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Biomedical subjects

M Talaulicar

Publications and source records attributed to M Talaulicar.

13 recordsLinked to original sources
PubMed1995

[Disability payments in diabetes mellitus in social security: what is necessary?].

Since their publication in 1974 the recommendations of the "German Society for Public and Private Welfare" are regarded as competent guideline for the allocation of grants concerning the diet for diabetic subjects according to section 23 part 4, position 2 BSHG (Federal German Law for Social Security). The former nutrition concepts are compared to the current international conceptions regarding the diet of diabetic individuals. Possible variations concerning food plans are shown in model plans considering realistic habits of consumption. Our analysis justifies additional expenses limited to about 20 to 30% for insulin-dependent diabetic subjects compared to an isocaloric regular diet. Additional expenses for obese non-insulin-dependent diabetic subjects are not necessary. There is an extremely slim portion allocated for food within the social security benefit according to section 22 BSHG. That will require an comprehensive supply of education for the realisation of the current recommendations for nutrition. The education programmes for compiling suitable food plans to remain within the scheduled cost limits need to be organized by regional carriers of social welfare, whereby public Health offices could make an important contribution.

Costs and Cost Analysis↗
PubMed1988

[Allergy to human insulin. Case reports on 3 patients].

Allergy against human insulin was demonstrated in three diabetics who had not previously been treated with animal-derived insulin. In all three patients the allergy developed within a few weeks or months of starting insulin treatment. The diagnosis was confirmed by intracutaneous tests and determination of insulin-specific IgE antibodies. Desensitisation was necessary in one patient, in the other two the allergic symptoms were successfully treated by local measures. Two of the patients are at present well controlled on human insulin, while the third is still undergoing desensitisation. Such cases of primary allergy against human insulin have not previously been reported in the German medical literature.

Aged↗
PubMed1985

[Hypoglycemia with loss of consciousness during insulin therapy as an initial symptom of Addison's disease. Report of 2 cases].

Within a six-month period, two type-I diabetics were admitted because of labile metabolic state with recurrent severe hypoglycaemia and unconsciousness. In both patients electrolytes were normal on admission. There were at first only few pointers to Addison's disease. But in both primary adrenocortical insufficiency was demonstrated to be the cause of the symptoms. Serological tests suggested an autoimmune genesis. Recurrent severe hypoglycaemia and unconsciousness in insulin-treated diabetics indicates that adrenocortical insufficiency should be excluded.

Addison Disease↗
PubMed1984

Effect of long-term fasting of obese patients on pancreatic exocrine function, gastrointestinal hormones and bicarbonate concentration in plasma.

The CCK- and secretin stimulated pancreatic volume, bicarbonate and enzyme secretion was investigated before and during fasting for 20 days in 12 obese subjects. Pancreatic function tests were performed at the start of the fasting period and on the 10th and 20th day. In an additional and comparable group of 8 obese patients plasma concentrations of cholecystokinin (CCK), gastrin and insulin as well as metabolic parameters (bicarbonate, beta-OH-butyrate and free fatty acids) have been measured before and during total fasting. During three weeks of total fasting the average overweight of the patients undergoing pancreatic function tests was reduced from 49 to 31% (-11.5 +/- 1,5 kg). A significant reduction of volume, bicarbonate, trypsin and amylase secretion occurred already after 10 days of total fasting. After 20 days these parameters were further significantly reduced compared to the 10th day. All mentioned parameters were found at the lower limit of the normal range at the end of the fasting period at 20 days. The only exception being lipase secretion; the decrease of this enzyme was not significant at the 5% level. No significant reduction of basal plasma concentrations could be observed for CCK and gastrin during the course of total fasting. The plasma insulin levels were significantly reduced after 7 days whereas at 10 and 20 days insulin concentration was not significantly lowered compared to day 1. A small but significant decrease in the blood bicarbonate concentration could be observed after 7 days of fasting which remained constant up to the end of the study.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxybutyric Acid↗
PubMed1982

[Treatment of unstable diabetes with a portable insulin-infusion pump (author's transl)].

