PubMed Health⌕ Search

Biomedical subjects

D Michaelis

Publications and source records attributed to D Michaelis.

At least 109 records · Page 6Linked to original sources

[Is primary or secondary prevention of diabetes mellitus in hyperliporoteinemia possible under long-term clofibrate therapy?].

The investigations of metabolism explained speak for an improved condition of the carbohydrate metabolism during the first months of the therapy. However, they are not sufficient to prove a preventive effect of clofibrat per se during long-term treatment. Our examinations by means of the glucose infusion test show that on certain defined conditions with intensive general treatment positive effects may be registered, which, however, cannot be reproduced in a large collective during outpatient care. On the contrary, it is to be assumed that the whole therapeutic regime has an influence. Nevertheless, one may establish that the incidence portion of the diabetes manifestation in patients with hyperlipoproteinaemia treated with regadrin corresponds nearly to that one of the average population of Dresden. It is puzzling that the death rate in patients with hyperlipoproteinaemia and diabetic condition of metabolism is significantly higher than in hyperlipoproteinaemia without disturbance of the carbohydrate metabolism.

Clofibrate↗

[Carbohydrate tolerance and behavior of insulin in the glucose infusion test in persons with normal weight with prediabetic suspicion].

In altogether 289 persons with normal weight with suspicion of the existence of a prestage of diabetes the 2 hour's glucose infusion test was carried out. In these cases 61% of the test persons showed a normal, 8% a critical, 26% a pathological and 5% a manifest diabetic metabolic condition. A reduction of the initial and late phase of the insulin secretion provable with deterioration of the carbohydrate tolerance must be regarded as cause of metabolic disturbances. The lack of a significant relation between diabetic heredofamiliality and carbohydrate tolerance indirectly refers to the importance of the environmental factors which on the basis of a genetic defect have a decisive influence of the morbidity caused by diabetes. The reduction of the initial phase which is provable already in potential diabetes, particularly clearly it is to be demonstrated in pathological and manifest diabetic metabolic situation, may be regarded as an early symptom of diabetes. Carbohydrate tolerance and preparation of insulin were reduced in decenniums of older age.

Adult↗

[Relations between portal and peripheral venous insulin, proinsulin and glucagon concentrations after oral glucose in man].

During cholecystectomy a catheter was inserted into the V. porta via V. umbilicalis. 7 or 8 days later an oral glucose tolerance test was performed (100 g). Blood glucose, insulin (IRI), proinsulin-like material (PLM), and pancreatic glucagon (IRG) concentrations were determined in portal as well as in peripheral venous blood. 5 out of 6 patients showed a disturbed carbohydrate tolerance in comparison to 53 healthy subjects. The IRI increased promptly after the oral glucose load. The portal IRI-concentrations are significantly enhanced in comparison to the peripheral levels, but between both a positive correlation exists (r = 0.9447; p less than 0.01). PLM was slightly increased in the first 10 minutes. The basal IRG levels were not enhanced. Significant differences between the portal and peripheral IRG concentrations could not be observed. The correlation coefficient was 0.8902. Thus, the peripheral venous concentrations of IRI, PLM and IRG can be used as a diagnostic tool of pancreatic hormone secretion in man.

Administration, Oral↗

Clinical and metabolic studies in children of diabetic-mothers.

Children of diabetic mothers are a high-risk group. The perinatal mortality and the malformation frequency of the newborns as well as the psychosomatic, somatic and speech development during childhood until the age of 15 were statistically significantly influenced by quality of metabolic compensation, toxaemia and urinary tract infections during pregnancy. To evaluate the diabetogenic risk in children of diabetic mothers metabolic follow-up studies were performed. A statistically significant insulin-high-response without disturbed carbohydrate tolerance was seen in 25% after intravenous glucose infusion and in 28% after oral glucose load. 17% exhibited a paradoxical growth hormone reaction, while the intravenous glucose tolerance and the insulin secretion was in the normal range. Both symptoms could be early diabetic signs in children of diabetic mothers. The oGTT had pathological results in 18% and the glucose infusion test in 8%.

Adolescent↗

[Diagnosis of the early stages of diabetes and prevention of diabetes manifestations].

