PubMed Health⌕ Search

Biomedical subjects

L D Elving

Publications and source records attributed to L D Elving.

24 records · Page 2Linked to original sources
PubMed1989

Screening for microalbuminuria in patients with diabetes mellitus: frozen storage of urine samples decreases their albumin content.

The influence of storage on urinary albumin concentration was prospectively studied with use of overnight urine specimens (Albustix negative) from 73 diabetic patients. From each urine sample four aliquots were taken. One was stored at 4 degrees C and assayed within two weeks, the other three were stored at -20 degrees C and assayed within two weeks and after two and six months. Albumin concentration was measured with laser immunonephelometry. The detection limit, 1 mg/L, suffices for the screening of diabetic patients for microalbuminuria. After storage for two and six months at -20 degrees C, significantly lower albumin concentrations were found. The difference was mainly caused by lower concentrations found in urine samples in which a precipitate had formed, which was the case in 22 and 25 samples, respectively. Thus, freezing of urine samples for determination of low concentrations of albumin may yield falsely low results. Urine samples are best stored at 4 degrees C and assayed within two weeks.

Albuminuria↗
PubMedDate not supplied

Severe hypoglycemia in diabetic patients: frequency, causes, prevention.

Over a 12-mo period, the frequency of severe hypoglycemic episodes was measured in a population of approximately 400 (50% type I) diabetic patients treated with insulin. There were 32 severe insulin reactions in 26 patients, a patient-yr incidence of 8%. The major precipitating causes were patients' errors (nine), and too much insulin or a wrong combination (six). In seven cases no cause could be found. For the group as a whole there was clear evidence of overtreatment as measured by insulin doses (0.89 +/- 0.43 U/kg/day versus 0.65 +/- 0.34 U/kg/day in a convenience group of 100 patients from the same diabetic population [P less than 0.05] ). Furthermore, 6-12 mo after the event the mean insulin dose had decreased from 0.82 +/- 0.25 to 0.69 +/- 0.27 U/kg/day in the subgroup of 20 hypoglycemic patients that could be followed (P less than 0.001). The mean HbAlc levels of the hypoglycemic group and the control group differed significantly (8.1 +/- 1.3% versus 8.7 +/- 1.7%, P less than 0.05). Six to 12 mo after the reaction, the mean HbAlc level in the follow-up subgroup rose from 8.1 +/- 1.3% to 9.1 +/- 1.1% (P less than 0.05). Patients' errors as a cause of the insulin reaction were not only the result of the patients' deficient knowledge but more often of lack of alertness and carelessness. We conclude that it is not possible to prevent all the severe hypoglycemic reactions in diabetic patients. However, besides avoiding overtreatment by the physician, teaching patients to respond more adequately to changing circumstances in daily life or to warning signs could also reduce the incidence of hypoglycemia.

Adolescent↗