A portable insulin-infusion pump (Promedos Siemens) was used in 19 patients with unstable or brittle diabetes. Continuous insulin supply was via the intravenous route in nine, subcutaneously in ten patients. The insulin pump was used in those patients in whom, after hospitalization for two to three weeks, the diabetes remained poorly controlled. In all patients the carbohydrate metabolism was normalised. Subcutaneous insulin infusion was as effective as the intravenous one. In all instances it was possible, partly by transferring insulin uptake during the day and night to two subcutaneous injections, to improve conventional control even after the infusion period was over. Continuous, regulated insulin supply - intravenously or subcutaneously - is superior to conventional subcutaneous administration. Portable insulin infusion pumps can be used in individual patients even without glucose sensing.

Adolescent↗
PubMed1982

Exocrine pancreatic function in insulin-dependent diabetes mellitus.

Exocrine pancreatic function was studied in patients with long-standing insulin-dependent diabetes mellitus using the secretin-pancreozymin test (n = 53), and estimation of immunoreactive trypsin (n = 43) and pancreatic isoamylase (n = 43). The secretin-pancreozymin test was abnormal in 23 patients (43%). The abnormalities found were a decreased output of lipase (37%), amylase (36%) or trypsin (26%) and bicarbonate (15%). Serum immunoreactive trypsin was below normal in only 6 (14%) and pancreatic isoamylase in 29 (67%) patients. There was no correlation between impairment of the secretin-pancreozymin test and decreased serum enzyme levels. It is concluded that an impairment of exocrine pancreatic function is frequent in insulin-dependent diabetics but that a decrease in serum enzymes, especially in pancreatic isoamylase, does not reflect an impairment of pancreatic function in these patients.

Adult↗
PubMed1981

Effect of exogenous insulin on fasting serum levels of gastric inhibitory polypeptide (GIP) in juvenile diabetes.

The effect of insulin on fasting levels of immunoreactive gastric inhibitory polypeptide (IR-GIP) has been examined in insulin-dependent, juvenile-type diabetics who were well-controlled with two doses of an intermediate insulin. After withdrawal of the evening insulin injection the fasting blood glucose and serum IR-GIP levels were elevated and decreased significantly following intravenous insulin towards normal values. There was a significant positive correlation between levels of blood glucose and serum IR-GIP before and during insulin application. It is suggested that fasting serum GIP levels increase in case of insulin deficiency because basal GIP secretion is suppressed by normal insulin levels.

Adult↗
PubMed1980

Inhibition of gastric inhibitory polypeptide (GIP) release by insulin and glucose in juvenile diabetes.

The effect of glucose and insulin on fat- and glucose-induced gastric inhibitory polypeptide (GIP) release has been studied in insulin-dependent juvenile-type diabetics. Blood glucose and serum immunoreactive GIP (IR-GIP) were measured after an oral load of 100 g glucose or 100 g fat was given and during an infusion of one of the following: saline, glucose, glucose plus insulin, or insulin. The infusion of insulin alone (in the presence of elevated glucose levels) or together with glucose significantly suppressed the IR-GIP rise after fat ingestion, but it did not alter the GIP response to oral glucose. Intravenous infusion of glucose had a slight but significant inhibitory effect on fat-stimulated increase of IR-GIP, which cannot be related to endogenous insulin release in these insulin-deficient diabetics. It is suggested that an insulin-mediated increase of glucose utilization in the GIP cell interferes only with increased GIP secretion stimulated by the utilization of fatty acids but not of glucose. This could explain the existence of a negative feedback control between insulin and GIP secretion for fat but not for glucose-induced GIP release.

Adult↗
PubMed1979

[Diabetic neuropathic cachexia (author's transl)].

Marked weight loss with cachexia together with severe depression and pain from symmetrical peripheral neuropathy were noted in a 66-year-old man, known to have had diabetes for six years, which required insulin on admission to hospital. The patient died of bronchopneumonia after one year. The severe neuropathy was proven both neurophysiologically and at necropsy. There was no diabetic retinopathy and no histological evidence of renal glomerulosclerosis. There was no evidence of a malignant tumour either clinically or at necropsy.

Aged↗