic neuropathy.

We have examined the immediate heart-rate response to standing to lying (S-L) in 83 male insulin-dependent diabetic subjects aged 40 +/- 11 years (mean +/-S.D.) who underwent five other cardiovascular autonomic tests. Using a specially devised scoring system, the patients were divided into 3 groups: 54 subjects without autonomic neuropathy; 17 'borderlines'; 12 with autonomic neuropathy. The results were compared with those of 50 sex and age matched controls. We evaluated: S-L1 = ratio between R-R mean before lying and R-R minimum over the first 5 beats after lying; S-L2 = ratio between R-R maximum between the 20th to 25th beat and R-R minimum over the first 5 beats after lying. In controls S-L1 was 1.23 +/- 0.098 (mean +/- S.D.), S-L2 1.56 +/- 0.2. In diabetic subjects without autonomic neuropathy S-L1 was 1.18 +/- 0.096 (p less than 0.01), S-L2 1.50 +/- 0.23. In the autonomic group S-L1 was 1.03 +/- 0.01 (p less than 0.001), S-L2 1.16 +/- 0.086 (p less than 0.001). We propose that the lowest normal and highest abnormal limits of S-L1 are 1.10 and 1.07, respectively, and that normal and highest abnormal limits of S-L2 are 1.23 and 1.41, respectively. We suggest the use of S-L1 as a pure parasympathetic test and S-L2 as a mixed but predominantly sympathetic test in the diagnosis of autonomic neuropathy.

Adult↗