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Biomedical subjects

E A Chantelau

Publications and source records attributed to E A Chantelau.

At least 19 recordsLinked to original sources
PubMed1993

Quality of centralized diabetes care: a population-based study in the German Democratic Republic 1989-1990.

The efficacy of care in the centralized diabetes care system in the former German Democratic Republic was evaluated on the basis of the recommendations of the St. Vincent Declaration. Eighty-three per cent (n = 190, 46% women) of all insulin-treated diabetic patients aged 16-60 years who were registered in one district diabetes care unit were examined. Of these, 131 patients had type 1 (insulin-dependent) diabetes (69%) and 59 type 2 (non-insulin-dependent) diabetes (31%). All patients were on animal insulin and 96% (n = 187) had conventional therapy consisting of fixed insulin dose and a fixed diet. Levels of glycosylated haemoglobin (normal 4.15%, SD 0.54) were 6.3 +/- 1.3% in type 1 and 7.4 +/- 1.7% in type 2 diabetics. Retinopathy was found in 35% of type 1 (proliferative 3.8%) and 23% of type 2 patients (proliferative 3.4%). No patient was blind. Screening for nephropathy identified 29% of type 1 and 47% of type 2 diabetics as having albuminuria > 20 mg/l in early-morning urine. The prevalence of hypertension was 31% and 69% for type 1 and type 2 patients respectively. Foot ulcers were found in 2.1% and lower limb amputations in 2.1%. The incidence of severe hypoglycaemia (except in pregnancy) was 0.07 per patient per year. This study shows that the diabetes care system was effective and the winding up of this system with the reunification of Germany was not a medical necessity. However, the system failed to establish an integrated regime with regional general practitioners for the effective treatment of hypertension.

Absenteeism↗
PubMed1987

Intensive insulin therapy justifies simplification of the diabetes diet: a prospective study in insulin-dependent diabetic patients.

Dietary and metabolic variables were investigated in 48 unselected, nonobese Type 1 (insulin-dependent) diabetic patients before and 3 mo after changing from (a) traditional insulin and diet therapy to (b) intensified insulin plus simplified diet therapy. HbA1c levels declined significantly from 9.04 +/- 0.25% with therapy (a) to 8.34 +/- 0.16% with therapy (b) (p less than 0.005). During (a), 58% of all patients used a personal diet plan, but only 15% of them performed food exchange according to the traditional diet prescription. Their eating habits remained unchanged during (b). Since improved metabolic control in this study could be obtained without adherence to traditional diet schedules, a simplification of the traditional diabetes diet prescription seems justified for nonobese Type 1 diabetic patients on intensified insulin therapy.

Adult↗
PubMed1985

Moderate intake of sucrose does not impair metabolic control in pump-treated diabetic out-patients.

The effects of dietary intake of sucrose versus the use of sodium cyclamate were studied in 10 Type 1 (insulin-dependent) diabetic patients on continuous subcutaneous insulin infusion therapy. After a 4-week run-in period, the patients were randomly assigned to a cross-over protocol with two 4-week periods during which they used sucrose or sodium-cyclamate as sweetener. During the experimental periods, 24 +/- 13 g/day sucrose and 348 +/- 270 mg/day of sodium cyclamate were consumed, respectively. Metabolic control was monitored by the patients performing blood glucose self-monitoring several times daily. Bi-weekly, all patients were followed-up in our outpatient clinic. Mean daily blood glucose concentrations as well as the average daily insulin dose did not differ between the three experimental periods. HbA1c-levels, serum lipids and body weight remained unchanged and within the normal ranges throughout the study. Thus, moderate dietary intake of sucrose did not affect metabolic control in these normal weight, near-normoglycaemic, normolipidaemic, pump-treated Type 1 diabetic patients during a 1-month period. Whether similar conclusions apply to less well controlled diabetic patients remains to be seen.

Adult↗
PubMed1984

Target fasting glycaemia for pump-treated type-I diabetics.

In 17 type-I diabetic patients on continuous s.c. insulin infusion (CSII) therapy, potential interrelationships between fasting levels of blood glucose (BG), serum free insulin (free IRI), total (free and bound) insulin (total IRI) and insulin-binding immunoglobulin G ( IgGI ) were evaluated. There was no consistent relationship between the basal s.c. infused insulin dosages and the associated insulinaemia or glycaemia. A significant inverse correlation was found between the fasting levels of serum free IRI and BG (P less than 0.005). On the basis of this interrelationship, a target range of 90-110 mg/dl for fasting BG during CSII treatment is proposed.

Adult↗
PubMed1983

Diet and pump-treated diabetes: a long-term follow-up.

Long-term effects of a liberalized diabetes diet without meal-planning and food-exchange were investigated in lean type-I diabetic patients treated by continuous subcutaneous insulin infusion (CSII). Food intake, body weight, HbA1c levels and serum lipids were recorded during conventional s.c. insulin injection treatment (CIT) and after 1 month or 14 months of CSII, respectively. During CSII plus liberalized diet, metabolic control improved significantly (compared to previous CIT plus conventional diet) as indicated by a decrease of HbA1c from 9.5% to 7.9% (p less than 0.005). Serum lipids remained unchanged. Body weight did not change significantly during CSII plus liberalized diet; mean body mass index increased from 21.5 to 22.4 kg/m2 (CIT vs. CSII, n.s.). During CSII, eating habits were similar to those of the general West Germany population regarding the number of meals and the nutrients composition. We conclude that during CSII, meal-planning and food-exchange that during CSII, meal-planning and food-exchange can be omitted provided the patients maintain (near-) normoglycaemia by appropriately adjusting the s.c. insulin delivery. Lean type-I diabetics on CSII do not require specific restrictions as to their caloric intake in order to prevent weight gain.

Adolescent↗
PubMedDate not supplied

Short-term evaluation of an electro-chemical system (ExacTech) for blood glucose monitoring.

114 venous blood samples (plasma glucose ranging between 2.6 and 30.7 mmol/l) were measured by a new pen-sized glucose meter designed for blood glucose self-monitoring working with an electro-chemical method. Glucose readings of three pen-meters were compared with plasma glucose measurements obtained from a standard glucose-oxidase-method. Precision, accuracy and clinical relevance were determined by assessment of the agreement between the two methods and error grid analysis. The mean differences between the pen-meters' blood glucose readings and plasma glucose were -1.35, -1.43 and -1.56 mmol/l, with limits of agreement (+/- 2 SD) of 2.2 and -4.9, 2.1 and -5.0 and 2.0 and -5.1 mmol/l, respectively. The 57 samples in the clinically relevant range, i.e., with plasma glucose concentrations below 13 mmol/l showed mean differences of -0.04, -0.10, and -0.04 mmol/l, with limits of agreement between -1.08 and 1.00 mmol/l, respectively. Error grid analysis showed that 90.7, 95.4, and 91.9% of the respective pen-meter readings fell in the zone A, i.e., gave clinically accurate results, the remaining values fell in zone B. One pen-meter broke during the study and had to be replaced. The results confirm that this new device gives accurate and reproducible measurements--faultless technical function provided--and, compares favorably with the well-established reagent strips for blood glucose self-monitoring.

Biosensing Techniques↗