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Results for “Glycemic levels”

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At least 127 records · Page 7Linked to original sources

PubMed1992

Short-term effect of red wine (consumed during meals) on insulin requirement and glucose tolerance in diabetic patients.

OBJECTIVE: To determine the effect of wine on insulin requirement or glucose tolerance. RESEARCH DESIGN AND METHODS: Five men with insulin-treated diabetes and 10 men with non-insulin-treated diabetes ate the same lunch with the same volume of either water or red wine (2 glasses). Insulin requirement was determined with an artificial pancreas (Biostator). Glucose tolerance was evaluated from the postprandial glycemic level. RESULTS: There was no significant difference in insulin requirement determined with an artificial pancreas in the insulin-treated patients after the two meals (31.5 +/- 4.21 U with water and 31.8 +/- 4.3 U with wine). Glucose tolerance in the non-insulin-treated patients was lower after the meal with wine. CONCLUSIONS: Moderate prandial wine consumption has no adverse effect on the glycemic control of diabetic patients. Thus, it appears unnecessary to proscribe the consumption of red wine in moderation with meals to diabetic patients. Wine contains tannins and phytates that can explain its action.

Adult↗

PubMed2003

The severity of clinical presentation of type 1 diabetes in children does not significantly influence the pattern of residual beta-cell function and long-term metabolic control.

AIM: The purpose of the present study was to compare relationships between the clinical presentation of type 1 diabetes in children and residual beta-cell secretion and long-term metabolic control. METHODS: This retrospective study was conducted in 66 diabetic children with age at diagnosis ranging from 0.7 to 14.8 yr. The patients showed contrasting characteristics at diagnosis: either diabetic ketoacidosis (DKA) (group 1, n = 29) or absence of metabolic derangement (group 2, n = 37) associated with marked (group 2A, n = 12) or mild hyperglycemia (group 2B, n = 25). A regular follow-up was available for at least 10 yr (10-32 yr) in all cases and for 20 yr in 23 cases. C-peptide levels were measured from diagnosis and thereafter at intervals for the first years of disease until becoming permanently undetectable. RESULTS: C-peptide levels at diagnosis were undetectable in about 20% of the cases both with and without DKA. C-peptide levels at diagnosis, the duration of measurable C-peptide levels and the maximum value found during follow-up were not significantly different in the three groups and were not correlated with glycated hemoglobin (GHb) calculated throughout the whole period. No differences were found between the groups of patients concerning GHb values and insulin dose at 10, 15 and 20 yr of disease. The patients of group 2A, characterized by an extremely high glycemic level without ketoacidosis, had a significantly higher prevalence of HLA DR3/4 heterozygosity. CONCLUSIONS: The severity of clinical presentation at diagnosis does not significantly influence residual beta-cell function, and long-term metabolic control.

Adolescent↗

PubMed2002

Smoking and the genetics of signal transduction: an association study on retinopathy in type 1 diabetes.

BACKGROUND: Recent studies suggest a complex association between smoking and retinopathy that probably depends on the interaction between many variables. We have reported an association between ACP1 phenotype and retinopathy in type 1 diabetes. Additionally, the deleterious effects of smoking on intrauterine growth are dependent on ACP1, a low-molecular-weight tyrosine phosphatase that modifies signal transduction. We examine here the interaction between smoking and ACP1 as a mediator of susceptibility to diabetic retinopathy in a sample of puerperae with type 1 diabetes. SUBJECTS AND METHODS: Seventy-eight women who had just delivered live infants were studied. ACP1 phenotype was determined by starch gel electrophoresis. Three-way contingency tables were analyzed. RESULTS: There is a significant epistatic interaction between smoking and ACP1 phenotype concerning their effects on retinopathy. In subjects with low ACP1 activity, frequency of retinopathy was slightly higher in smokers than in nonsmokers. However, in subjects with medium-high ACP1 activity, frequency of retinopathy was significantly lower in smokers than in nonsmokers. A logistic regression analysis using retinopathy as the dependent variable revealed that smoking, ACP1, and ACP1 by smoking interaction, as well as the interaction between smoking and age of the women, are the most robust predictors of retinopathy. CONCLUSIONS: The effect of smoking on retinopathy in women with type 1 diabetes depends on many variables, which supports the hypothesis of complex interactions between smoking and other variables in the pathogenesis of this disease. Variability of genetic factors involved in signal transduction may affect endothelium proliferation through the regulation of growth factors and through regulation of glycemic levels. Because cigarette smoke influences signal transduction, its impact on diabetic retinopathy may be mediated by ACP1.

