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Biomedical subjects

G Panzram

Publications and source records attributed to G Panzram.

At least 19 recordsLinked to original sources
PubMed1988

[Development of angiopathies in type 2 diabetes mellitus--results of a prospective 10 year study].

In 150 newly detected type 2 diabetics the formation of macro- and microangiopathic complications during a 10-year control period was prospectively analysed, in order to demarcate possible factors of influence for the vascular prognosis under preventive points of view. Already at the time of manifestation there was with 34.3% an above average high prevalence of the coronary heart disease, particularly in the female sex. The prevalence of the coronary heart disease further increased to 49.7% in the course of diabetes and showed a correlation to the initial age, to the existence of overweight, hypertension, hyperlipoproteinaemia and nicotine consumption. The PMA was found comparatively more infrequent in the manifestation of diabetes (9.7%), but in the course of the disease highly significantly and independently of sex increased to 61.9%. The development of PMA was correlated with the age, the existence of hypertension and overweight. The frequency of retinopathy increased from initially 3.7% to 18.7%, the prevalence of nephropathy from 4.0% to 22.2%, without having found prognostic influence factors at the date of the diagnosis of diabetes.

Adult↗
PubMed1988

Lipoprotein pattern in long-term diabetes of an at least 35 years' duration. Results of the Erfurt Study.

All diabetic patients suffering from the disease for at least 20 years and living in the closed area of the Erfurt district in 1970 have been followed prospectively since that time. In 47 of them still alive in 1985, i.e. after more than 35 years of diabetes, serum lipid and apolipoprotein concentrations were measured and compared to those of non-diabetic subjects without cardiovascular diseases (n = 47) pair-matched by sex, age, and body weight. In males (n = 27) significantly (p less than 0.01) higher levels of HDL cholesterol and apolipoprotein A-I as well as lower concentrations of triglycerides and a lower total cholesterol/HDL cholesterol risk ratio than in nondiabetic control subjects could be found. In long-term diabetic females (n = 20), apolipoprotein A-I levels were also increased (p less than 0.02). Trends in HDL cholesterol and triglycerides were similar to those found in males but did not reach statistical significance. Higher concentrations of total cholesterol (p less than 0.02), LDL cholesterol (P less than 0.05), and apolipoprotein B (p less than 0.02), however, did not fit in with a beneficial lipoprotein pattern. The frequency of pathological lipoprotein patterns was not higher than among the non-diabetic control subjects (32% and 40%, respectively). According to these findings an antiatherogenic lipoprotein pattern might be considered, at least in males, as one of the determinants causing the multifactorial event of long-term survival in diabetes.

Cholesterol↗
PubMed1988

Serum lipids and apolipoproteins in relation to glycaemic control and diabetic nephropathy in long-term survivors of diabetes: results of the Erfurt Study.

Follow-up data of all 208 long-term diabetics (duration of the disease at least 20 years) living in the closed area of the Erfurt district in 1970 had demonstrated the importance of lipoprotein pattern for longevity. Now the dependence of lipoprotein levels on both the diabetes-related conditions nephropathy and glycaemic control has been examined in 47 of them, still alive in 1985 that means 35 or more years after the onset of diabetes. Glycaemic control was assessed by measuring the glycosylated haemoglobin (n = 44). Diabetic nephropathy was assumed in case of persistent proteinuria. Poor glycaemic control (n = 16) was associated with increased levels of atherogenic lipoproteins as reflected by higher concentrations of total cholesterol, LDL cholesterol, apolipoprotein B, and triglycerides, as well as a changed HDL composition indicated by a decreased HDL cholesterol/apolipoprotein A--I ratio. Higher ratios of total cholesterol to HDL cholesterol and apolipoprotein B to apolipoprotein A--I point to an increased risk of developing atherosclerotic diseases in poorly controlled diabetics. 86% of the well controlled long-term diabetics had non-pathological values of LDL cholesterol, triglycerides, apolipoprotein B, HDL cholesterol, and apolipoprotein A--I but only 31% of the poorly controlled patients did so. Diabetic nephropathy in the absence of chronic renal failure (n = 10) was characterized by higher values of LDL cholesterol, triglycerides, total cholesterol/HDL cholesterol, and apolipoprotein B/apolipoprotein A--I. 80% of the subjects with a pathological lipoprotein pattern were proteinuric or in poor glycaemic control or both. Therefore, it is concluded that prevention of these two conditions might help to delay atherosclerosis via its beneficial influence on lipoprotein metabolism.

