Delayed insulin absorption due to subcutaneous edema.

A prospective study to determine if subcutaneous edema interferes with insulin absorption was performed. Forty-six patients entered the study. Three groups were formed. Twenty patients with generalized edema (Group 1), ten of them with non-insulin dependent diabetes mellitus (NIDDM). Twenty patients without edema (Group II). 10 of them with NIDDM; and six patients with mild edema (Group III). The disappearance of I125-insulin was measured throughout 360 minutes. The rate of absorption in group I was significantly lower and delayed than in group II. The amount of insulin absorbed at 360 minutes was 3 to 4 fold lower in group I than in group II (p 0.001). Group III had intermediate values. The peak of plasma I125-insulin level was 3 to 4 fold lower in group I than group II. The impairment of insulin absorption in subjects with edema was more evident in those with NIDDM. In conclusion, this study demonstrates that subcutaneous edema impairs insulin absorption. Insulin absorption from subcutaneous tissue varies due to several conditions, resulting in a difficult glycemic control. Previous studies have shown that insulin absorption is affected by several factors as the site of injection, room and skin temperature, physical exercise, the thickness of adipose tissue, local massage, and local degradation of insulin. Edema due to chronic complications such as nephropathy and cardiopathy often occurs in long-standing diabetic subjects. However, the effects of edema of the skin and subcutaneous tissue on insulin absorption has not been previously examined. The aim of this study was to assess if edema affects the absorption of insulin.

[Effect of fever on gastric emptying and on serum gastrin levels]. / Efecto de la fiebre sobre el vaciamiento gástrico y los niveles séricos de gastrina.

We studied the effect of fever on gastric emptying and serum gastrin 17 levels. 8 patients with fever and normal gastric emptying were selected. Blood samples were obtained for measuring serum gastrin 17. We used Tc99m scintiscanning to measure gastric emptying. Differences between fever and normal temperature were significant. Gastric emptying in fever was 118 +/- 54 minutes and 55 +/- 22 minutes for normal temperature (p less than .01). Serum gastrin was 47.7 +/- 13 pg/ml in normal temperature and with febrile patients was 30 +/- 5.7 pg/ml (p less than .002). We conclude that fever retards gastric emptying, perhaps independently of serum gastrin level.

Circulating gonadotropin pattern in anorchia syndrome. Response to treatment.

Two anorchidic brothers, 16 and 25 years of age were studied; three, 60 min interval samples were drawn on the day -1 followed by a daily sample for five days, and after every seven days. 25 mg of testosterone propionate were administered daily during 24 days and after, 100 mg of testosterone enanthate were administered every 14 days (prolonged action). Testosterone, F S H and L H were quantified by R I A. Testosterone concentrations were 0.75 and 0.52 ng/ml; F S H 22.0 and 24.0 ng/ml and L H, 18.0 and 25.0 ng/ml respectively in A. F. M. and A.F.J. With testosterone propinate, F S H basal levels were decreased in 53 and 55 per cent, and L H, 80 and 86 per cent in A.F.M. and A.F.J. respectively. With prolonged action testosterone, F S H and L H levels were within normal limits after a 7 day administration course. Due to the decrease in F S H and L H initial levels as a result of treatment we concluded that in the anorchia syndrome, receptors in the hypothalamus - pituitary axis maintain their normal ability of feedback mechanism response with testosterone administration and thus prolonged action testosterone is the best substitute.