In order to obtain a dynamic picture of the way abnormal insulinemia, as a function of blood glucose, occurs in the morning in subjects with insulinoma, we have measured amended plasma insulin (IRI)/blood glucose (BG) ratio during the fasting period of 4 sleeping subjects with insulinoma. Healthy subjects and subjects suffering from other diseases were used as reference in order to determine variations of this ratio during the night. BG and IRI were assayed at intervals of 15 or 30 min. Subjects with insulinoma differed from the other subjects by a very elevated ratio dispersion around the mean value with highly significant peaks (greater than 100). Mean value always remained outside the range (7-82) which covers the total range of values measured in healthy and pathological subjects.

Adenoma, Islet Cell↗

PubMedDate not supplied

Portal, hepatic and peripheral insulin immunoreactive substances before and after removal of an insulinoma.

Plasma insulin immunoreactivity (IRI) results from high molecular weight substances with insulin immunoreactivity (HWIRI), proinsulin (PI) and insulin (I). Their respective concentrations and percentages of IRI were determined preoperatively in the hepatic and peripheral circulations and after surgery in the latter two and in the portal circulation in a patient with a pancreatic adenoma. Removal of the insulinoma resulted in a highly significant reduction of PI concentration in the hepatic (from 16.2 +/- 1.9 microU/ml to 7.3 +/- 0.8 microU/ml) and in the peripheral (from 24.0 +/- 2.0 microU/ml to 9.2 +/- 1.2 micro U/ml) venous systems. Similarly, I concentration decreased in the hepatic (from 36.9 +/- 3.4 microU/ml to 28.0 +/- 1.0 microU/ml) and peripheral (from 33.8 +/- 3.4 microU/ml to 19.8 +/- 2.0 microU/ml) venous systems. HWIRI concentration decreased in the hepatic venous system (from 6.9 +/- 0.8 microU/ml, to 4.8 +/- 0.6 microU/ml), but the decrease in the peripheral venous system (from 9.7 +/- 1.4 microU/ml to 8.2 +/- 1.2 microU/ml) was not significant. It was found that the concentration of I virtually was the same in hepatic and peripheral blood prior to operation in contrast to a decrease seen after the operation. This indicates that the hyperinsulinemia caused primarily by the autonomous hypersecretion of the insulinoma was amplified by a decreased degradation of insulin by the liver and kidney. Our results also indicate that HWIRI was found with the highest concentration in the peripheral blood independently of the adenoma.

Adenoma, Islet Cell↗

PubMedDate not supplied

Factitious hypoglycemia mimicking insulinoma.

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Adenoma, Islet Cell↗

PubMedDate not supplied

The prevalence of retinopathy is similar in diabetes mellitus secondary to chronic pancreatitis with or without pancreatectomy and in idiopathic diabetes mellitus.

In a retrospective study, we compared the prevalence of retinopathy in two groups of 88 diabetic patients (84 men, 4 women) with either diabetes mellitus secondary to chronic pancreatitis (CP-DM group) or idiopathic diabetes mellitus (I-DM group). The patients of these two groups were pair-matched according to age (48.7 +/- 1.1 versus 48.8 +/- 1.0 yr in CP-DM and I-DM groups, respectively; mean +/- SEM), sex, duration of diabetes (7.96 +/- 0.56 versus 8.08 +/- 0.8 yr) and therapy (80 on insulin and 8 on oral hypoglycemic agents in each group). Retinopathy was assessed by bilateral ophthalmoscopic examination of the fundus after pupillary dilation in all 176 patients and by fluorescein angiography in 47 patients with CP-DM and 35 patients with I-DM. Forty-one percent of patients in the CP-DM group and 45.5% of patients in the I-DM group had diabetic retinopathy (P greater than 0.5). In each group, patients with retinopathy were older than patients without retinopathy (51.6 +/- 1.3 versus 46.7 +/- 1.8 yr in the CP-DM group, P less than 0.01, and 52.1 +/- 1.5 versus 46.0 +/- 1.2 yr in the ID-M group, P less than 0.01). They had diabetes of longer duration (10.9 +/- 1.0 versus 5.9 +/- 0.6 yr in the CP-DM group, P less than 0.001, and 10.5 +/- 1.0 versus 6.0 +/- 0.6 yr in the ID-M group, P less than 0.001). The prevalence of retinopathy increased parallel to the duration of diabetes in a similar way in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Effect of exchange of ham for boiled egg on plasma glucose and insulin responses to breakfast in normal subjects.

Blood glucose (BG) and plasma insulin (IRI) were measured during two breakfasts different only by the nature of proteins--egg (E) or ham (H)--in eight normal subjects. Compared with H, E led to a flattened BG response at 30, 40, and 50 min and to a sustained BG from 150 to 240 min. Integrated BG response was not significantly different between E and H. After E, the IRI response decreased at 90 min and 120 min (P less than 0.05). Integrated IRI response with E was significantly smaller than with H (P less than 0.025). The reasons for the effect of E ingestion on BG are not obvious; pancreatic and/or intestinal mechanisms may be involved. It is suggested that greater consideration be given to the protein composition of the test meals when they are used in studies of glucose homeostasis.

Adult↗

PubMedDate not supplied

A long term treatment with a venotropic drug. Results on efficacy and safety of Daflon 500 mg in chronic venous insufficiency.

UNLABELLED: Drugs for long term administration have to prove their efficacy and safety. Previously published double blind controlled studies (from single dose to two months treatment) have already demonstrated the phlebotropic activity of Daflon 500 mg in chronic venous insufficiency (CVI). The aim of the study was to investigate the safety of this agent during one year of continuous administration. Two-hundred and fifteen out-patients suffering from CVI received Daflon 500 mg, 2 tablets per day. Therapeutic activity was evaluated every 2 months on: 1) venous symptoms (functional discomfort, cramps, evening oedema) assessed by a 0 to 4 scale; 2) supramalleolar and calf circumferences; 3) overall assessment of efficacy (excellent, useful, nil). Acceptability was assessed by recording the side effects and measuring laboratory parameters. RESULTS: 170 patients completed the study. Functional symptoms were statistically significantly improved as shown by the following: functional discomfort: 0.55 +/- 0.06 vs 2.63 +/- 0.06, supra-malleolar circumference in cm: 22.5 +/- 0.2 vs 23.1 +/- 0.2, and calf circumference in cm: 34.7 +/- 0.3 vs 35.2 +/- 0.3. This improvement in the symptoms quickly appeared from the first control (M2) and reached about 50% of the total decrease. Overall assessment of efficacy was evaluated as follows: excellent = 58%, useful = 33%, nil = 9% of the cases. Laboratory parameters remained constant during the 12 months. Side effects were essentially gastralgia (n = 7). According to these results, it appears the efficacy and safety of Daflon 500 mg are corroborated even after a one year administration.

Adult↗

PubMedDate not supplied

[Metabolism of lipoproteins].

The authors described shortly the metabolism of lipoproteins, specially the recently acquired data on their physiology. First are reviewed the chemical and physical characteristics of lipoproteins, of apoproteins and their functions, then the enzymes of vascular metabolism of lipoproteins, specially apo B and apo B, E receptors. The various lipoproteins chylomicrons, VLDL, LDL and HDL are described from synthesis to catabolism and by the way, the various pieces of this metabolic puzzle are placed.

Animals↗