Apolipoproteins↗
PubMed1987

[Prospective analysis of the natural course of non-insulin dependent diabetes mellitus in early adulthood].

Non-insulin-dependent diabetics with early manifestation of the disease (NIDDM) who were registered by an epidemiological cross-sectional study 1979 in the Erfurt district were pursued prospectively and 47 of the 58 patients underwent a re-examination five years later. The changes of therapy performed (7 new administrations of insulin, 9 change from diet to normal food) as well as the metabolic development of the patients under epidemiological aspect prove the heterogeneity of NIDDM and the doubtfulness of hitherto existing MODY-criteria. The oGTT performed in 37 patients 9 times resulted in a full remission and in 4 cases in an IGT. Including the 10 insulinized patients 34 diabetics (72.3%) had remained manifest. In contrast to the initially different degree of post-load hyperglycaemia in patients with and without remission the behaviour of the insulin secretion did not show any significant differences in the course and between the groups of patients. Young non-insulin-dependent diabetics are mainly among a representative target population type-II-diabetics with early onset. In contrast to this type-I-diabetics with a long insulin-free initial phase go into the background. In our population real MODY-cases are apparently extraordinarily rare.

Adolescent↗
PubMed1987

[Long-term effect of combination glibenclamide-insulin treatment in the secondary failure of sulfonylurea therapy--results of a one-year double blind study].

The long-term efficacy of combined insulin-glibenclamide treatment was investigated in 79 secondary drug failure patients by means of a double-blind, randomized placebo-controlled study. During a one-year follow-up period the patients on insulin plus glibenclamide required significantly lower exogenous insulin doses. Coincidentally, C-peptide concentrations were significantly raised in the verum versus the placebo group. Additionally, the administration of glibenclamide resulted in a decreased level of hyperglycaemia during the first six months of the observation period. Glibenclamide withdrawal after six and again after twelve months of the combined therapy provoked a deterioration of glycaemic control, as well as a lowering of the C-peptide concentrations. The findings demonstrate a prolonged beneficial effect of the combined treatment, in contrast to the solely short-term effects predicted by numerous studies. The metabolic improvement must be ascribed in part to the beta-cytotropic effect of glibenclamide. Extrapancreatic pathways via receptor/postreceptor mechanisms cannot be excluded.

Blood Glucose↗
PubMed1987

[Prospective follow-up studies in long-term diabetes. Results of the Erfurt study].

In 1970, in cooperation with the 14 district diabetic consultation centers of the Erfurt region (German Democratic Republic), all 208 known diabetics of the region with a known history of diabetes of at least 20 years (maximally 42 years) were registered and underwent multidisciplinary investigations. They were followed prospectively for at least 15 years. At the end of this period of observation, in 1985, 135 patients had died, 59 were still alive, the course of 14 is unknown. Of the 59 patients who were still alive in 1985, 49 (44 type I) were re-examined. There was a 2.1 times excess mortality rate compared with metabolically normal, interindividually paired (by age, sex and weight) controls. Cause of death in 89 patients (69.9%) was arteriosclerosis, predominantly of the coronaries, renal failure in only 9 (6.7%). Nearly all those patients who already in 1970 had evidence of advanced microangiopathies (proliferating retinopathy; persistent proteinuria) and/or macroangiopathy (authors' scoring system for coronary, cerebral and peripheral vascular disease) died during the observation period. Ophthalmoscopically normal or only mildly abnormal fundi revealed little tendency towards progression, despite the 35-55 years' duration of diabetes. Similar observations were made in the survivors as regards initially normal ECGs. The prognosis of long-term diabetes was decisively influenced by age and the severity of any arteriosclerotic disease, but not by the duration of diabetes.

