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H Leblanc

Publications and source records attributed to H Leblanc.

At least 19 recordsLinked to original sources
PubMed2006

Intra-cyclic distance per stroke phase, velocity fluctuations and acceleration time ratio of a breaststroker's hip: a comparison between elite and nonelite swimmers at different race paces.

The aim of this study was to compare the intra-cyclic velocity graphs of breaststroke swimmers at two skill levels in relation to their movement phases. Two groups of nine male swimmers were videotaped underwater at three swimming race paces corresponding to their actual competitive times for the 200-m, 100-m and 50-m breaststroke. Their forward intra-cyclic hip velocity was recorded with a velocity-meter. The breaststroke cycle was divided into four phases: leg propulsion, leg-arm lag phase, arm propulsion, and arm and leg recovery. From the velocity-time data, the following parameters were computed: an index of velocity fluctuations (IVF), the distance covered during each stroke phase, and an acceleration-deceleration time ratio (ADTR). The main results showed that in both groups of swimmers, when the race pace increased, the distance covered during the leg-arm lag phase decreased, while the other swimming phases remained stable. When expressed in relative values, the percentage of distance covered during the leg-arm lag phase decreased. In nonelite swimmers, the percentage of distance covered in the other stroke phases increased significantly, while only a tendency was noted in the elite group. Elite swimmers demonstrated a higher ADTR at the 50-m pace than at their 100-m and 200-m paces. An inter-group comparison showed that elite swimmers had higher values for the IVF and ADTR, which indicated their capacity to accelerate to boost the swim and highlighted the relevancy of these factors to discriminate skill level.

Acceleration↗
PubMed2005

Arm-leg coordination in flat breaststroke: a comparative study between elite and non-elite swimmers.

The aim of this study was to compare the arm-leg coordination in flat breaststroke among four groups of swimmers (elite males, elite females and non-elite males, non-elite females) of two different competitive levels. Using a velocity-video system, both forward acceleration and deceleration phases of the hip were first identified. Based on these phases, four temporal gaps indicated the time duration between arm and leg actions throughout three race paces (200, 100, and 50 m). For both groups, a velocity increase was combined with an increase of stroke rate, a decrease of stroke length, and an increase of the propulsive phases and a decrease of the glide phases. However, when the relative duration of one stroke cycle was considered, the elite swimmers had significant shorter time of the glide phase than lower competitive level swimmers (18.80 % vs. 31.04 % for females and 11.89 % vs. 19.60 % for males) combined with a longer stroke length (respectively 2.05 m vs. 1.73 m and 2.03 m vs. 1.82 m). Furthermore, the temporal gaps of the elite swimmers showed a greater continuity in the arm and leg actions, which indicates a better timing than non-elite swimmers. It was concluded that elite breaststroke swimmers are able to optimise their propulsion by reducing their glide phase and using a more continuous timing between arm and leg coordination.

Adolescent↗
PubMed2004

Evaluation of arm-leg coordination in flat breaststroke.

This study proposes a new method to evaluate arm-leg coordination in flat breaststroke. Five arm and leg stroke phases were defined with a velocity-video system. Five time gaps quantified the time between arm and leg actions during three paces of a race (200 m, 100 m and 50 m) in 16 top level swimmers. Based on these time gaps, effective glide, effective propulsion, effective leg insweep and effective recovery were used to identify the different stroke phases of the body. A faster pace corresponded to increased stroke rate, decreased stroke length, increased propulsive phases, shorter glide phases, and a shorter T1 time gap, which measured the effective body glide. The top level swimmers showed short time gaps (T2, T3, T4, measuring the timing of arm-leg recoveries), which reflected the continuity in arm and leg actions. The measurement of these time gaps thus provides a pertinent evaluation of swimmers' skill in adapting their arm-leg coordination to biomechanical constraints.

Adolescent↗
PubMed2003

Marital status and family size of type 1 diabetic patients in a French cohort.

OBJECTIVE: To compare the marital status, the number of offspring and the cumulative incidence of type 1 diabetes in offspring of type 1 diabetic men and women. METHODS: From the database of patients attending our department, we reviewed the files of all the 352 subjects aged >=40 years with type 1 diabetes and compared male and female patients for whom age, age at diagnosis of diabetes, marital status, socio-economic status, number and age of offspring, diagnosed type 1 diabetes in the offspring could be obtained from patient's record and/or direct interview (86 males and 78 females). RESULTS: In this population, 73% of women and 81% of men were married or living a marital life (NS), and 35% of women versus 8% of men had no offspring (P<0.0001). The proportion of parents with 2 offspring or more was 43% in females and 61% in males (p=0.03) and was not related to the socio-economic status. The number of offspring with diagnosed type 1 diabetes was small (8/229) and did not show significant association with gender of the parent, with a cumulative incidence of 3.2 and 3.7% in offspring of type 1 diabetic mothers and fathers respectively. CONCLUSION: Type 1 diabetic women born before 1960 had fewer children than men. In this cohort, there was no difference in the cumulative incidence of type 1 diabetes in offspring of type 1 diabetic men and women despite reduced family size in women.

