Glucose-dependent insulin-releasing peptide [GIP] in patients with type 2 diabetes mellitus with and without autonomic neuropathy

This study was conducted to investigate the role of glucose-dependent insulin-releasing peptide or gastric inhibitory polypepetide [GIP] in the control of glycemic state in patients with type 2 diabetes mellitus in the presence and absence of autonomic neuropathy. Twenty patients with type 2 jiabetes mellitus and 10 healthy normal subjects were studied. The diabetic patients were divided into 2 equal groups: one group with autonomic neuropathy [AN] and the other without AN according to cardiovascular autonomic function tests. Patients and controls were subjected to clinical examination and determination of HbA[1c]%, fasting blood sugar and basal insulin level. One-hour after ingestion of standard mixed meal [50 gm carbohydrate and 8% amino acid in 400 ml water] blood samples were collected for determination of glucose, insulin, and GIP plasma levels. Insulin resistance index was calculated from the homeostasis model assessment equation [HOMA]. A significantly impaired postprandial GIP and insulin levels as well as their responses to the ingestion of the mixed meal in the type 2 diabetics with AN was observed compared to those without AN. Postprandial GIP level was found to be correlated negatively with postprandial glucose level [r=-0.54] and positively with postprandial insulin level [r=-0.45], P < 0.05 for all diabetic patients. In diabetic patients with AN, significant -negative correlations were detected between duration of diabetes and postprandial GIP level [r= -0.66], absolute GIP response [r= -0.74], as well as% GIP response [r=- 0.71] [P < /= 0.05 for all.]. GIP plays an important role in the physiologic control of postprandial glucose homeostasis. GIP responses were lower in the diabetics as a group compared with healthy subjects despite similar basal levels. Moreover, In diabetic patients with autonomic neuropathy, there was a delayed and impaired GIP response to the mixed meal. Their absolute and% GIP responses were significantly lower than those of control subjects and patients without autonomic neuropathy

Effect of menstrual cycle phases on exercise performance in athletic and non athletic females

To investigate the exercise performance during the follicular and luteal phases of the menstrual cycle and the influence of exercise training on certain steroidal sex hormones estrogen, progestrone and testosterone. Some cardiorcspiratory parameters and sex hormone levels were assessed in 20 asymptomatic eumenorrheic femals [10 athletic, and 10 non-athletic] under basal condition and at the end of maximum incremental exercise bout, during both phases of the menstrual cycle. The resting ventilatory data in the luteal phase were higher than those of follicular phase in both athletes and non athletes. The ventilatory data at the end of maximum incremental exercise showed better performance during follicular phase as evidenced by higher levels of minute ventilation [V[e]] maximum oxygen consumption. [max V[02]] and max V[02]/kg] and lower levels of VE/V[02] and VE/V[co2]. The percent changes after exercise in progestrone levels during both luteal and follicular phases were significantly lower in athletic group [331.9% +/- 99.16 and 114.4% +/- 15.9 respectively] compared to corresponding values of non athletic [545.1% +/- 164.27 and 137.2% +/- 40.77] [P < 0.001]. The present data suggest better performance during follicular versus luteal phase of menstrual cycle. Moreover, training causes decreased basal levels of sex hormones and sluggish response to exercise

pulmonary performance and airway reactivity in acute and chronic fascioliasis before and after triclabendazole treatment

The pulmonary performance and airway reactivity were evaluated in 16 acute and 12 chronic fascioliasis patients before and after treatment with triclabendazole in a trial to clarify some underlying pulmonary changes which can explain the chest symptomatology that may accompany this intestinal fluke. Before treatment, the maximum voluntary ventilation was impaired in the acute and chronic cases. In the acute stage, the affection was in the small airways [as denoted by lower values of FEF75% compared to control]; while in the chronic stage, the impairment was more generalized including not only the small and large airways [as shown by diminished FVC, FEV1, FEFmax, FEF25%, FEF50% and FEF75%] but also the upper airway [as noticed by lower values of FIVC and FIF50% compared with the corresponding control values]. By individual analysis of the dose response slopes [DRS], 37.5% of acute and 33.3% of chronic cases had bronchial hyperactivity. After triclabendazole treatment and cure of the patients, most of the pulmonary flow rates improved significantly compared with the pretreatment values. Moreover, all cases regained normal bronchial reactivity and the DRS diminished significantly than during fascioliasis infection. It is concluded that, although the fluke doesnot have a cycle in the lung, yet if may have an impact on the pulmonary performance and airway reactivity which subsides greatly after treatment with triclabendazole