Adult↗
PubMed1985

[Circadian behavior of hemostaseologic parameters in diabetic patients and metabolically healthy individuals].

In three groups of test persons [10 persons each with healthy metabolism under fasting (A) and intake of food (B); 10 insulin-dependent diabetics (C)] the determinations of the thromboplastin time, the partial thromboplastin time, the bleeding time, the spontaneous fibrinolytic activity, the number of thrombocytes and the aggregation of platelets were carried out on the day (A) and round the clock (B abd C), respectively. The values of the fasting persons with healthy metabolism distributed themselves on the day constantly in the area of width of errors. Under food intake persons with healthy metabolism showed circadian variations of the several tests. In diabetics the parameters of haemostasis revealed in the course of day a clear increase of the unstable behaviour compared with the control group B. There were no relations to the actual blood sugar value. In a tendency to more coagulation-active values in the late afternoon interindividually a general biorhythmical behaviour pattern could not be recognized. The proved increased circadian labilisation of the haemostasis potential in diabetics deserves more attention with regard to the connection between thrombophilia and atherogenesis.

Adolescent↗
PubMed1985

[Clinical and functional studies of diabetic cardiopathy].

In 30 diabetics and 30 patients with healthy metabolism who anamnestically, clinically and electrocardiographically did not show any references to a coronary heart disease the systolic time intervals and contractility indices of the carotid pulse curve were determined in lying position as well as under passive and active orthostasis load. Diabetics with a microangiopathy already under conditions of rest showed a tendency to pathological values. Unequivocal deviations were to be registered under conditions of the tilting table, particularly when the values obtained under orthostasis are related to the measuring data in rest. The restricted cardiac regulation breadth of diabetics with microangiopathy is particularly expressed in a compared with the control groups clearly reduced reaction of the presphygmic phase, the time of pressure increase as well as the quotients PEP/LVET, LVET/ICT and PEPstanding/PEPlying.

Adolescent↗
PubMed1985

Long-term diabetes--associated factors in survivorship and mortality.

Patients with long standing diabetes mellitus were analysed in order to identify associated factors in survivorship and mortality. Two population-based investigations were performed. In the Erfurt district all 20 years' survivors (208 patients, survival time up to 42 years) were studied longitudinally. Within the total diabetic population of the GDR all 40 years' survivors (159 patients, survival time up to 59 years) were investigated cross-sectionally in a multicentre study. During a 12-year follow-up a 2,6 fold excess mortality was registered. Although most patients in both studies were insulin-treated type-1 diabetics, death due to renal failure was observed only in 7%. In general the appearance of macroangiopathy was considerably postponed. Coronary heart disease represented the main cause of death (41.9%). Taking together both studies, to successfully overcome several decades of diabetes appears to be associated with age, age of onset, body weight, blood pressure, daily insulin dose, serum triglycerides, dietetic adherence and degree of compliance. In long-term diabetics, duration of illness exerts no prognostic influence. Some patients have survived for even half a century of diabetes despite additional atherogenic risk factors and bad compliance. Obviously, long-term diabetes is a multifactorial event including protective mechanisms yet unknown. Most long-term studies in diabetes so for have been based on case material from specialized centres (Oakley et al. 1974, Paz-Guevara et al. 1975, Dekkert et al. 1975) or have been performed without an epidemiologic background (Chazan et al. 1970, Ryan et al. 1970, Cochran et al. 1979). Due to unavoidable selection factors those studies do not provide representative samples of the diabetic population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

[Prognosis of diabetes mellitus after an early diagnosis by means of glucosuria screening. Results of a 10 year course control].

The 10-year course of diabetes in 250 patients detected by glucosuria screening in 1963 was evaluated in an inter-individual pair comparison with patients from the same territory admitted during the same calendar year. Pairs were grouped according to age, sex, and weight. Judged by mortality, survival time, causes of death, and vascular complications, the medium-term prognosis was not improved by screening, although in the screening group a strict diet could be maintained to a greater extent. Problems of evaluation and effectiveness of mass examination in chronic diseases are discussed. Glucosuria and hyperglycemia do not suffice as screening criteria for the early recognition of the complex risk of arteriosclerosis in maturity onset diabetes. Multi-screening in groups with especially high diabetes risk is expected to yield higher effectiveness than the mass screening hitherto performed.

