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Biomedical subjects

L Papoz

Publications and source records attributed to L Papoz.

At least 109 records · Page 6Linked to original sources
PubMed1981

Long-term study of mortality and vascular complications in juvenile-onset (type I) diabetes.

A cohort of 372 insulin-dependent diabetic children, diagnosed between October 1949 and December 1960, were followed-up until December 1976 by the same team of physicians. At the time of diagnosis all patients were under 16 yr of age and were given standardized treatment which did not change from 1949 to 1976. The therapy consisted of daily insulin adjustment based on clinical assessment, the degree of physical activity, and the results of semi-quantitative urine tests for sugar and ketone bodies. These tests were systematically performed before breakfast, lunch, and dinner. Diet was normal, unmeasured, rich in carbohydrates (approximately 60%), and quantitatively unrestricted unless the patient was overweight. Rates for mortality and for the principal complications among this cohort were computed by the actuarial method. During the 26 yr of study, 26 deaths occurred, 16 of which were directly connected with diabetes. After 16 yr of follow-up, rates of proteinuria and hypertension were 4% and 2.1% respectively. The incidence of retinopathy reached 27%, including 1.5% proliferative retinopathy. After 26 yr, the rates rose to 14% for proteinuria, 16% for hypertension, and 85% for retinopathy, including 18% in the proliferative phase.

Adolescent↗
PubMed1981

[Prevalence of diabetes in a random sample from the gouvernorat of Tunis (author's transl)].

Prevalence of diabetes was estimated on the basis of both interviewing the subjects and measuring fasting blood glucose among a one per cent random sample from the population of the Gouvernorat of Tunis. Sampling was done using the household as unit and three stages of randomization. The number of households investigated was 1 449, a total of 9 712 subjects. In this sample, including 45% of males, mean age is equal to 24.8 years in males and 26.0 in females. Globally, prevalence is equal to 2.3%, half-composed of previously known diabetics. In more than 50% of them, the disease was revealed by cardinal symptoms and 17% are insulin-treated. The frequency of the disease, already known or newly diagnosed, is steadily lower than 1% in the first classes of age and then distinctly increases from thirty years of age in males and forty in females, reaching a value close to 10% after sixty years.

Adolescent↗
PubMed1980

[Metabolic control in 107 maturity onset diabetic out patients (author's transl)].

Hemoglobin A1c concentrations were measured in 107 out patients with non insulin treated diabetes. A good correlation was observed between Hb A1c and random post-prandial plasma glucose levels. Mean Hb A1c concentrations were slightly higher in these diabetics than in controls but markedly lower than values observed in insulin treated patients. Sixty three per cent of the patients had Hb a1c levels below three standard deviations above our normal mean value. Random post-prandial plasma insulin levels were correlated to the degree of overweight but not other parameters. The best results were observed in patients treated by diet alone (31 % of the whole population) and in those on diet and sulfonylureas (30 %) who were also the less older and the less overweight subjects.

Biguanides↗
PubMed1980

Diabetic control in 102 insulin-treated out-patients.

Haemoglobin AIc concentrations were measured in 102 insulin-treated diabetic outpatients. Only 19% had Hb AIc levels below three standard deviations above the normal mean value (5.23 +/- 0.05%). There were no correlations between Hb AIc levels, random C-peptide immunoreactivity or age. A significant correlation (r = 0.49; p < 0.001) was, however, observed between HbAIc and random plasma glucose levels. The mean random plasma glucose value was normal (89 +/- 18 mg/100 ml; 5 +/- 1 mmol/l) in the patients on insulin three times a day who had received short acting insulin 160 +/- 6 min before the sampling. --A significant inverse correlation was found (r = -0.26; p < 0.01) between the number of daily insulin injections and the HbAIc concentration. --These results suggest that the use of multiple daily insulin injections improves diabetic control. It should however be emphasised that the patients receiving multiple insulin injections were younger than those on the single injection regime and had lower plasma insulin antibody titres, different social and psychological status and a shorter duration of the disease.

Adult↗
PubMed1980

Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population.

