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Biomedical subjects

M Buysschaert

Publications and source records attributed to M Buysschaert.

118 records · Page 7Linked to original sources
PubMedDate not supplied

Metabolic and psychological evolution of insulin dependent diabetic patients during a 6 months insulin-pen treatment.

The aim of the study is to assess whether an insulin pen-treatment (NovopenR) could be of interest in 10 type I insulin dependent diabetic patients (C-peptide: 0.04 +/- 0.01 pmol/ml, mean +/- SEM), with metabolic and psychological parameters being together taken into account. The daily insulin doses were comparable during the previous treatment with conventional syringes (2-3 daily injections of ActrapidR and MonotardR) and the pen therapy: 0.65 +/- 0.05 vs 0.68 +/- 0.04 U/kg b.w. The metabolic control assessed by HbA1 levels was unchanged before and after 6 months pen treatment: 10.7 +/- 0.7 vs 10.9 +/- 0.6%, respectively. However, fructosamine increased from 2.89 +/- 0.26 to 3.92 +/- 0.20 mmol/l (p less than 0.01) during pen treatment. The psychological objective variables showed no significant changes after pen treatment. In contrast, the staff ratings about the patients attitude toward illness and the spouse evaluation of subjective well-being increased from 40.2 +/- 8.4 to 49.5 +/- 7.8 (p = 0.03) and 34.8 +/- 23.4 to 51.1 +/- 21.1 (p = 0.04), respectively. In conclusion, in a limited group of patients, a multiple injection regimen by pen treatment did not lead to an improved metabolic control. However, subjective psychological tests showed that some aspects of well-being tended to improve.

Blood Glucose↗
PubMedDate not supplied

Effect of the addition of simple sugars to mixed meals on the glycemic control of insulin treated diabetic patients.

In order to evaluate the long term effects of a daily intake of simple sugars upon the glycemic control, 10 insulin treated diabetic outpatients received, according to a randomized cross over design, a conventional or a sucrose-enriched isocaloric, isoglucidic diet (about 20 g sucrose per day, given as desserts and/or soft drinks during or after mixed meals) for 3 months each. The daily insulin doses remained identical during both diets: 0.58 +/- 0.07 vs 0.58 +/- 0.06 U/kg body weight (mean +/- SEM) after conventional and sugar-enriched diet, respectively. The percentages of short acting insulin were also similar: 50 +/- 4 vs 49 +/- 4%. The mean glycemic profiles after lunch and dinner were comparable with both regimens. Moreover, glycosylated hemoglobin levels were 10.0 +/- 0.3 vs 9.9 +/- 0.4% after conventional and sucrose enriched diet, respectively. Plasma cholesterol and triglycerides remained unchanged. In conclusion, a relatively small daily intake of sucrose for 3 months has no clinical and/or metabolic side effects. Therefore, it seems no longer justified to completely ban sucrose from the diet of diabetic patients.

Blood Glucose↗
PubMedDate not supplied

[Palpebral asymmetry and Graves' ophthalmopathy].

The authors report one case of Graves' ophthalmopathy with a palpebral asymmetry, which was characterized by a left ptosis and a right palpebral retraction. In connection with Graves' disease, many ocular signs were described, including exophthalmos, ophthalmoplegia, palpebral retraction and visual loss, but unilateral ptosis was rarely reported. The orbital CT-scanning demonstrated the bilateral enlargement of the extraocular muscles, due to the infiltrative process met in Graves' disease. The ptosis and the palpebral retraction were suspected to be related to the extension of this infiltrative process in the levator palpebrae.

Aged↗
PubMedDate not supplied

[Comparative value of anorectal manometry and electrocardiography in the diagnosis of diabetic autonomic neuropathy].

Searching for silent anorectal autonomic neuropathy, we investigated the anorectal sensorimotor function in 79 continent diabetics. Thirty four per cent of the patients had a basal anal sphincter pressure lower than 40 mm Hg N = 54.5 +/- 15.5 mm Hg and 11 p. 100 had a threshold of conscious rectal sensation higher than 20 ml (N less than or equal to 20 ml). An electrocardiogram was performed and the change in heart rate resulting from successive deep breaths was recorded for each patient. Cardiac autonomic neuropathy was diagnosed when cardiac frequency did not change with ventilation. This was reflected by a ratio E/I (largest RR space during expiration on the electrocardiogram to the shortest during inspiration) close to one. Compared to cardiac criteria for autonomic neuropathy, the sensitivity of anorectal manometry in the detection of diabetic autonomic neuropathy was 77.2 p. 100 and specificity was 82 p. 100. Low basal anal sphincter pressure in asymptomatic diabetics seems to be a sensitive and specific criteria for the assessment of diabetic autonomic neuropathy and correlates closely with cardiac criteria.

Adult↗
PubMedDate not supplied

[Artificial pancreas: clinical and therapeutic value in 11 patients (author's transl)].

Fluctuations in blood glucose levels which occur in the brittle diabetic explain the difficulty of blood glucose control by insulin therapy as used at the present time. The artificial endocrine pancreas is a bedside device capable of maintaining blood sugar value within a normal range by the administration of adequate amounts of insulin or glucose given at the optimal time. The glycemic control of 11 brittle diabetics is improved during the 5 days after a 24 hour connection with the AEP. A better determination of adequate subcutaneous doses of insulin, based on the circadian insulin profile infused by the artificial endocrine pancreas, achieved the improvement of glycemia. Glucagon profile preceeding, during and after AEP is also discussed. Using a method of two injections daily of a mixture acterapid and semi-lente, as a general rule it is found that approximately fifty per cent of the dose must be given in the acterapid form. Glucagon value decreases during the 24 h artificial endocrine pancreas. This is suggestive of a possible role of hyperglucagonemia in brittle diabetes.

Adult↗
PubMedDate not supplied

[Use of the artificial pancreas in the diagnosis and management of an insulinoma (author's transl)].

The artificial endocrine pancreas is generally used to control blood glucose in brittle diabetic patients. In this study, it was applied to the diagnosis and surgical management of a pancreatic insulinoma. Several tests were performed without the risks inherent to severe hypoglycemia. It was also used during surgery, permitting an optimal blood glucose control.

Adenoma, Islet Cell↗
PubMedDate not supplied

[Treatment of insulin-dependent diabetes by continuous subcutaneous infusion of insulin (author's transl)].

Blood glucose levels were measured in 2 groups of patients with insulin-dependent diabetes during continuous subcutaneous infusion of insulin. Results demonstrated that continuous insulin infusion in totally insulin-dependent patients provides control of the diabetes comparable to that obtained by conventional optimized insulin therapy. Furthermore, the good control of blood glucose levels following infusion may permit remission in patients in whom the diabetes is of recent onset.

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