Adult↗

PubMed1993

Unaltered cerebral blood flow during hypoglycemic activation of the sympathochromaffin system in humans.

To determine if increases in plasma epinephrine and norepinephrine caused by hypoglycemia are associated with increments in cerebral blood flow (CBF), we measured CBF with positron emission tomography in normal humans at ambient fasting arterial plasma glucose levels and at clamped plasma glucose levels of 5.3, 3.5, and 2.8 mmol/l using the hyperinsulinemic, stepped hypoglycemic clamp technique. Despite significant increases in plasma epinephrine to 7,340 +/- 350 (SE) pmol/l and in plasma norepinephrine to 3.32 +/- 0.35 nmol/l, mean hemispheric CBF (41 +/- 1, 49 +/- 1, 48 +/- 2, and 51 +/- 3 ml x 100 g-1 x min-1) remained constant at the ambient (5.2), 5.3, 3.5, and 2.8 mmol/l glycemic levels, respectively. Furthermore, there was no correlation between CBF and either plasma epinephrine levels ranging from 160 to 10,580 pmol/l or plasma norepinephrine levels ranging from 0.56 to 5.10 nmol/l. Failure to demonstrate any dose-response relationship between plasma catecholamine levels and CBF argues against their primary role in cerebrovascular control during hypoglycemia.

Adult↗

PubMedDate not supplied

Plasma and red cell sorbitol assay in diabetic subjects.

Plasma and red cell sorbitol concentrations, fasting plasma glucose, glycosylated hemoglobin (GHb) were evaluated in 30 diabetic patients and 42 normal subjects. Red cell sorbitol levels were evaluated in hemolysate and non-hemolyzed samples. Mean red cell sorbitol concentrations evaluated after hemolysis were 21.5 +/- 5 nmol/ml in diabetics and 12.2 +/- 4 nmol/ml in controls (p less than 0.001). Mean values of red cell sorbitol determined in non-hemolyzed samples were 13.9 +/- 3 nmol/ml in diabetics and 8.1 +/- 3 nmol/ml in controls (p less than 0.001). Mean plasma sorbitol concentrations were 8.4 +/- 3 nmol/ml in diabetics and 5.2 +/- 1 nmol/ml in controls (p less than 0.001). The within and between run reproducibilities evaluated in plasma, hemolysate and non-hemolyzed red cells gave the lowest values for hemolyzed red cell samples. The studies on stability showed that samples neutralized and stored at -20 degrees C gave reproducible values if assayed within 3 days. A positive correlation was found between red cell hemolysate sorbitol concentrations and fasting plasma levels in both diabetics (r = 0.56; p less than 0.001) and controls (r = 0.62; p less than 0.001). Red cell hemolysate sorbitol concentrations were also positively correlated to GHb in both diabetics (r = 0.64; p less than 0.001) and controls (r = 0.36; p less than 0.05). We believe the most effective sorbitol assay to be that obtained in hemolyzed red cells and that these values related to glycemic levels could be a useful index of metabolic control and an indicator of tissue sorbitol levels in humans.

Adult↗

PubMed2005

Diabetic nephropathy is associated with decreased circulating estradiol levels and imbalance in the expression of renal estrogen receptors.

