Negotiating Diet in Networks: A Cross-European Study of the Experiences of Managing Type 2 Diabetes.

Food and diet are central aspects of diabetes self-management but the relevance of social networks for the way people are supported in their management of type 2 diabetes is often under-acknowledged. In this article, we aimed to explore the coalescences between these two phenomena among people with type 2 diabetes to increase knowledge of interactions within social network related to daily diet. The article is based on 125 qualitative interviews with individuals with type 2 diabetes from five European countries. Based on assumptions that people with chronic illnesses reshape relationships through negotiation, we analyzed negotiations of food at different levels of network. The respondents' reflections indicate that there are complex negotiations that influence self-management and food, including support, knowledge, and relationships within families; attention and openness in social situations; and the premises and norms of society.

Chromatographic profiles at E-280 nm for urinary precipitates in morbus Rett.

Previously we have observed different characteristic chromatographic ultraviolet absorbancy profiles at 280 nm for urinary protein precipitates from patients with behavioral disorders. The purpose with this study was to look for similar changes in urinary protein excretion from the grossly disabled patients with the Rett syndrome. Benzoic acid precipitates from the urine from 20 patients were chromatographed on a Sephadex G-25 gel column. There appeared 3 different profiles: 6 as observed in normal controls, 5 like that in compulsive behavior, and 9 were similar to those observed for autistiform-schizophreniform patients. The profiles did not mirror the behavioral observations for the patients, although the first group of 6 patients were the least disabled, whereas the last 9 patients were the most seriously ill. In conclusion the chromatographic profiles suggest a heterogeneous group of patients, but we need more observations for several patients over time, as there may be a change with the exacerbation of the disease.

Acute in vivo stimulatory effects of human pituitary lipid-mobilizing factor on plasma levels of glucagon and insulin in rabbits.

The lipid-mobilizing factor LMF is prepared from deep-frozen human pituitary glands by alkaline extraction, followed by acetone precipitation at pH 4.8, Sephadex gel filtration and DEAE-cellulose chromatography. In addition to its adipokinetic effect in rabbits, LMF also increased the plasma levels of glucagon and insulin in rabbits in doses of 15 to 100 micrograms. The LMF-induced increases in the plasma levels of glucagon were most pronounced in fasted rabbits, whereas the increases in the plasma levels of insulin were most pronounced in fed rabbits. Glucose infusions decreased the LMF-induced hyperglucagonaemia and increased the LMF-induced hyperinsulinaemia. Somatostatin did not inhibit the LMF-induced hyperglucagonaemia with statistical significance, but inhibited the LMF-induced hyperinsulinaemia. The plasma levels of glucose were slightly decreased by 20 and 40 micrograms LMF in fasted rabbits and were unchanged in fed rabbits. In fasted rabbits, LMF had a toxic effect and 100 micrograms LMF killed one rabbits. Human growth hormone (hGH), prepared from the pituitary glands after removal of LMF, also increased the plasma levels of glucagon and insulin in rabbits. It is possible that the observed effects of LMF and hGH were due to the presence of some biologically active substances from the pituitary gland. These postulated substances could be involved in the pituitary control of the endocrine pancreas, and work is in progress to isolate them from the LMF preparation.

Chromatographic analysis of urine and dialysate from schizophrenic patients undergoing hemodialysis.

Maladjustments in the central nervous system may result in altered concentrations of neuropeptides in cerebrospinal fluid and urine. Urinary protein-peptide precipitates from psychiatric patients have previously been observed to have different chromatographic profiles with regard to the ultraviolet absorbancy at 280 nm. Hemodialysis has previously been reported to improve some schizophrenic patients and has been recommended in treatment trials. Seven chronic schizophrenic patients were selected for hemodialysis in a double-blind crossover study. Specimens of 24-h urine collections were obtained the day before, the day of, and the day after active and sham dialysis. The chromatographic profiles obtained on Sephadex G-25 gel columns did not change with active dialysis. Materials with ultraviolet absorbancy at 280 nm also precipitated from dialysates and showed the same pattern following active and inactive dialysis. Thus, no biochemical evidence for removal of any pathogenetic humoral substance during hemodialysis could be provided.

Childhood psychosis and urinary excretion of peptides and protein-associated peptide complexes.

Twenty-four infantile autistic children were compared with 12 children with other kinds of childhood psychoses, 5 children with so-called minimal brain dysfunction syndrome, 5 children with attention deficit disorder, 14 children with mental retardation, and 19 normal children with regard to chromatographic profiles of urinary products that give ultraviolet absorbency at 280 nm. Six main types of chromatographic patterns emerged. Fifty-four percent of the autistic children and 17% of the children with other psychoses showed a distinct pattern that was not seen in any other cases. Only 8% of the autistic children showed the "normal" pattern seen in 95% of the normal and 93% of the mentally retarded children without psychosis. The ultraviolet absorbency peaks of the chromatograms possibly correspond to peptides and protein-associated peptide complexes. It is argued that these products are probably at least partly of CNS origin.

