ABSTRACT
The results obtained with an artificial pancreas in 34 diabetics (15 women, 19 men) are reported. The group included 20 insulin dependent and 14 non-insulin dependent cases and the applicability of the technique is discussed.
Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 2/drug therapy , Insulin Infusion Systems , Adolescent , Adult , Aged , Child , Evaluation Studies as Topic , Female , Humans , Male , Middle AgedABSTRACT
Due to the ways their disease develops diabetics are more likely to require surgery than the rest of the population and operations constitute a stress factor with high rates of morbidity and post-operative mortality due essentially to cardiovascular and infectious complications. In normal subjects the stimulation of the hypothalamohypophyseal axis and the suprarenal marrow induced by surgical stress mobilizes energy substrates that provoke the secretion of insulin that prevents their accumulation and improves their utilization. In diabetics the inadequacy or lack of insulin secretion unbalances these mechanisms to the great danger of the patients themselves. For this reason patients' pre-operative conditions must be very carefully assessed and treatment designed to prevent the increase of catabolic ways due to the lack of insulin must be given. Some of the many treatment protocols proposed are described and discussed, a distinction being made between diet, non insulin and insulin dependent diabetics. The post-operative risk constituted by the onset of non-ketoacidotic hyperosmolar coma, as occurs in other severe stress situations should also be remembered.
Subject(s)
Diabetes Complications , Anesthesia/methods , Blood Glucose/analysis , Diabetes Mellitus/metabolism , Diabetes Mellitus/surgery , Diabetes Mellitus, Type 1/therapy , Diabetes Mellitus, Type 2/therapy , Humans , Insulin/metabolism , Insulin/therapeutic use , Intraoperative Care/methods , Postoperative Care/methods , Preoperative Care/methods , Risk , Stress, Physiological/etiology , Stress, Physiological/metabolismABSTRACT
Hypoglycaemia often arises after physical exercise in insulin-dependent diabetics treated with fast and slow acting insulin. Some claim that this is closely linked to the injection site for fast insulin and related to altered mobilization of the hormone from its subcutaneous deposit. Others attribute it to hyperinsulinism. The hypoglycaemia occurring after physical exercise in subjects treated with slow insulin and that arising even hours after physical exercise are then considered.
Subject(s)
Blood Glucose/metabolism , Diabetes Mellitus, Type 1/metabolism , Insulin/metabolism , Physical Exertion , Abdomen , Arm , Humans , Injections, Subcutaneous , Insulin/administration & dosage , Insulin/blood , Insulin, Long-Acting/administration & dosage , Insulin, Long-Acting/metabolism , Insulin, Regular, Pork , Leg , Receptor, Insulin/metabolismABSTRACT
Some remarks are presented on the contraceptive treatment of diabetic females with emphasis on the relationship between progestins and estrogenic progestins and the metabolism of carbohydrates and fats, haemostasis and arterial hypertension. Indications for the contraceptive treatment of insulin dependent and non-insulin dependent diabetics and subjects exposed to diabetic risk are supplied.
Subject(s)
Contraceptives, Oral/metabolism , Diabetes Mellitus/metabolism , Glucose/metabolism , Contraceptives, Oral/adverse effects , Diabetes Mellitus/blood , Diabetes Mellitus, Type 1/metabolism , Diabetes Mellitus, Type 2/metabolism , Dose-Response Relationship, Drug , Estradiol Congeners/adverse effects , Estradiol Congeners/metabolism , Female , Glucose Tolerance Test , Hemostasis/drug effects , Humans , Hypertension/chemically induced , Lipid Metabolism , Progesterone Congeners/adverse effects , Progesterone Congeners/metabolism , Risk , Time FactorsSubject(s)
Hodgkin Disease/complications , Nephrotic Syndrome/complications , Adolescent , Adult , Aged , Antineoplastic Agents/adverse effects , Child , Child, Preschool , Female , Hodgkin Disease/drug therapy , Hodgkin Disease/radiotherapy , Humans , Male , Middle Aged , Nephrotic Syndrome/chemically induced , Nephrotic Syndrome/etiology , Radiotherapy/adverse effectsABSTRACT
An account is given of the clinical and serological associations between diabetes and autoimmune diseases, especially those between diabetes and antihyperoglobulin, antithyroid, anti-intrinsic factor, anticorticoadrenal cell, and anti-nucleic acid autoantibodies. Body fluid antipancreas autoimmunity is examined from various standpoints relating to antipancrease cell antibodies (ICA), autoantibodies against glucagon-secreting cells (ECA) and somatostatin-secreting cells (SCA), and anti-islet cell surface antibodies (McLaren and Lernmark antibodies). Particular attention is directed to ICAs, since these have supplied the background for the recent division of type I diabetes into Ia viral and Ib autoimmune. Stress is laid on both the soundness and the problems forming part of ICAs, since their actual pathogenetic role (cytoplasmic markers?) still has to be determined, even though their persistent and significant association with autoimmune polyendocrinopathies is certain.
Subject(s)
Autoantibodies/analysis , Autoimmune Diseases/complications , Diabetes Complications , Anemia, Pernicious/complications , Diabetes Mellitus/immunology , Endocrine Glands/immunology , Endocrine System Diseases/complications , Hormones/immunology , Humans , Intrinsic Factor/immunology , Pancreas/immunology , Thyroid Diseases/complications , Thyroid Hormones/immunologyABSTRACT
Antipancreas autoimmunity is one of several immunity problems in diabetes. Such of its features as are revealed by inhibition of leukocyte migration, lymphocyte transformation in response to insulin antigens, relation between cell autoimmunity and later complications, and the behaviour of peripheral T and B lymphocyte membrane markers are explained. The aetiological role of viral infections is discussed, and the pathogenetic hypothesis deducible from the histological findings. Lastly, the modalities underlying a combination between the HLA (human leukocyte antigen) system and diabetes are considered.