BACKGROUND: The incidence of cardiovascular and renal disease is lower in premenopausal women than in aged-matched men. However, in the setting of diabetes mellitus (DM), this "female advantage" no longer exists: the incidence and progression of DM and its associated end-organ complications are equal in men and women, regardless of age. We have recently reported that estrogen supplementation attenuates the progression of diabetic nephropathy, suggesting that lack of estrogen may nullify female sex as a protective factor against DM. OBJECTIVE: This study examined circulating levels of estradiol in DM and expression of estrogen receptor subtypes (ERa and ERP) in the nondiabetic (ND) and diabetic (D) kidney. METHODS: : The study was performed in ND and streptozotocin-induced D Sprague-Dawley rats after 2 weeks (male and female) and 12 weeks (female) of DM. The animals (N = 8/group) were kept either intact, ovariectomized (OVX), or OVX with 17beta-estradiol (E(2)) supplementation (OVX + E(2), 5 mug/kg/d). Plasma estradiol levels were measured by enzyme-linked immunosorbent assay, and expression of renal ERalpha and ERbeta was measured by immunohistochemistry and Western blot analysis. RESULTS: DM was associated with reduced circulating estradiol levels (ND: mean [SEM] 37.1 [7.2]; D: 24.5 [9.3] pg/mL; P < 0.05). The diabetic kidney exhibited increased expression of ERalpha protein (ND: 0.82 [0.06]; D: 1.15 [0.09] arbitrary units; P < 0.05), but no differences in ERP were observed. This resulted in an overall increase in the ratio of ERalpha/ERbeta protein expression in the diabetic kidney. No differences in the expression of ERa were observed in either females or males with similar glycemic levels after 2 weeks of DM. CONCLUSIONS: Reduced circulating levels of estradiol and imbalance in the expression of estrogen receptor subtypes in the diabetic kidney may explain why female sex is no longer a protective factor in the setting of DM. Thus, estradiol supplementation may be an effective regimen in attenuating the onset and progression of diabetic renal complications.

Animals↗

PubMed2000

Effect of acarbose on glycemic control, serum lipids and lipoproteins in type 2 diabetes.

OBJECTIVE: To assess the efficacy of acarbose monotherapy during 12-weeks treatment on the fasting glycemic level, lipid and lipoproteins profiles, in patients with type 2 diabetes mellitus. SETTING: Type 2 diabetics were selected from out patient department of Baqai Diabetes and Endocrine Centre, and one other diabetic clinic of Karachi, during 1996-97. DESIGN: A prospective intervention trial, and a 10 days screening period with a follow-up of 12 weeks. METHODS: Forty-four patients (36 men and 8 women, mean age 55.09 +/- 1.72 years) were included of whom 25 (56.81%) patients were previously treated with diet alone, 11(25%) with diet and glibenclamide, 5(11.36%) with diet and gliclazide, and 3(6.81%) with diet and chlorpropamide, more than at least 3 months known duration of diagnosed type 2 diabetes, body mass index (BMI) 23.69 +/- 0.49 kg/m2, were insufficiently controlled on diet alone, or diet plus sulfonylureas, were studied. The dosage of acarbose was started with 50 mg t.i.d with each meal, if necessary, was titrated upward on subsequent visits to 100 mg t.i.d with each meal, based on tolerability and efficacy. Fasting blood glucose, lipid and lipoprotein profiles were determined at the baseline and at the end of the study. RESULTS: Acarbose treatment was associated with significant reduction in fasting blood glucose from (mean +/- SE) 173.89 +/- 3.89 mg/dl at day 0 to 161.29 +/- 3.41 mg/dl at day 90 (P < 0.01). The serum total triglyceride level was (mean +/- SE) 188.85 +/- 5.91 mg/dl at entry, and was also significantly decreased to 158.57 +/- 4.48 mg/dl at day 90, this reduction was found statistically significant (P < 0.01). Whereas very-low density lipoprotein cholesterol reduced significantly from 33.08 +/- 1.09 mg/dl at day 0 to 31.02 +/- 0.95 mg/dl at day 90 (P < 0.01). Acarbose had no significant effect on serum total cholesterol, low-density lipoprotein cholesterol, and High-density lipoprotein cholesterol concentrations. Almost, all adverse experiences, as reported by patients on acarbose, were related to the digestive system and included diarrhea, flatulence, bloating and nausea. Most symptoms were of mild to moderate intensity and tended to improve with time. Overall, acarbose was well tolerated and the adverse experience profile was clinically acceptable. CONCLUSION: In type 2 diabetic patients, acarbose as monotherapy for 12 weeks resulted in beneficial effects on glycemic control, fasting blood glucose, mean serum total triglyceride and very-low density lipoprotein cholesterol decreased significantly. Perhaps attainment of normoglycemia on a long-term basis would result in more normal lipid and lipoprotein levels. Furthermore use of acarbose can be considered as a useful alternative in such type 2 patients, if they are difficult to control with diet alone or diet plus sulfonylureas (JPMA 50:152, 2000).