Adult↗
PubMed2002

Metabolic and immunogenetic prediction of long-term insulin remission in African patients with atypical diabetes.

AIMS: We aimed to characterize a cohort of 'atypical' diabetic patients of sub-Saharan African origin and to analyse possible determinants of long-term remission. METHODS: Over 6 years, we studied the clinical and therapeutic profile of 42 consecutive patients undiagnosed or untreated prior to inclusion presenting with cardinal features of diabetes mellitus. We measured insulin secretion and sensitivity at inclusion. Immunogenetic (anti-GAD, anti-ICA and HLA class II) markers of Type 1 diabetes were compared with a 90-non-diabetic unrelated adult African population. RESULTS: Twenty-one ketonuric patients (age 42 +/- 9 (sd) years; body mass index (BMI) 26 +/- 3 kg/m2) were initially insulin-treated (IT), and 21 non-ketonuric patients (age 38 +/- 8 years; BMI 26 +/- 5 kg/m2) had oral and/or diet therapy (NIT). Insulin could be discontinued in 47.6% (10/21) IT with adequate glycaemic control (HbA1c 6.7 +/- 1.3%), while insulin was secondarily started in 38.1% (8/21) NIT in expectation of better control. The initial basal (odds ratio (OR) 9.1, 95% confidence interval (CI) 1.3-64.4) and stimulated C-peptide (OR 8.17, 95% CI 1.5-44.1) were independently associated with remission. Insulin resistance was present in all the groups, more marked in the insulin-treated NIT. Anti-GAD antibodies and ICA were rare, but 38.1% IT vs. 1.1% controls had Type 1 diabetes HLA susceptibility haplotypes (P < 0.001) without significant difference between the subgroups. CONCLUSION: Prolonged discontinuation of insulin is frequent in African diabetic patients initially presenting with signs of insulinopenia. In our patients, long-term insulin therapy was not associated with immunogenetic markers of Type 1 diabetes. The initial measure of insulin secretion seemed a good predictor of long-term remission.

Acute Disease↗
PubMed1997

Multicentre evaluation of the DCA 2000 system for measuring glycated haemoglobin. DCA 2000 Study Group.

The recommended method for assessing long-term blood glucose control in diabetic patients is the measurement of glycated haemoglobin (Hb). The Ames DCA 2000 system for assaying glycated Hb uses an immunoassay with a monoclonal antibody specific for an aminoacid sequence within the HblAc molecule. This study compared the performance of the DCA 2000 system for HblAc measurement with that of high-performance liquid chromatography (HPLC). A total of 1.016 insulin-dependent and non-insulin-dependent diabetic patients from 5 outpatient clinics took part. The correlation coefficients between DCA 2000 and HPLC data ranged between 0.94 and 0.98, depending on site. The mean variations and 95% confidence intervals for the differences between the results for each sample were: site A 0.172 (-1.186 to 1.53), site B -0.275 (-1.317 to 0.767), site C -0.146 (-0.868 to 0.576), site D -0.088 (-0.864 to 0.688), and site E -0.251 (-1.099 to 0.597). The sensitivity of the DCA 2000 assay ranged between 80 and 94%, and the specificity between 88 and 100%, depending on site. For pooled results, the correlation coefficient assayed by the two methods was 0.95. The mean variation was -0.116 and the 95% confidence interval -1.23 to 0.998. The sensitivity of DCA 2000 was 91%, and the specificity 94%. DCA tended to underestimate HbAlc slightly as compared to HPLC. This study confirms the reliability of DCA 2000 for measuring glycated Hb. The system is easy to use and provides valuable information for the care of the diabetic patients.

Antibodies, Monoclonal↗
PubMed1996

Are the implications of the Diabetes Control and Complications Trial (DCCT) feasible in daily clinical practice?