According to our experiences the value of the GIT in the diagnostics of the pre-stages of diabetes on account of the recognizability of the two phases of secretion of insulin and the good reproducibility is above the value of the oGTT and iGTT. In consequence of the large methodical expenditure it is left to the highly specialized stationary diagnostics. The development of the carbohydrate intolerance is concomitant with a significant reduction of the glucose-induced insulin secretion in the early phase. In contrast to this, in about 70 per cent the second phase of secretion corresponds to the normal when the pathological carbohydrate tolerance appears and is significantly reduced to 60 per cent only at the time of the manifestation of diabetes. The reduction of weight as well as buformin are suitable therapeutics of the manifestation prophylaxis. In these cases in the adipose asymptomatic diabetes should primarily always be striven for a normalisation of the body-weight, whereas for test persons with normal weight the indication for the buformin-therapy is given.

Carbohydrates↗

[Comparison between the oral glucose tolerance test and the glucose infusion test in the characterization of protodiabetes].

Within 3 days the 2-hour glucose infusion test (GIT) and the 50gm oral glucose tolerance test (oGTT) were performed in 113 normal weight and 33 obese persons suspected to protodiabetes and in 14 control subjects respectively. The results are compared with criteria from a group of healthy persons without any heredity of diabetes worked out in our laboratory. In about 66 per cent of the investigated subjects a concordance between both tests could observed in carbohydrate tolerance. Abnormal results were found more frequently after the oral glucose application. From these finding it was concluded a higher sensitivity of the oGTT. On the other hand followup studies of the disagreed diagnosis have shown that in 91 per cent the test results of the GIT were reproduced. The insulin secretion pattern agreed in 70 per cent between both tests. Whereas the insulin secretion pattern during the oGTT does not allowed to differ between the groups using the glucose infusion test we were able to observe a significant diminished hormone release in the initial as well as in the late phases, if the carbohydrate tolerance was pathologically. Summarizing the results we concluded that the GIT is characterized by a good reproducibility and a higher diagnostic importance than the 50 gm oGTT.

Administration, Oral↗

[Results of long-term biguanide therapy as a preventive measure in protodiabetes].

55 patients with pathological glucose tolerance received a long term treatment with buformin (200 mg daily). In 43 of the protodiabetics the duration of treatment was one year, in 29 of them two years and in 11 three years. The age of the patients was 38 years and the mean relative body weight was 118 per cent. The effect of buformin on glucose tolerance and insulin secretion was tested with the glucose infusion test before and after the periods of treatment. After one year we found in 58 per cent, after two years in 69 per cent and after three years in 64 per cent of the protodiabetics an improvement of glucose tolerance. In these groups the results showed a rise of the IRI in the low responder and a decrease of the IRI in the high responder. The good effects on glucose tolerance were not demonstrable in the compared groups with long-term treatment of diet only.

Adolescent↗

Effect of glucose infusion on venous blood levels of immunoreactive proinsulin activity, insulin activity and fat parameters in healthy and protodiabetic subjects.

Concentrations of immunoreactive insulin activity (IRI) and proinsulin activity (IRP), blood glucose, free fatty acids (FFA), glycerol, cholesterol, triglycerides were analyzed in 140 subjects suspect of protodiabetes and 50 healthy persons before, during and after a glucose infusion test (GIT). The protodiabetic subjects were classified into normweight, overweight, obese, hyperlipemic groups with diet or with Regadrin therapy and each of them subdivided into such with normal and such with pathological carbohydrate tolerance. Norm- and overweight subjects with asymptomatic diabetes were characterized by a significant reduction of insulin secretion during both phases. Obese patients with or without hyperlipoproteinemia demonstrated an increased IRI reaction during the late phase of secretion. Carbohydrate intolerance was associated with an enhancement of basal triglyceride levels and a reduced depression of glycerol and FFA during the GIT. There were no differences in fasting or reactive IRP concentrations between healthy and protodiabetic subjects with normal carbohydrate tolerance. In asymptomatic diabetes the IRP levels were increased during the late secretion phase, but the percentage of IRP in total IRI was normal or--in existing high response--significantly reduced in comparison to norm response. The results do not support an enhanced IRP secretion as the cause of carbohydrate intolerance.

Adult↗