Acarbose↗

PubMedDate not supplied

Evaluation of metabolic control in women with gestational diabetes mellitus by the continuous glucose monitoring system: a pilot study.

OBJECTIVE: To evaluate the blood glucose concentrations in a group of women with gestational diabetes mellitus (GDM), by the use of a continuous glucose monitoring system (CGMS). METHODS: Seven women with diet-controlled GDM (group G1), 5 with diet- and insulin-controlled GDM (group G2), and 7 healthy, pregnant women (group N) were included in the study. The treatment was adjusted on the basis of self-monitoring of blood glucose (SMBG). The self-monitoring was performed 4 times a day, with the goals of fasting blood glucose values of <90 mg/dL and postprandial (2 hours after each meal) values of <120 mg/dL. Then patients were submitted to a 72-hour period of use of the CGMS. RESULTS: In the 3 study groups--N, G1, and G2, respectively--no significant differences were noted in individual study parameters, measured with the CGMS in regard to the following: mean 24-hour glycemia (85, 87, and 91 mg/dL), fasting blood glucose (79, 88, and 82 mg/dL), postprandial glucose (96, 97, and 105 mg/dL), mean glucose level during the night (77, 71, and 75 mg/dL), and area under the glycemia curve (281, 315, and 310). Moreover, no significant difference was found in the total duration of glycemia below 60 mg/dL (317, 300, and 370 minutes) or the duration of glycemia of more than 120 mg/dL (259, 225, and 394 minutes) in group N, G1, and G2, respectively. With use of the CGMS, however, in comparison with SMBG, a wider range of glycemic levels was observed in all 3 study groups: for the healthy, pregnant women, 41 to 194 mg/dL versus 61 to 151 mg/dL; for G1, 40 to 244 mg/dL versus 40 to 180 mg/dL; and for G2, 40 to 173 mg/dL versus 50 to 157 mg/dL. CONCLUSION: The therapy, based on SMBG levels, when applied to the group of women with GDM, brought the glucose levels under effective control, with mean outcome values similar to those observed in the group of normal pregnant women. Nevertheless, using the CGMS, we detected long, asymptomatic periods of high and low blood glucose levels, both in the patients with GDM and in the unaffected pregnant women. The use of the CGMS for monitoring blood glucose profiles might be beneficial in this group of pregnant women.

