Biomedical subjects

M M Pedersen

Publications and source records attributed to M M Pedersen.

39 records · Page 3Linked to original sources

PubMedDate not supplied

Lack of effects of angiotensin-converting enzyme (ACE)-inhibitors on glucose metabolism in type 1 diabetes.

To evaluate the impact of ACE-inhibitors on insulin-mediated glucose uptake, glucose-induced glucose uptake, and hepatic glucose production, a sequential glucose clamp was performed in eight normotensive Type 1 diabetic patients after 3 weeks of enalapril therapy 20 mg day-1 and during control conditions. The experiments were carried out in random order. Mean arterial blood pressure was significantly reduced during ACE-inhibition (95 +/- 3 (+/- SE) vs 84 +/- 3 mmHg; p less than 0.02), while blood glucose control as assessed by HbA1c was unaltered (7.9 +/- 0.5 vs 7.6 +/- 0.5%). The night prior to the study normoglycaemia was maintained by a Biostator. A two-step hyperinsulinaemic euglycaemic clamp (insulin infusion rate 0.3 and 0.8 mU kg-1 min-1) was followed by a hyperinsulinaemic and hyperglycaemic clamp (insulin infusion rate 0.8 mU kg-1 min-1, plasma glucose 11 mmol l-1). Insulin concentrations were comparable with and without enalapril treatment. During the hyperinsulinaemic clamps isotopically determined glucose disposal was unchanged (low dose 2.5 +/- 0.3, high dose 4.3 +/- 0.7 vs 2.6 +/- 0.3 and 4.3 +/- 0.7 mg kg-1 min-1, enalapril vs control). Glucose-induced glucose disposal (9.2 +/- 1.2 vs 9.1 +/- 1.2 mg kg-1 min-1) was also similar, as were non-protein respiratory exchange ratios (indirect calorimetry). Glucose production was not changed by enalapril. In conclusion, treatment with enalapril has no significant effect on glucose metabolism in Type 1 diabetes.

3-Hydroxybutyric Acid↗

PubMedDate not supplied

Blood pressure by 24 h ambulatory recordings in type 2 (non-insulin dependent) diabetics. Relationship to urinary albumin excretion.

The relationship between blood pressure and microalbuminuria, both associated with cardiovascular disease and death, is sparsely studied in Type 2 (non-insulin-dependent) diabetes, and results may be interfered by the phenomenon of "white-coat-hypertension". We therefore investigated blood pressure by 24h ambulatory recordings (oscillometry) and examined whether blood pressure related to the level of urinary albumin excretion rate (UAER) by synchronous 24h collections. Seventeen diabetics (50-75 years of age) with microalbuminuria (15 less than UAER less than 200 micrograms/min) (DM), 15 with normal urinary albumin excretion (DN) and 10 healthy controls (C) participated. All groups were of comparable sex, age degree of obesity and had normal serum creatinine, and the groups of diabetics were of similar known duration, glycemic control and frequency of antihypertensive treatment. Blood pressures measured at the clinic were significantly higher (p less than 0.01) than 24h recordings. An average systolic pressure of 142 +/- 11 mmHg in DN was increased (p less than 0.01) as compared to C: 130 +/- 10 mmHg, but no further increase was seen in DM: 146 +/- 19 mmHg. Diastolic pressures were not different among the groups (C: 77 +/- 8 mmHg, DN: 80 +/- 11 mmHg, DM: 79 +/- 9 mmHg). Average 24h systolic pressure correlated to the UAER r = 0.61, p = 0.009 in DM, whereas not in DN. By the present method we found isolated systolic hypertension in Type 2 diabetes which may express "vascular stiffness". There was, however, no further rise in blood pressure in patients with microalbuminuria, but in these patients albuminuria may be pressure dependent and/or expressive of vascular pathology.

Aged↗

PubMedDate not supplied

Reducing protein in the diabetic diet.

Long-term protein intake may have pathogenic influence on development of late diabetic complications. A review of the latest results in insulin-dependent diabetic patients shows that short-term lowering of protein intake reduces the characteristic early glomerular hyperfiltration as well as microalbuminuria and proteinuria in diabetic nephropathy. A sustained beneficial effect on the progression rate of nephropathy may be achieved. Based on this evidence it is advisable to avoid the traditionally high protein intake in diabetes. We suggest a protein-controlled diet--with protein comprising 14 energy %--as a goal in uncomplicated diabetes. In patients with progressive albuminuria or proteinuria prescription of a low-protein diet with 10% protein should be considered as supplementation to antihypertensive treatment. At present we do not find sufficient evidence for suggesting an intake of 10% protein (corresponding approximately to recent recommendations on 0.8 g prot/kg body weight) also in uncomplicated diabetes. Both a 10 and 14% protein diet will differ somewhat from the diet of the background population and the present diet of many diabetic patients. Therefore the introduction of such diets requires a careful individualized diet therapy in which repetitive evaluation and estimation of compliance are performed. A reduction of protein intake to 10 energy % represents a profound diet intervention.

Diabetes Mellitus, Type 1↗