Patterns of peptides and protein-associated-peptide complexes in psychiatric disorders.

Peptidic neurones may be considered as multisignal intergrators and transducers. When formation or release of peptide outstrips genetically determined breakdown capacity, overflow of peptides to the body fluids and urine may be expected. In this paper, pathological urinary chromatographic patterns of peptides are shown for genetic, functional and mixed disorders. Part symptoms of the disorders may be induced with the biologically isolated and purified peptides as well as with chemically synthesized peptides.

Development of hearing in hereditarily deaf white mink (Hedlund) and normal mink (standard) and the subsequent deterioration of the auditory response in Hedlund mink.

Behavioural responses have been elicited to acoustic stimuli in hereditarily deaf white mink (Hedlund). This revealed onset of auditory function at an average age of 31 days. The period of hearing lasted on the average only 7 days. Similar observations have been reported in other hereditarily deaf animals (cat, mouse, guinea pig). It is suggested that the onset of auditory function follows a progressive pattern which corresponds to the circulation of blood in the cochlea. Moreover, it is suggested that the subsequent deterioration of hearing follows a regression of this vascular pattern and thus a vascular pathogenesis may be responsible for this type of genetic deafness.

Congenital generalized lipodystrophy and experimental lipoatrophic diabetes in rabbits treated successfully with fenfluramine.

Lipoatrophic diabetes has been produced in rabbits by injection of a fraction prepared from the urine from patients with congenital generalized lipodystrophy. Both these conditions are considered to be hypothalamic syndromes. The animals, and a patient with congenital generalized lipodystrophy and latent diabetes were treated with the dopamine receptor blocker, pimozide, for 4 and 17 months, respectively. The results were discouraging even though the patient got a daily dose of 16 mg pimozide. Fenfluramine has a lowering effect on brain serotonin, and peripheral effects on glucose and triglyceride metabolism. This drug improved the general condition of the rabbits with lipoatrophic diabetes, as well as that of the patient with congenital generalized lipodystrophy. The rabbits became normoglycaemic and insulin sensitive. In the patient a normalization of the urinary excretion of the serotonin metabolite 5-OH-indole acetic acid was observed. His voracious hunger and profuse perspiration were reduced, the hyperkeratotic layer of the skin peeled off, and the pigmentations of the skin decreased. There was observed an improvement of ALAT and ASAT, normalization of the fasting blood glucose, and increased sensitivity to exogenous insulin. After 11 months of 200 mg fenfluramine daily addtitional administration of 2 g clofibrate per day produced normalization of the serum triglyceride concentration and a marked reduction of the resistance to insulin. Three more patients with congenital generalized lipodystriphy, two of whom have manifest diabetes, have now started treatment with fenfluramine and are improving. The rabbits got relapse of their lipoatrophic diabetes when the fenfluramine treatment was stopped. It is suggested that a disturbance in the serotonin metabolism of the central nervous system may be of pathogenetic importance in congenital generalized lipodystrophy.

Lipoatrophy produced in mice and rabbits by a fraction prepared from the urine from patients with congenital generalized lipodystrophy.

Urine from 5 patients with congenital generalized lipodystrophy has been fractionated by protein precipitation and Sephadex gel filtration. A fraction with a molecular weight in the range of 1000 was observed to be metabolically active in mice, rats, and rabbits. Hypophysectomized rats got hypoglycaemia following an injection, and the lipolytic-hyperglycaemic effect of ACTH was reduced after injection into intact mice. This effect was probably due to insulin release, because no insulin-like activity was observed on isolated fat cells in vitro. Persistant changes were observed in the animals after 3 weeks of daily injections of the urinary fraction. Adult mice and rabbits developed lipoatrophy with decrease of body weight in spite of a doubling of the food consumption. The metabolic rate and the body temperature were raised. Infantile animals developed a lipodystrophic state with increased growth velocity, and 50 per cent increase of the body weight, although no fat depots were observed. The treated animals got hyperglycaemia, hypertriglyceridaemia, hyperinsulinaemia, and insulin resistance. The rabbits developed manifest diabetes. The corresponding fraction prepared from the urine from the lipoatrophic rabbits produced lipoatrophy after injection into the mice. It is suggested that the lipodystrophic urinary fraction is of hypothalamic origin, and that it acts through the pituitary gland. The fraction is still heterogenous, and was observed to contain thyrotrophin releasing activity.