Adult↗

PubMed2025

Treatment preference for once-weekly versus once-daily DPP-4 inhibitors in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND/OBJECTIVE: Although once-weekly and once-daily DPP-4 inhibitors have gained widespread market recognition, patient preference differences remain a key focus. This meta-analysis compares treatment preferences for once-weekly versus once-daily DPP-4 inhibitors in T2DM, offering evidence to guide clinical decisions and healthcare policies. METHODS: PubMed, OVID, EBSCO, Web of Science, CNKI, Wanfang, and clinical trial registries were searched up to June 30, 2025. After screening literature against predefined criteria, a systematic review was conducted to compare the effects of once-weekly and once-daily DPP-4 inhibitors on the treatment preferences of patients with T2DM. RESULTS: 8 RCTs with 1,575 participants were analyzed. No significant difference in medication adherence and DTSQ total score between the once-weekly and once-daily groups (p > 0.05). HbA1c percentage (MD = -0.21, 95% CI [-0.42, -0.01], p < 0.05) decreased significantly with once-weekly dosing, while GA and FPG showed no change (p > 0.05), this suggests greater improvement in HbA1c percentage levels following a switch to once-weekly DPP-4 inhibitors. Once-weekly DPP-4 inhibitors showed higher musculoskeletal/connective tissue disorder risk (RR = 2.63; 95% CI [1.18, 5.83]), but no significant differences in other adverse events (p > 0.05). No significant differences in treatment burden between both groups (p > 0.05). CONCLUSION: No statistically significant association between treatment preferences for once-weekly versus once-daily DPP-4 inhibitors among T2DM patients and medication adherence, treatment satisfaction, glycemic level changes, safety, or treatment burden for these two dosing regimens. Further research is needed to elucidate the influence of physician prescribing behavior on these preferences.

Humans↗

PubMed2004

Conglutin gamma, a lupin seed protein, binds insulin in vitro and reduces plasma glucose levels of hyperglycemic rats.

This work describes the in vitro interaction between a lupin seed protein, namely, conglutin gamma, and insulin. The binding to an insulin-immobilized matrix occurs in the pH range from 7.5 to 4.2 and is strongly affected by ionic strength, suggesting that it is driven primarily by electrostatic interactions. The quantitative parameters of the binding were determined by surface plasmon resonance. On the basis of the conditions required for the interaction to take place and the quantitative binding parameters, it appeared that the interaction is specific, despite the fact that the origin of the two protein molecules is completely different. The effect of the oral administration of conglutin gamma on the glycemic levels of rats subjected to glucose overloading was a statistically significant reduction in glycemia comparable to that of metformin, a well-known glucose lowering drug. These findings represent the first molecular evidence of the possible use of a legume protein in the control of glycemia.

Administration, Oral↗

PubMed2003

Resistance to glomerulosclerosis in B6 mice disappears after menopause.

The frequency of chronic renal failure increases with age, especially in women after menopause. Glomerulosclerosis is a common cause of chronic renal failure in aging. We reported that pre-menopausal female C57BL6 (B6) mice are resistant to glomerulosclerosis, irrespective of the type of injury. However, we now show that B6 mice develop progressive glomerulosclerosis after menopause. Glomerular lesions, first recognized in 18-month-old mice, consisted of hypertrophy, vascular pole sclerosis, and mesangial cell proliferation. Diffuse but moderate mesangial sclerosis and more marked hypertrophy were present at 22 months. At 28 to 30 months the glomerulosclerosis was diffuse and increased levels of type I and type IV collagen and transforming growth factor-beta 1 mRNA were present. Urine albumin excretion was significantly increased in 30-month-old mice. Mesangial cells isolated from 28-month-old mice retained their sclerotic phenotype in vitro. Comparison of the effects of uninephrectomy (Nx) in 20-month-old and 2.5-month-old mice revealed a 1.7-fold increase in urine albumin excretion, accelerated glomerulosclerosis, and renal function insufficiency in 20-month-old Nx mice, but not in 2.5-month-old Nx mice. Glycemic levels, glucose, insulin tolerance, and blood pressure were normal at all ages. Thus, B6 mice model the increased frequency of chronic renal failure in postmenopausal women and provide a model for studying the mechanism(s) of glomerulosclerosis in aging women.