The Diabetes Control and Complications Trial was conducted in heavily-equipped centres on a selected and motivated patient cohort. The aim of the present study was to evaluate at one-year follow-up the results of intensive insulin therapy in patients with insulin-dependent diabetes mellitus attending a department of diabetology. From October 1, 1993, to December 31, 1994, all our hospitalised patients under 55 years of age with HbA1c levels above 8% and receiving 2 daily insulin injections were offered the opportunity to shift to 3 daily injections (short-acting insulin in the morning and at midday, and a mixture of short-acting and intermediate insulin in the evening). Patients were instructed to increase blood glucose self-monitoring and to see their diabetologist more often (once every two months). Five patients refused and 45 accepted this proposal: 22 women and 23 men (mean age 31.8 +/- 10.9 yr), BMI 23.5 +/- 2.9 kg/m2, duration of diabetes 12.8 +/- 10.1 yr, HbA1c 10.0 +/- 2.0%. Five patients were lost to follow-up, 2 asked to have their medical file transferred, 3 returned to 2 daily injections, and 5 consulted only once during the year of follow-up. For the 29 patients seen after one-year follow-up, the decrease in HbA1c levels from 10.0 +/- 1.9% to 9.5 +/- 1.8% was not statistically significant. Sixteen patients complained of increased occurrence of hypoglycaemia (3 comas). In routine clinical practice, the prescription of intensive insulin therapy to non-selected insulin-dependent diabetic patients can be associated with a high number of patients lost to follow-up (17% in our study). An increase in the number of daily insulin injections will improve glycaemic control only if self-monitoring and medical surveillance are also intensified. However, many long-term poorly-controlled insulin-dependent diabetic patients are reluctant to comply with these recommendations.

Adult↗
PubMed1995

Detection of coronary artery disease in diabetic patients.

Coronary artery disease may be difficult to detect in diabetic patients. This study was designed to determine the specificity and sensitivity of three noninvasive tests. Accordingly, the results of 48-h ambulatory electrocardiogram (ECG) monitoring, maximal ECG exercise test, and intravenous dipyridamole myocardial thallium scintigraphy were compared in 59 middle-aged diabetic patients who were consecutively selected for suspected coronary artery disease. All patients also underwent coronary angiography, which was performed regardless of the results of the non-invasive tests. Twenty patients (34%) had significant coronary lesions, i.e. stenosis equal to or greater than 70%, and 16 of these 20 patients (80%) had double or triple vessel disease. Sensitivity and specificity were, respectively, 25% and 88% for ambulatory ECG monitoring, 75% and 77% for the exercise test and 80% and 87% for thallium myocardial scintigraphy. This observation strongly supports the use of non-invasive tests for the detection of coronary artery disease in those diabetic patients at high risk of such disease. As the exercise test is cheaper and more widely available than thallium myocardial scintigraphy it should be used as a first line examination. Dipyridamole myocardial scintigraphy may provide an alternative solution for those patients who cannot perform maximal exercise, or with atypical clinical presentation.

Adult↗
PubMed1994

Immunoradiometric assay of human intact proinsulin applied to patients with type 2 diabetes, impaired glucose tolerance, and hyperandrogenism.

We describe an immunoradiometric assay for human intact proinsulin in serum. In this method, one monoclonal antibody, coated onto polyacrylamide beads, cross-reacts with proinsulins and insulin. A sandwich is formed with intact proinsulin, split (65-66) proinsulin, and des (64-65) proinsulin binding with an 125I-labeled monoclonal antibody specific for an epitope at the intact B-C junction of proinsulin. Because split (65-66) and des (64-65) proinsulin concentrations are very low in serum, this assay essentially measures intact proinsulin. When we used 1-mL serum samples, the mean detection limit was 0.4 pmol/L. Mean proinsulin concentrations (pmol/L) were 3.4 (range 1-9.1) in healthy fasting subjects, 28.5 (9.7-101) in patients with type 2 diabetes (treated with metformin and sulfonylureas), 5.0 (1.6-9.3) in women with hyperandrogenism and normal insulinemia, 10.3 (2.6-36) in women with hyperandrogenism and hyperinsulinemia, and 8.5 (4.8-21.3) in patients with impaired glucose tolerance.

Adult↗
PubMed1993

Hepatic glucose production during intraperitoneal and intravenous closed-loop insulin regulation of blood glucose in type 1 (insulin-dependent) diabetic patients.

Intraperitoneal infusion of insulin should be more physiological than intravenous insulin since part of the insulin is directed toward the portal vein, which allows the liver to retain its major role in glucose homeostasis. The regulation of hepatic glucose production during the intraperitoneal and intravenous infusions of insulin were compared in eight Type 1 (insulin-dependent), C-peptide-deficient diabetic patients. Primed, continuous infusions of [6,6-2H]glucose were given in the postabsorptive state and during continuous infusion of unlabelled glucose at 1.5 and 4 mg/kg.min, while normoglycaemia was maintained by closed-loop intraperitoneal and intravenous insulin delivery. During all three periods, plasma glucose concentrations remained near normal (variations 3.8-6.1%). The insulin infusion rates required for normal plasma glucose concentrations were essentially the same for the intravenous and intraperitoneal routes in all cases, although the variations were greater with intraperitoneal insulin. Plasma free-insulin levels were only slightly, non-significantly lower with intraperitoneal infusion than with intravenous infusion. Hepatic glucose production was significantly lower with intraperitoneal insulin during all three conditions: basal: 1.71 +/- 0.14, i.p. vs 2.37 +/- 0.26 mg/kg.min, i.v.; 1.5 mg/kg.min glucose infusion: 0.49 +/- 0.23, i.p. vs 0.88 +/- 0.18 mg/kg.min, i.v.; 4 mg/kg.min glucose infusion: 0.31 +/- 0.10, i.p. vs 0.56 +/- 0.12 mg/kg.min, i.v.. These results, obtained with steady-state conditions for plasma glucose, isotopic plasma glucose enrichments and unlabelled glucose infusion rates, suggest that better control of hepatic glucose production leading to normoglycaemia was achieved with the intraperitoneal infusion.

