ABSTRACT
Measurements were made of muscle capillary basement membrane thickness (CBMT) in 95 normal boys and girls and 167 postpubescent insulin-dependent diabetics. Of 110 diabetics in whom "higher" degrees of metabolic control were maintained, only two had increased CBMT values. Of 57 diabetics in whom "lower" degrees of metabolic control were maintained, 26 had increased CBMT values. Two or more muscle biopsies were done in each of 65 diabetic subjects: Mean CBMT values of 24 subjects with "higher" degrees of metabolic control for two to nine years remained within the normal range; values of 23 subjects with "lower" degrees of metabolic control for only one to three years increased from 858 +/- 142 A to 1,155 +/- 227 A: values of 13 subjects who had been in "lower" degrees of control decreased from 1,255 +/- 232 A to 869 +/- 135 A after maintaining "improved" metabolic control for about a year. In postpubescent diabetics, the CBMT is labile and progresses or regresses depending on the degree of metabolic control.
Subject(s)
Basement Membrane/pathology , Capillaries/pathology , Diabetes Mellitus, Type 1/pathology , Diabetic Angiopathies/pathology , Adolescent , Adult , Biopsy , Blood Glucose/analysis , Child , Diabetes Mellitus, Type 1/drug therapy , Female , Follow-Up Studies , Glycosuria/diagnosis , Humans , Insulin/therapeutic use , Longitudinal Studies , Male , Muscles/blood supply , Muscles/pathologyABSTRACT
Ten patients with type I diabetes mellitus were enrolled in a program of exercise and carbohydrate "control" using self-monitored glucose determinations and self-adjusted insulin. Glucose control was improved for the group, although normoglycemia was not uniformly achieved. Pulse volume measurements performed at the onset and after 8-10 mo documented a drop in systolic arm blood pressure with increases in the ankle-arm index (P < 0.001). Quadriceps biopsy was successfully performed at the beginning and after 8-10 mo for analysis of basement membrane thickening (BMT) in seven patients. Six patients showed a decrease in basement thickening on rebiopsy (P = 0.02). One patient showed increased BMT. This was the only patient to maintain a mean hemoglobin A1c of greater than 10% for the duration of the study. These observations indicate that abnormalities of BMT and pulse volume recordings may be more labile measurements than previously thought and may be amenable to therapeutic intervention. The relationship of these variables to the severe micro- and macrovascular sequelae of diabetes mellitus remains to be established.
Subject(s)
Basement Membrane/physiopathology , Blood Glucose/analysis , Diabetes Mellitus, Type 1/physiopathology , Insulin/therapeutic use , Physical Exertion , Adolescent , Adult , Blood Pressure , Diabetes Mellitus, Type 1/drug therapy , Female , Glycosides/analysis , Heart Rate , Hemoglobin A/analogs & derivatives , Hemoglobin A/analysis , Humans , Male , Patient ComplianceABSTRACT
The adrenal glands of 13 patients with low-renin hypertension that was refractory to medical treatment were examined. Eight patients underwent total adrenalectomies and five underwent subtotal adrenalectomies. All of these patients had grossly visible adrenocortical changes. Ten patients had gross cortical nodules, and ten showed nonnodular cortical hyperplasia; seven had both. All ten patients with gross nodules had microscopic nodules as well. Of the 13 patients with low-renin hypertension, 12 (92%) had substantially lower blood pressure postoperatively without medication. During a follow-up period ranging from 14 to 38 months, three patients were normotensive without medication, nine patients had lowered blood pressures without medication and were easily maintained normotensive on antihypertensive medication, and one patient had no significant reduction in blood pressure postoperatively and no improvement in blood pressure control with antihypertensive drugs.
Subject(s)
Adrenal Glands/pathology , Hypertension/pathology , Adrenal Cortex/pathology , Adrenalectomy , Adult , Follow-Up Studies , Humans , Hyperplasia , Hypertension/surgery , Middle Aged , Renin/bloodABSTRACT
Skeletal muscle capillary basement membrane thickness was determined in age- and sex-matched normal and spontaneously diabetic Mystromys albicaudatus. In nondiabetic animals the average basement membrane thickness was 482.6+/-48.7 A as against 779.0+/-319.9 A in the diabetic ones. This difference was statistically significant at P less than 0.005.
Subject(s)
Capillaries/pathology , Diabetes Mellitus/veterinary , Disease Models, Animal , Muscles/blood supply , Animals , Basement Membrane/pathology , Blood Glucose/metabolism , Diabetes Complications , Diabetes Mellitus/pathology , Fasting , Glycosuria/complications , Hyperglycemia/complications , Ketone Bodies/urine , Male , Microscopy, Electron , Rodent Diseases/pathology , RodentiaABSTRACT
The kidneys of 175 nondiabetic and diabetic Mystromys albicaudatus were evaluated histologically by light microscopy. The degree of capillary basement membrane thickening and the predominant glomerular histologic pattern were recorded. Statistical analyses indicated that glomerulosclerosis is associated with diabetes in this species. In addition, a granular capillary basement membrane lesion occurred more frequently in diabetic than in nondiabetic animals.