Aging↗

PubMed1998

United Kingdom Prospective Diabetes Study 24: a 6-year, randomized, controlled trial comparing sulfonylurea, insulin, and metformin therapy in patients with newly diagnosed type 2 diabetes that could not be controlled with diet therapy. United Kingdom Prospective Diabetes Study Group.

BACKGROUND: Uncertainty exists about the suitability of oral hypoglycemic drugs and insulin therapy for patients with newly diagnosed type 2 diabetes. OBJECTIVE: To assess and compare response to sulfonylurea, insulin, or metformin over 6 years in patients with newly diagnosed type 2 diabetes in whom disease could and could not be controlled with diet therapy alone. DESIGN: Multicenter, randomized, controlled trial. SETTING: Outpatient diabetes clinics of 15 hospitals in the United Kingdom. INTERVENTION: Sulfonylurea (chlorpropamide or glyburide), insulin, or metformin (if patients were obese). PATIENTS: 458 patients with newly diagnosed type 2 diabetes that could not be controlled with diet and had hyperglycemic symptoms or fasting plasma glucose levels greater than 15 mmol/L during the initial 3 months of diet therapy (primary diet failure group) and 1620 patients in whom disease was controlled by diet therapy and who had fasting plasma glucose levels of 6 to 15 mmol/L and no hyperglycemic symptoms while receiving diet therapy alone. MEASUREMENTS: Fasting plasma levels of glucose and insulin, hemoglobin A1c concentrations, body weight, and therapy required. RESULTS: Compared with the diet-controlled group, the primary diet failure group was younger and less obese and had more retinopathy, lower fasting plasma insulin levels, and reduced beta-cell function. At 6 years, patients allocated to insulin had lower fasting plasma glucose levels than did patients allocated to oral agents, but hemoglobin A1c concentrations were similar. Forty-eight percent (95% CI, 37% to 58%) of patients in the primary diet failure group maintained hemoglobin A1c concentrations less than 0.08. By 6 years, 51% of patients (CI, 42% to 62%) allocated to ultralente insulin required additional short-acting insulin and 66% of patients (CI, 58% to 73%) allocated to sulfonylurea required additional therapy with metformin or insulin to control symptoms and maintain fasting plasma glucose levels less than 15 mmol/L. Patients allocated to insulin gained more weight and had more hypoglycemic attacks than did patients allocated to sulfonylurea. Obese patients allocated to metformin gained the least weight and had the fewest hypoglycemic attacks. For all therapies, control achieved at 6 years was worse in the primary diet failure group than in the diet-controlled group. CONCLUSIONS: Because initial insulin therapy induced more hypoglycemic reactions and weight gain without necessarily providing better control, it may be reasonable to start with oral agents and change to insulin if goals for glycemic levels are not achieved.

Adult↗

PubMed2005

Reproducibility and variability in the action of injected insulin.

Insulin-treated patients are generally taught to adapt their doses of insulin according to the glycemic level obtained during self-tests. They usually adhere to medical recommendations, but are often confused by the results, which may not correspond to expectations. Patients have to contend with variability and a certain degree of unpredictability in the results. Our knowledge of the factors involved in this variability is often imprecise. We review here the factors depending on the preparation of insulin itself, not only with regard to its crystallization but also the speed at which the hexamers dissociate into dimers. The development of fast and slow-acting analogues is discussed along with their value in improving glycemic predictability. In addition to these factors, we mention those stemming from the injection technique itself, which are directly related to the instructions given to the patients. For crystallized insulin preparations, shaking the bottle is an important element that the development of slow-acting analogues should eliminate, but the time lapse before withdrawing the needle, the anatomical site of the insulin injection, and the depth of the injection are also factors for variability. Greater predictability in the action of insulin will be obtained from a combination of progress in manufacturing procedures and better patient education.

Animals↗

PubMed1984

A study of triiodothyronine-catecholamine interactions: their effect on plasma fatty acids in Pacific hagfish Eptatretus stouti.

