Quantitative and qualitative changes in the early insulin response to glucose in subjects with impaired carbohydrate tolerance.
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Biomedical subjects
Publications and source records attributed to D Michaelis.
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In order to select a population at risk for the development of diabetes for a prospective study of the relationship of islet cell antibodies (ICA), islet cell surface antibodies ( ICSA ), and glucose tolerance after mumps infection, we carried out a screening program for diabetes. A diabetic survey was conducted among 1581 children (less than 16 yr of age) with mumps infection 14 mo before the survey, using a brief questionnaire combined with urinary glucose analysis. Responses to the screening program were obtained from 68.4% (N = 1080) of the children. Out of a total of 1080 subjects, 1069 (99%) had no diabetes mellitus, diabetic symptoms, or glucosuria. A "positive urine glucose screen" was obtained in 11 subjects (1%) of the study group. These individuals all had a normal oral glucose tolerance test according to the new WHO definition. A group of 86 children was randomly selected from the total group of 1080 children for follow-up glucose tolerance, ICA, and ICSA . Irrespective of the negative urine glucose screen impaired glucose tolerance was diagnosed in 3.5% (N = 3) of the 86 children. The prevalence of ICA and ICSA was 78% and 36%, respectively. The simultaneous prevalence of ICA and ICSA was 33%. The pathogenetic role of mumps infection and ICA/ ICSA and their possible relationship to slow progressive beta cell destruction remain to be elucidated.
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The authors describe characteristics and clinical application of the "ROTOP-insulin-test'' set. Radioimmunological insulin determination is carried out by the principle of reverse titration: 50 ml of plasma is incubated for 18 hours with antiserum. The remaining free valencies of insulin antibodies are bound with the excess of 125I-insulin. Bound 125I-insulin is precipitated after the addition of alcohol. The variation coefficient is 7.4% in one batch and 9.1% in analysis in 48 hours (insulin concentration = 2.08 ng/ml = 49 mcU/ml). The precision index of the standard curve was 0.022. Insulin secretion was analyzed in 107 healthy persons with a normal body weight under conditions of prolonged glucose infusion. Two phases of insulin secretion were shown.