3-Hydroxybutyric Acid↗
PubMed1992

Non-invasive identification of severe coronary artery disease in patients with long-standing diabetes mellitus.

OBJECTIVES: To detect severe coronary artery disease in asymptomatic middle-aged diabetic patients exposed to coronary artery disease risk factors. PATIENTS AND METHODS: Forty-four middle-aged patients (30 to 65 years of age) with a known duration of diabetes exceeding 10 years and at least one additional cardiovascular risk factor were studied. Patients were free of anginal chest pain and had a normal 12-lead ECG at rest. All patients underwent 24-hour ambulatory ECG, maximal bicycle exercise electrocardiography and intravenous dipyridamole thallium myocardial scintigraphy. If one of these 3 non-invasive tests revealed signs of myocardial ischaemia, a coronary angiography was performed. RESULTS: Non-invasive investigation yielded the diagnosis of myocardial ischaemia in 9/44 patients (20%). Six of the 9 patients had significant coronary artery stenoses (> 70% narrowing) and 5 exhibited severe triple-vessel disease. With dipyridamole thallium scintigraphy, the positive predictive value for diagnosis of coronary artery disease was optimal. CONCLUSION: In diabetic patients with additional coronary risk factors, periodical thorough clinical examination and resting ECG may fail to detect severe coronary disease. More sophisticated cardiovascular non-invasive tests should then be proposed as part of the periodical care of these patients.

Coronary Angiography↗
PubMed1991

[Prevention of terminal kidney failure in insulin-dependent diabetics. Current status and prospects].

Thirty percent of insulin-dependent diabetics develop a nephropathy which, when left untreated, leads within a few years to terminal renal failure with its considerable human and financial consequences. Antihypertensive drugs constitute the most effective means of slowing down the deterioration of glomerular filtration. Terminal renal failure and its cardiovascular complications can really be prevented provided the patient is treated at the early stage of incipient diabetic nephropathy. During the last few years, various therapeutic measures have been suggested with very promising short- and medium-term results. The dream of a true prevention of diabetic nephropathy will become a reality when the results of well-controlled clinical trials with prolonged follow-up will be available.

Acute Kidney Injury↗
PubMed1990

[Antidiabetic treatment and monitoring during pregnancy in diabetes].

In pregnant diabetic women one of the goals of antidiabetic treatment and monitoring is to maintain blood glucose near normal values between 4.4 and 6.1 mmol/l. If possible such values should be obtained before conception. To reach these goals four components of health care delivery are of major importance. Education dealing with contraception and planification of the pregnancy, diet modified according to the state of pregnancy, self blood glucose monitoring to allow anticipatory optimized insulin therapy. During pregnancy the systematic use of continuous subcutaneous insulin infusion does not seem to be associated with any significant benefit dealing with metabolic control or the perinatal and neonatal morbidity and mortality. In pregnant diabetic patients the usefulness of the dosage of glycated haemoglobin is limited due to the spontaneous fluctuations of this value during pregnancy, as well as the delay of the variation of this index during a period of poor glycemic control. In this condition glycated proteins as fructosamine may be more useful but many technical problems for this determination are still to be solved.

Biomarkers↗
PubMed1989

Treatment of hypertension in diabetic patients.

There is increasing evidence that a slight elevation of blood pressure values may have a deleterious effect on diabetic angiopathy. Hypertensive diabetic patients are prone to suffer clinical and/or biological side effects of antihypertensive agents. More recently calcium antagonists and angiotensin converting enzyme inhibitors have proved effective and better tolerated in hypertensive diabetic patients. New data from the literature and from our group are reviewed. In patients with incipient or clinical nephropathy, angiotensin converting enzyme inhibition reduces urinary albumin excretion and preserves glomerular filtration rate. The effects of treatment of hypertension on blood pressure control obtained in small groups of selected and motivated patients are at variance from those obtained in routine practice. Poor compliance is the major problem in hypertensive diabetic patients. The rationale exists to provide early aggressive antihypertensive treatment in this population but we must develop new drugs that are more effective and better tolerated. We have also to improve health care delivery, information and education for these patients.

Antihypertensive Agents↗