Plasma circulating levels of fatty acids (PFA) were measured in intact and in triiodothyronine (T3)-treated Pacific hagfish Eptatretus stouti. Intraperitoneal injection of both pharmacological (200 ng/g) and physiological (1 ng/g) doses of T3 caused an elevation of PFA 24 and 48 hr after treatment. The implantation of capsules containing the antithyroid compound, 6-propylthiouracil (6-PTU) decreased PFA levels. Twenty-four hr after T3-injection the norepinephrine (NE) content of plasma declined, whereas epinephrine (E) titres increased. Forty-eight hr after T3-treatment the mean titres of dopamine (D) and NE were lower than in the control group of hagfish. The treatment of hagfish with E in either pharmacological (2-3 micrograms/g) or physiological (2-3 ng/g) doses did not cause any elevation of PFA during the 72 hr following injection. In the same experiment the high dose of E induced long-lasting hyperglycemia, whereas the low dose had no substantial effect on glycemic levels. The data provide evidence that in hagfish, unlike in higher animals, the observed lipolytic effect of administered T3 is not mediated through the potentiation of the fat mobilizing action of catecholamines.

Animals↗

PubMed1982

The effect of gestational age on amniotic fluid glucose in pregnancy complicated by diabetes mellitus.

Amniotic fluid glucose was measured in 189 amniotic fluid samples from 117 well-controlled Class A to F diabetic pregnant women from 32 to 40 weeks' gestation. A simultaneous maternal plasma glucose level was determined at each amniocentesis. Samples were obtained with the mother in the fasting or nonfasting (3.8 hours after breakfast) state. Amniotic fluid glucose correlated significantly with simultaneous maternal glucose (r = 0.562; p = 0.001). A significant downward linear trend of mean amniotic fluid glucose with advancing gestational age was demonstrated (p less than 0.01). No trend of mean simultaneous maternal glucose with gestational age was seen. These results were not affected by maternal prandial status at the time of amniocentesis. It is concluded that amniotic fluid glucose decreases with advancing gestational age in well-controlled diabetic pregnant women independent of maternal glycemic levels. Studies of amniotic fluid glucose and/or its relationship to other metabolic hormones must take this into account.

Amniocentesis↗

PubMed1996

[Comparative effects of captopril and chlorthalidone on glucose tolerance and insulin levels essential hypertensives].

PURPOSE: To compare the effects of chlortalidone (CL) and captopril (Cp) upon glucose tolerance and serum insulin levels in essential hypertensive patients. METHODS: Non obese essential hypertensive patients with normal glucose tolerance test (OGTT) and diastolic blood pressure (DBP) > 90 mmHg and < or = 115 mmHg in the seated position were treated, in a randomized fashion, with Cp or CL during 16 weeks, after 16 weeks of placebo. The OGTT was performed after placebo and after active therapy, with serum insulin levels determinations carried out before and 120 minutes after oral glucose load. RESULTS: Twenty four patients in the CL group and 19 in the Cp concluded the study. Hypocalemia (serum potassium < 3.8mEq/L or serum potassium reductions > or = 0.9mEq/ L) occurred in nine patients of the CL group (CL H). In this group CL therapy induced increments in the area under the curve of glycemia during OGTT (582 vs 610mg/h/dL, p < 0.05) that were not observed in the normocalemic patients of the CL (CLN) or Cp groups. Serum insulin levels during OGTT did not change with active therapy in all three groups. The insulin sensitivity index, however, decreased significantly in the CLH (1.9 vs 1.4; p < 0.05) and CLN (10.1 vs 4.3, p < 0.05) but remained unchanged in the Cp group (3.1 vs 2.5; NS). The insulin response to glucose index increased in the Cp (0.28 vs 0.40; p < 0.05) group but not in the CLH (0.25 vs 0.42; NS) and CLN (0.07 vs 0.24). CONCLUSION: The antihypertensive therapy with chlortalidone in essential hypertensive patients may result in reductions in the peripheral sensitivity to insulin that can be accompanied by increases in glycemic levels after oral glucose load, particularly in patients who develop hypocalemia. Our results indicate that Cp therapy induces increments in insulin response to glucose without detectable changes in peripheral insulin sensitivity.