Diabetes Mellitus↗
PubMed1977

[The course of asymptomatic diabetes under varying preventive therapy--concluding report of a 5-year prospective study].

During a prospective study the course of asymptomatic diabetes in different preventive treatment (diet, additionally tolbutamide, carbutamide or buformin) was observed concerning the frequency of manifestation and the behaviour of the oral glucose tolerance. Among the 100 protodiabetics after 5 years 38 clinical manifestations could be established, which finally nearly equally were distributed to all 4 groups of treatment. Only under the influence of buformin an effect preventing manifestation limited to 2 years appeared. Patients with persisting full or partial remissions continuously and more decreased in weight than cases of manifestation. Furthermore, the course was determined by the initially existing degree of hyperglycaemia as well as by the improvement of the glucose tolerance achieved in the first year. On account of the results of the examinations and the existing literature a preventive use of oral antidiabetics cannot be recommended.

Buformin↗
PubMed1977

[Studies on mortality in diabetics in a circumscribed region: age and death, length of diabetes and causes of death].

Studies were carried out in regard to the age at death, duration of diabetes mellitus at the time of death and cause of death in an unselected evaluation of the findings in all 1694 diabetics who died in Erfurt and environs over an 11-year period. The The mean age of the patients at the time of death was 70.6 years, with virtually no difference between the sexes. Only six patients died prior to the age of 40. In accordance with the age structure of diabetics in a circumscribed area, the average survival time was 6.5 years. The interval between the first manifestation of the disease and death was 0 to 4 years in 45% of the patients; only every fifth patient survided for 10 or more years. These results are interpreted as being a reflexion of the frequent incidence of preceding or simultaneously-occuring atherosclerosis in these diabetics. Cardiovascular incidents affecting, above all, the coronary and cerebral vessels, account for about 60% of the deaths. Differences between these results and other statistical analyses can be explained on the basis of the unselective nature of the case material in the present study which was, moreover, collected in a defined region over a definite period of time.

Adult↗
PubMed1976

[Comparative analysis of electrocardiographic findings in diabetics and metabolically healthy persons].

The electrocardiograms of 447 diabetics and of the same number of non-diabetic test persons who were coordinated as biostatic twins, taking into consideration age, sex, and weight, were evaluated according to the Minnesota-code and compared. The cardiac endangering of the diabetics was most clearly expressed in the larger frequency of infarctions and the chronic-ischaemic heart disease which can be proved in all age groups. Diabetic males with short duration of diabetes showed the highest frequency of infarctions. The frequency of coronaropathy which is not increased in most age groups in the long-term diabetics compared with the control persons characterizes them as a positive selection of diabetics with an apparantly primarily low atherogenic potency. Hypertonus and/or adiposity were concomitant with a nearly doubled frequency of the ischaemic heart disease. The breadth of the P-wave as a possible reference to angiopathic changes in the region of the atrium was significantly larger in the diabetics in all age groups than in the control group.

Adult↗
PubMed1976

[The influence of insulin, glucose and other monosaccharides on the platelet functions (author's transl)].

In vitro investigations were carried out on the action of insulin, glucose, xylose, galactose, fructose and sorbitol on the platelet aggregation test according to Breddin, on the ADP- and collagen-inducced aggregation and the release of platelet factor 4 as well as on the retraction. When incubating platelet-rich plasma with insulin and glucose simultaneously, a marked inhibition of the ADP- or collagen-induced platelet aggregation and release reaction results. Insulin as well as glucose impaired the platelet function only at high concentrations, this inhibition however did not reach that of a combination of both. Fructose, xylose and sorbitol exerted no significant inhibitory effects. In contrast to the prevented aggregation, the retraction was enhanced. As the causal mechanism for the inhibition of the platelet function the Crabtree effect is discussed.

Blood Platelets↗