[A method for early diagnosis of reduced mobility of hand joints in diabetes mellitus type I]. / Metoda wczesnego rozpoznawania ograniczenia ruchomosci stawów rak w cukrzycy typu I.

The study aimed at elaborating the technique of an early diagnosis of cheiroarthropathy. The study involved 170 patients with diabetes mellitus type I aged between 16 and 45 years and disease duration ranging from 1 year to 33 years. Advanced cheiroarthropathy with shining waxy skin was diagnosed in 41 patients (group I). No lesions characteristic for cheiroarthropathy was diagnosed in 122 patients (group II) while in 7 patients (group III) only skin lesions without contractures were noted. Proliferative retinopathy was significantly more frequent (p less than 0.001) in the group with cheiroarthropathy--39% to 8%. Mean age of patients of group I is 31.5 +/- 5.9 years, in group II--31.0 +/- 6.6 years. Duration of diabetes mellitus is 17.8 +/- 6.2 and 9.6 +/- 7.2 years respectively (p less than 0.05). An angle of metacarpophalangeal joint of the V finger extension was measured in all patients with goniometer. A significant difference was noted in both groups: 34.4 +/- 8.08 degrees and 56.5 +/- 7.1 degrees, respectively (p less than 0.01). Mathematic models were designed basing on the value of measured angle and duration of the disease. These models facilitate possible risk of cheiroarthropathy. Systematic measurements of metacarpophalangeal joint extension seems valuable means of early diagnosis of diabetic cheiroarthropathy and follow-up of such patients.

[Short-term subcutaneous infusion of insulin using a portable insulin pump in the treatment of diabetes mellitus]. / Zastosowanie krótkotrwalych podskórnych wlewów insuliny za pomoca przenosnych dozowników insuliny w leczeniu cukrzycy.

The authors evaluated the effectiveness of treatment by means of constant subcutaneous insulin infusions (CPWI) in patients with diabetes staying in hospital. The infusions were made by means of portable insulin pumps (Microjet Bolus 1, Microjet Bolus 2 and Promedos E 1). The therapy was applied in a group of 15 patients with diabetes admitted to hospital because of symptoms of uncontrolled diabetes, among them 3 patients with diabetes freshly diagnosed. After 2-3 days of infusions 12 patients had glycaemia level approached to the physiological level. Only in one case of diabetes with significant resistance to insulin, the physicians were not able to control the diabetes. After 4-9 days of CPWI, patients who had been given conventional insulin injection had their insulin day demand reduced by 11-33%. In 4 cases the insulin demand had been established by means of Biostator GCIIS, after the introduction of the pumps the demand decreased by 40 +/- 5%, when the open loop system was applied. The above results suggest that the use of constant subcutaneous insulin infusion by means of a dosimeter may be recommended as a method of determining day demand for insulin, significantly shortening hospitalization period in patients with uncontrolled diabetes.

[Treatment of diabetes mellitus type 1 by long-term infusion of insulin]. / Leczenie cukrzycy typu 1 dlugotrwalymi wlewami insuliny.

In the article the authors evaluate the portable insulin pump, a prototype designed at the Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences, and also Promedos E1 pump produced by Siemens in the therapy of patients with diabetes type 1 brittle. Two patients underwent therapy by means of continuous intravenous insulin infusions (CDWI) for two months, two other patients--(CPWI) for about five years. The authors made an evaluation of the two methods by counting mean blood glucose, value M according to Schlichtkrull and determining the level of glycosylated haemoglobin. By continuous infusions of insulin, the authors achieved better diabetes control than with the previous conventional therapy.

[Effect of insulin sensitivity on the occurrence of early-morning hyperglycemia in patients treated with insulin]. / Wplyw insulinowrazliwosci na wystepowanie wczesnorannej hiperglikemii u chorych na cukrzyce leczonych insulina.

The study was aimed at elucidation of the effect of insulin-sensitivity on the occurring of the dawn phenomenon. Diabetic patients were investigated in whom the fasting glycaemia was often higher than 17 mmol/l (300 mg%). In all patients the euglycaemic state was maintained by a continuous i.v. infusion of insulin using a micropump and a changing infusion of glucose using Biostator. A slight increase in the insulin-sensitivity was seen in the early morning in 3 patients in whom the glucose consumption during the constant insulin infusion was 4 mg/min/kg b.w. Among 7 patients with lower glucose consumption in 6 a markedly low insulin-sensitivity was seen at down. The investigations allow to assume that the dawn phenomenon occurs mainly in patients with uncompensated diabetes which induces changes in insulin-sensitivity.