Adolescent↗

PubMed1996

Central beta-adrenoceptor involvement in neural control of blood glucose in pigeons.

The effects of ICV injections of adrenaline (30 nmol in 1 microL of saline) on blood glucose levels were investigated in conscious adult pigeons. This procedure increased blood glucose levels at 15-45 min after treatment. Previous ICV injection of propranolol (50 nmol) suppressed the increase observed at 15 min. The higher propranolol dose (100 nmol) was more effective than the lower dose (50 nmol) at blocking adrenaline-induced hyperglycemia. On the other hand, the ICV pretreatment with an alpha-adrenergic antagonist, phentolamine, slightly potentiated the hyperglycemia caused by ICV injection of adrenaline. The IP administration of propranolol (100 nmol) or phentolamine (100 nmol) before adrenaline ICV failed to induce change in the hyperglycemic response induced by this catecholamine. Both IP and ICV injections of these adrenergic blockers, before ICV injections of saline, evoked no changes in baseline glycemic levels. Therefore, elevation of blood glucose concentration by ICV adrenaline and blockade of the response by propranolol suggest the involvement of a central beta-adrenergic mechanism in the neural control of glycemia in pigeons.

Animals↗

PubMed2000

Undernutrition during early lactation period induces metabolic imprinting leading to glucose homeostasis alteration in aged rats.

This study examines the effects of early postnatal undernutrition on the glucose homeostasis of rats at one year of age, comparing the effects of a free protein diet (FPD) and a normal diet containing 25% of protein (NPD) supplied during the first 10 days of lactation. The insulin secretion and the insulin sensitivity, using the glucose clamp technique, were studied in these rats. The analysis of the integrated area of insulin secreted by isolated islets stimulated with 16.7 mM glucose was reduced in the FPD group when compared with the NPD (FPD = 5.07 +/- 1.6 ng/ml/50 min.; NPD = 35.8 +/- 12 ng/ml/50 min., p < or = 0.001). Using the glucose clamp technique the plasma glucose concentration was raised by continuous glucose stimulation with 10 mg/Kg(-1) x min(-1). After 30 minutes the NPD displayed a lower level of plasma glucose concentration (FPD = 220.8 +/- 8 mg/dl.; NPD = 185 +/- 3 mg/dl., p < or = 0.01). Afterwards, the hyperglycemia of the NPD increased and in both groups was, subsequently, similarly maintained and, after 90 minutes of continuously glucose infusion, there was no difference between the groups (FPD = 191.6 +/- 8 mg/dl.; NPD = 189.3 +/- 17 mg/dl). In order to test the peripheral sensitivity to glucose, insulin 1.67 mU x Kg(-1) min(-1) was administered together with glucose 10 mg x kg(-1) x min(-1) (50 minutes after the beginning of the clamping). The glycemia after the insulin administration compared to glycemia 90 minutes of FPD was significantly reduced and the NPD maintained the same glycemic level ( FPD from 220.7 +/- 8 mg/dl to 170.6 +/- 5 mg/dl, p < or = 0.001; NPD from 195.3 +/- 10 mg/dl to 185.2 +/- 6 mg/dl.). Also, after the insulin administration the plasmatic insulin was raised but after 90 minutes the FPD group displayed a lower insulin concentration when compared to the same point of time for the NPD group (FPD = 0.8 +/- 0.01 ng/ml; NPD = 1.8 +/- 0.03 ng/ml., p < or = 0.01). The data suggest that undernutrition during early postnatal may cause a metabolic imprinting which leads to a decreasing action of the insulin secretory apparatus and increased insulin sensitivity as an adaptive response.

Aging↗