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Biomedical subjects

M Toeller

Publications and source records attributed to M Toeller.

At least 37 records · Page 2Linked to original sources
PubMed1996

Nutritional intake of 2868 IDDM patients from 30 centres in Europe. EURODIAB IDDM Complications Study Group.

The EURODIAB IDDM Complications Study, a cross-sectional, clinic-based study, was designed to measure the prevalence of diabetic complications in stratified samples of European insulin-dependent diabetic (IDDM) patients. As diet may be related to diabetic complications, nutritional intake was analysed in the study population. The aims of this first nutritional paper are to describe the nutrient intake in 2868 IDDM patients from 30 centres in 16 countries throughout Europe, to investigate the degree of regional differences in nutrient intake and to compare current intakes with recommended levels. Nutritional intake from 1458 male and 1410 female IDDM patients was assessed by a validated 3-day record (two weekdays, Sunday) and centrally analysed. Mean energy intake for all patients was 2390 +/- 707 kcal/day. Mean protein intake was 1.5 +/- 0.5 g/kg body weight. Carbohydrate intake was 43% and fibre intake 18 g/day. Alcohol intake for the total cohort was 2% of energy. Total fat contributed 38% of energy, with 14% from saturated fat. The Italian centres reported lower total and saturated fat intakes compared with other centres. Recommendations from the Diabetes and Nutrition Study Group of the EASD for total fat, saturated fatty acids and carbohydrate were only achieved by 14%, 14% and 15% of patients, respectively. The data of the present study clearly indicate current problems in the nutritional intake of European IDDM patients. These findings contribute to the definition of future targets in the nutritional management of IDDM patients, to be achieved as part of the initiatives taken by the St. Vincent Declaration action programme.

Adolescent↗
PubMed1994

alpha-Glucosidase inhibitors in diabetes: efficacy in NIDDM subjects.

With alpha-glucosidase inhibitors generally improved metabolic control is achieved in NIDDM patients regardless of whether acarbose is administered in addition to other oral anti-diabetic agents or to diet alone. The most significant finding is the reduction of postprandial blood glucose concentrations. Long-term studies show a decrease in glycosylated haemoglobin and often also in fasting blood glucose levels. Placebo-controlled studies have proven that postprandial insulin concentrations are decreased under acarbose treatment while fasting plasma insulin is usually unchanged. The major side-effects of acarbose treatment involve the gastrointestinal system and include flatulence, abdominal discomfort and diarrhoea. Symptoms diminish with treatment time and are less severe when the treatment is started with low doses. Acarbose should usually be initiated as a 50 mg dose immediately before each major carbohydrate containing meal. Monotherapy with acarbose does not cause hypoglycaemia, however, hypoglycaemia may occur with combination of sulphonylurea or insulin treatment by the well-known reasons. In this case hypoglycaemia has to be treated by taking glucose.

Acarbose↗
PubMed1993

Diet and diabetes.

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Alcohol Drinking↗
PubMed1993

[Nutritional therapy in diabetes mellitus].

Most aspects of the nutritional therapy of diabetes mellitus apply equally to IDDM and NIDDM patients and are also appropriate for people with high risk of cardiovascular diseases. A restriction of energy, a reduction of saturated fatty acids as well as of alcoholic drinks and simple sugars are the most important measures. This modification of nutritional intake together with increased fibre consumption is not only appropriate to avoid hyperglycaemia in diabetic patients but has also its benefits in patients presenting with the metabolic syndrome (possible reduction of hyperinsulinaemia, hypertension and hyperlipoproteinaemia). Diabetic patients should have regular screening for microalbuminuria. At first signs of an early stage of nephropathy patients should be advised to restrict their protein intake. About 50% of daily energy intake should be derived from carbohydrates and fat intake should be no more than 35% of total energy (saturated fatty acids less than 10% of energy). Carbohydrate exchange units are usually not necessary in NIDDM patients. In addition diabetes specialty foods are not an essential part of the nutritional therapy. The success of the nutritional therapy in diabetic patients is substantially dependent upon qualified counselling and education of the patients by the physician (as far as possible with the assistance of a dietitian).

Diabetes Mellitus, Type 1↗
PubMed1992

Nutritional recommendations for diabetic patients and treatment with alpha-glucosidase inhibitors.

Adjunctive treatment with acarbose (possibLy together with sulphonylurea or insulin treatment) can be effectively utilised to achieve blood glucose control if postprandial hyperglycaemia is a problem and cannot be sufficiently controlled by dietary modifications. The alpha-glucosidase inhibitor, acarbose, should be taken with meals that are rich in complex carbohydrates and low in simple sugars, as recommended by diabetes associations, to achieve the greatest possible benefit from treatment.

