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V Galuppi

Publications and source records attributed to V Galuppi.

11 recordsLinked to original sources

[Intensified insulin therapy and insulin micro-pumps during pregnancy].

Before conception and during pregnancy in diabetic patients, every possible effort should be made in order to obtain a good, if not perfect, metabolic control and to warrant maternal and fetal health. Multiple daily injections are required to achieve a very strict glucose regulation in pregnant patients with insulin-dependent diabetes mellitus. The most usual intensive insulin administration patterns require 3 premeal doses of short-acting insulin and 1 (at bedtime) or 2 (one in the morning and one at bedtime) injections of intermediate or slow-acting insulin. As an alternative choice, insulin pumps allow a continuous subcutaneous infusion with short-acting insulin according to a basal rate which cover the insulin need during the night and between meals. Premeal and presnack surges of insulin are administrated by the patient herself. Home glucose monitoring must be used to adjust insulin doses. Target glucose levels every diabetic pregnant woman should try to achieve are lower than in non-pregnant women: fasting glycaemia should be below 100 mg/dl, 1 hour post-prandial value below 140 mg/dl and 2 hour post-prandial level below 120 mg/dl. The stricter the control and treatment goals are, the more frequently hypoglycaemia may occur. Hypoglycaemia may be harmful especially for patients with severe diabetic complications and may affect the fetus. Therefore, every pregnant diabetic woman should receive individualized treatment and glycaemic goals according to her clinical features, her compliance and her social and cultural background.

Blood Glucose↗

[Paralysis of oculomotor nerves in diabetes mellitus. A retrospective study of 44 cases].

Data from the clinical charts of 44 diabetic patients with oculomotor palsy were studied. The sixth cranial nerve was involved in 55 p. 100 of cases, the third in 39 p. 100 and the fourth in 6 p. 100 of cases. Forty three patients had type II diabetes mellitus; in 19 the oculomotor palsy revealed diabetes, while in 25 patients diabetes mellitus had been diagnosed for 9.5 +/- 6.2 years. The oculomotor palsy resolved within an average of 93 days on average (range 156-39 days). Twenty eight patients had arterial hypertension and 23 ischemic cardiopathy of peripheral arteriopathy. There appeared to be no correlation between oculomotor palsy and the quality of glycemia control, renal function, the presence of diabetic retinopathy, or other diabetic neurological complications.

Aged↗

Hyperglycemic effect of sucrose ingestion in IDDM patients controlled by artificial pancreas.

The hyperglycemic effect of 28 g sucrose, taken during a mixed meal, was studied in six insulin-dependent diabetes mellitus (IDDM) patients controlled by artificial pancreas. On 2 consecutive days the patients were given, in random order, two Italian meals containing macaroni, bread, meat, vegetables, fruit, olive oil, and an eggnog made with sucrose (meal A) or saccharin (meal B). The two meals were isocaloric and contained equal amounts of carbohydrates. The feedback control on blood glucose continued for 180 min after the meals. Plasma glucose levels and insulin infusion rates delivered by the artificial pancreas after the two test meals did not show any significant differences regarding basal and peak values, peak times, and areas under the curves. A modest amount of sucrose, taken during a mixed meal, does not produce a hyperglycemic effect higher than an equal amount of complex carbohydrates in IDDM patients controlled by artificial pancreas. The same may be expected in well-controlled IDDM patients in conventional therapy because a correlation exists between insulin requirement for conventional therapy and insulin delivered during glucose-controlled insulin infusion.

Adult↗

Long-term effects of eating sucrose on metabolic control of type 1 (insulin-dependent) diabetic outpatients.

The aim of the study was to investigate the effects of regularly eating a moderate amount of sucrose (30 g/day) in 12 type 1 (insulin-dependent, IDDM) diabetic outpatients in fair blood glucose and lipid control. Two diets, each lasting two months, were compared in a randomized cross-over study. The former was a high-carbohydrate high-fiber diet for diabetic patients with Italian alimentary habits, the latter had the same composition except that 30 g of sucrose replaced 30 g of complex carbohydrates with high glycemic index (bread). The two diets contained equal amounts of carbohydrates, proteins and lipids; the only difference being the contribution of oligosaccharides to total carbohydrates (22% vs 34%) and cholesterol amount. During the control diet, glycosylated hemoglobin was substantially unchanged in both control and sucrose diet periods (control diet: 6.91 +/- 0.29 (SE) vs 6.80 +/- 0.25%; sucrose diet: 6.75 +/- 0.31 vs 6.91 +/- 0.36%). This was true also for fructosamine (control diet: 3.92 +/- 0.21 vs 3.76 +/- 0.18%; sucrose 3.50 +/- 0.14 vs 3.64 +/- 0.20 mmol/l). Circulating blood lipid levels, body weight and daily insulin dose did not show any significant variations during the study. Moderate amounts of sucrose may be allowed to IDDM patients with Italian alimentary habits without worsening diabetic control.

Adolescent↗

Diabetes as pro-infective risk factor in total hip replacement.

It is widely accepted that diabetic patients, above all poorly controlled ones, are more susceptible to infection. To verify whether diabetes might be considered a pro-infective risk factor in total hip replacement, 1,042 patients, who from 1969 to 1979 underwent an operation for arthropros thesis of the hip, were studied. The patients were subdivided into two groups according to whether they were diabetic or not. The diabetic patients, though well controlled by diet or by diet plus oral hypoglycemic agents, received insulin for at least two days before surgery. In the early post-operative phase they showed transient worsening of glycemic control rapidly corrected by increased insulin dosage. The patients of both groups were operated in low air exchange operating theaters, by the same staff and using standardized surgical techniques, and all received antibiotic coverage as preventive treatment against infections for a week after surgery. Infection and suppuration occurred in 11% of diabetic patients and only in 2% of non-diabetic patients (p less than 0.001); in these cases the prostheses were removed after unsuccessful antimicrobial treatment. Our study indicates that diabetes mellitus must be considered a proinfective risk factor in patients who undergo an operation for total hip replacement and suggests that a conservative approach is required in diabetic patients.

Aged↗