[Monitoring hypoglycemia in elderly diabetic patients: a prospective study]. / Plaidoyer pour un dépistage systématique de l'hypoglycémie du sujet âgé diabétique: une étude prospective.

Hypoglycaemia is often underestimated in the elderly diabetic patient, as clinical manifestations of hypoglycaemia in these patients are frequently atypical. This prospective study, enrolling 100 elderly diabetic patients (age: 79.3 years) shows a great incidence of hypoglycaemic events (24%) during the first day of hospitalisation in a geriatric unit. According to the results of this study, common risk factors for hypoglycaemia in the elderly (advanced age, insulin therapy, renal insufficiency, polymedication, fragility) have no significant predictive value. It appears that screening for risk factors is not enough to prevent hypoglycaemia in the elderly diabetic patient, thereby a careful monitoring of glycaemia during the first days (and nights) of hospitalisation is required. Renewed efforts at better defining appropriate therapeutic goals, taking into account the patient's life expectancy and comorbidities, will help prevent the occurrence of hypoglycaemia in the elderly diabetic patient.

Transcriptome of a mouse kidney cortical collecting duct cell line: effects of aldosterone and vasopressin.

Aldosterone and vasopressin are responsible for the final adjustment of sodium and water reabsorption in the kidney. In principal cells of the kidney cortical collecting duct (CCD), the integral response to aldosterone and the long-term functional effects of vasopressin depend on transcription. In this study, we analyzed the transcriptome of a highly differentiated mouse clonal CCD principal cell line (mpkCCD(cl4)) and the changes in the transcriptome induced by aldosterone and vasopressin. Serial analysis of gene expression (SAGE) was performed on untreated cells and on cells treated with either aldosterone or vasopressin for 4 h. The transcriptomes in these three experimental conditions were determined by sequencing 169,721 transcript tags from the corresponding SAGE libraries. Limiting the analysis to tags that occurred twice or more in the data set, 14,654 different transcripts were identified, 3,642 of which do not match known mouse sequences. Statistical comparison (at P < 0.05 level) of the three SAGE libraries revealed 34 AITs (aldosterone-induced transcripts), 29 ARTs (aldosterone-repressed transcripts), 48 VITs (vasopressin-induced transcripts) and 11 VRTs (vasopressin-repressed transcripts). A selection of the differentially-expressed, hormone-specific transcripts (5 VITs, 2 AITs and 1 ART) has been validated in the mpkCCD(cl4) cell line either by Northern blot hybridization or reverse transcription-PCR. The hepatocyte nuclear transcription factor HNF-3-alpha (VIT39), the receptor activity modifying protein RAMP3 (VIT48), and the glucocorticoid-induced leucine zipper protein (GILZ) (AIT28) are candidate proteins playing a role in physiological responses of this cell line to vasopressin and aldosterone.