Acarbose↗
PubMed1991

[Diet therapy of diabetes mellitus].

For the most part, nutritional recommendations for type I and type II diabetics are quite similar to those for groups at risk of coronary heart disease. A "diabetic" diet aims to provide just the right amount of calories and in particular to limit the amount of saturated fatty acids ingested while providing suitable carbohydrates; daily nutrition is taken in the form of several small meals ingested throughout the day. Such a diet can not only normalize blood glucose, but can also help reduce such diabetic-related risks as overweight, insulin resistance, dyslipoproteinemia and hypertension.

Blood Glucose↗
PubMed1990

[Rheologic changes in the postprandial phase].

In this study, the postprandial changes of blood rheology and lipid parameters after a lipid-enriched test meal (75% lipids) versus a normal lipid composition control meal (30% lipids) were monitored. Six healthy volunteers were given a high lipid test meal (85 g lipids, 3800 kJ) as well as a control test meal (30% lipids, 3730 kJ) after 7 days. 3-6 hours after ingestion of the test meal, triglyceride levels peaked with an increase of about 120% after the lipid-enriched test meal and of about 55% after the control meal. The mean levels of plasma viscosity increased from 1.25 mPas to 1.29 mPas 3 hours after ingestion of the lipid-enriched test meal, whereas the blood rheology parameters, such as plasma viscosity and red blood cell aggregation, were nearly unchanged after the control meal with normal lipid composition. The changes of plasma viscosity after the lipid-enriched test meal were caused by an increase of triglyceride levels and an increase of fibrinogen levels in the postprandial phase by nearly 60% (mean value). Two different rheological reaction patterns have been demonstrated. Whereas 5 individuals showed the increase of blood rheology parameters mentioned above, one person had a very pronounced increase of plasma viscosity from 1.34 to 1.42 mPas and fibrinogen levels from 155 mg/dl to 280 mg/dl after the lipid-enriched test meal. This marked postprandial increase of blood viscosity may contribute to a flow limitation of myocardial microcirculation in patients with coronary artery disease.

Adult↗
PubMed1990

[Diabetes education].

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Adaptation, Psychological↗
PubMed1984

[Improved metabolic state in insulin-tested diabetes. Self-testing of blood or urine glucose on 2 days per week].

Randomized serial tests of their metabolic state over four weeks, without self-testing and during daily urinary glucose-profile testing (4 tests) with the Diabur-Test or blood-glucose levels with the Haemo-Gluco-test 20-800 (5 tests daily) on two days weekly were undertaken on 27 unselected insulin-treated outpatient diabetes. HbA1, blood glucose, serum cholesterol, triglycerides and VLDL, LDL and HDL cholesterol were the target values. The following metabolic values were significantly reduced (P less than 0.05) during blood-glucose self-testing, compared with the results during the non-testing phase: HbA1 on average by 11%, blood-glucose (starving) by 20%, serum cholesterol by 9%, serum triglycerides by 13%. Self-testing of urinary glucose (compared with the test-free phase) brought little improvement in the metabolic state. The results of self-testing were the more impressive the worse the metabolic state during the phase without self-testing. Except for VLDL and HDL cholesterol, changes in HbA1 correlated well during all phases with changes in the other metabolic values (P less than 0.05).

Adolescent↗
PubMed1982

[Small reflectometers, independent of the electric current, for home blood glucose monitoring. Testing for correctness and precision].

Thirty small reflectometers not requiring mains electricity (23 Glucosemeter and 7 individual appliances of various makes) were tested under standardised laboratory conditions as to their relative and absolute accuracy in the measurement of blood glucose. The hexokinase method delivered the reference values. The investigation demonstrated systematic deviations of 1 to 97%, coincidental deviations of 8 to 24% and total deviations of between 25 and 153%. If one accepts a value of up to 50% for the total deviation only 13 out of 30 reflectometers are acceptable. The results show that each individual meter must be assessed by the doctor before it can be given to the patient for glucose monitoring at home.

Blood Chemical Analysis↗
PubMed1979

[Massive obesity with disturbance of glucose tolerance (author's transl)].

A long-term study of 63 extremely obese persons with disturbed glucose tolerance showed a further deterioration of glucose tolerance over 10 years. In 9 out of 23 patients manifest diabetes mellitus developed despite partial weight reduction (greater than or equal to 10% of the initial weight excess). Out of 14 patients who did not lose weight during this time even 11 developed manifestations of diabetes. All patients who were in different weight groups at the 5- and 10-year follow-up showed a deterioration in glucose tolerance after 10 years. In the individual groups there were only minimal differences in other characteristics apart from the different weight behaviour.

Adult↗