The possible role of plasma insulin levels as a risk factor of coronary heart disease has been studied in a population of 7246 non diabetic, working men, aged 43-54 years, initially free from heart disease, and followed for 63 months on average. 128 new coronary heart disease events (non fatal myocardial infarction and coronary related deaths) were detected during this period. The annual risk is analysed by a multivariate model including age, serum cholesterol and triglycerides, blood pressure, smoking, obesity, plasma glucose and insulin fasting and 2 hours after a 75 g oral glucose load. It is shown that the fasting plasma insulin level and the fasting insulin-glucose ratio are positively associated with risk independent of the other factors. The same variables, 2 hours after the glucose load are also positively associated with risk but their contributions are not significant in the multivariate analysis. It is concluded that high insulin levels may constitute an independet risk factor for coronary heart disease complications in middle aged non diabetic men.

Adult↗
PubMed1980

[Dietary behavior during pregnancy (author's transl)].

A study on dietary behavior during pregnancy was performed between June and December 1975 at the Saint Antoine Maternity Hospital in Paris. In addition to the routine clinical examinations at the 3rd, 6th, 8th and 9th month of pregnancy, the women were systematically questioned on their dietary and tobacco habits. Results show that: (1) the mean caloric intake is constant during the first trimester and then significantly decreases in the last two trimesters (2) the fatter the woman before pregnancy, the lower the caloric intake at the successive examinations (3) the total weight gain is positively related to the caloric intake during the first trimester, but not related to the dietary data observed at the 6th, 8th or 9th examinations (4) birth weight seems to be more related to body size before pregnancy than to weight gain.

Adult↗
PubMed1978

Blood cells and alcohol consumption with special reference to smoking habits.

In the course of the Paris study on risk factors of cardiovascular disease in a large professional group, 7710 active and apparently healthy men aged between 48 and 54 were examined. This study measured the relationship between clinical abnormalities suggesting alcoholic liver disease (ALD) and the following blood parameters: white (WBC) and red (RBC) blood cell counts, haematocrit (H), and mean corpuscular volume (MCV), the former computed as H/RBC ratio. A subsequent analysis was performed on a random sample of 485 subjects without ALD who were questioned on their daily average alcohol consumption. Each subject was classified as ;smoker' or ;non-smoker' according to his daily tobacco consumption for the last five years. Analysis of the data confirmed that smoking and alcohol were related to the blood parameters; but, according to smoking habit, different relationships between alcohol consumption (or ALD) and MCV, RBC, or WBC counts were found: for smokers, RBC count significantly decreased and MCV increased with alcohol consumption (or ALD); for non-smokers, WBC count significantly increased with alcohol consumption (or ALD). So, it would be of interest to consider the relation between alcohol and tobacco in interpreting possible changes in blood parameters and in formulating hypotheses on the mechanisms of their specific action.

Alcohol Drinking↗
PubMed1975

Agreement and discrepancy in the evaluation of normal and diabetic oral glucose tolerance test.

Systematic analysis with a five-hour OGTT of 340 subjects representative of people likely to be examined in a center specialized in diabetes detection was performed by multiple discriminant analysis, which provides indices of discrimination for different sets of blood glucose (BG) values. The relative sensitivity and the relative specificity of six different diagnostic methods: Fajans and Conn, Wikerson, WHO, British Diabetic Association, UGDP, and European Study Group of Diabetes Epidemiology were computed, giving a quantitative determination for the degree of discrepancy in the definition of diabetes: only 48 per cent of the subjects are classified in the same way by any of the diagnostic criteria. The time(s) of sampling and the index or indices of OGTT which are the most efficient in screening diabetes were estimated from homogeneous groups of subjects universally recognized as nondiabetic (URND) or as diabetic (URD) according to the different diagnostic methods. Better discriminating power (DP) between URD and URND compared with the maximum DP as measured by D2 of Mahalanobis from the seven BG values of the OGTT is given by the two-hour (70.2 per cent) than by the one-hour (49.5 per cent) BG value when a single value is used; the one-two-hour BG value is the best set of two times (80.7 per cent). The different indices now in use for the classification of the OGTT have been found less effective than the weighted sum of one-two-hour BG values. The difficulty in obtaining highly specific diagnostic tests is discussed in relation to the consequences on a partly automated screening in large populations.

Administration, Oral↗