ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00325.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SummaryResidual pancreatic B‐cell function was investigated in children with diabetes mellitus in whom classification of the type of disease was difficult at the first visit.Intravenous glucagon tests were performed at the first visit and subsequently, the C‐peptide responses compared.Based on our data on a limited number of patients, we propose C‐peptide concentrations of 3.0 to 3.5 ng/ml at the peak or at 6 min after injection of glucagon, as the critical level which distinguishes non‐insulin dependent from insulin‐dependent diabetes mellitus.However, the degree of obesity, clinical stage and other factors also need to be considered in the classification of diabetes

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00326.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractWe studied ICA, HLA and insulin secretory capacity in 87 children with positive urinary screening and more than 2 points in the oral glucose tolerance test in order to establish criteria by which they could be classified into type 1 or type 2 diabetes mellitus. Fifty‐five non‐obese, ketosis‐prone insulin dependent diabetic children were used as controls for type 1 diabetes mellitus. Our conclusions were as follows:1. Type 1 diabetics were non‐obese (on insulin therapy), ICA positive, ketosis‐prone, had an insulin secretory capacity (Z IRI) of less than 100/nU/ml, and most of them possessed HLA‐Bw54‐DR4 or DRw9, DRw53 but did not possess Bw52‐DR2 haplotype.2. In the patients who were treated by dietary regimens alone for certain periods, however, insulin secretory capacities gradually deteriorated and they finally became insulin dependent. The children of this group who were not obese during insulin therapy and possessed an HLA haplotype identical to that in type 1 diabetes, regardless of ICA, might be classified as having slowly progressive type 1 diabetes.3. The major difference between type 1 and slowly progressive type 1 diabetes was a family history of diabetes. Genetic factors might modify the clinical course of type 1 diabetes mellitus.4. If the sensitivity of ICA or related autoantibodies to islet cells can be detected more readily, it should become easier to distinguish between type 1

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00327.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractHLA, ICA (islet cell antibody) and autoantibodies were studied in 65 Japanese patients with type 1 diabetes mellitus to elucidate the existence of immuno‐genetic heterogeneity. Patients with autoantibodies had increased frequencies of HLA DRw9 antigen and of HLA haplotype of Bw61‐DRw9, and a slow decay of ICA, while patients without autoantibodies had increased frequencies of HLA DR4 antigen and of HLA haplotype of Bw54‐DR4, and a rapid decay of ICA. These findings support the concept of immunogenetic heterogeneity in Japanese type 1 diabetes mel

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00328.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00329.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractWe treated six newly diagnosed children with insulin‐dependent diabetes mellitus (IDDM) with high‐dose gammaglobulin therapy in a clinical trial of immunomodulation. Approximately 400 mg/kg/day of polyethylene glycol‐treated gammaglobulin was given by intravenous injection for four to five days.After the initial therapy, four out of six patients showed an elevation of serum CPR and a decline of their insulin requirements; this indicates an improvement of insulin secretory function of pancreatic beta cells.A second course of gammaglobulin was given to four patients one year after the initial therapy, and the same results were observed in two out of four patients.These results suggest that high‐dose gammaglobulin might provide some protection against the deterioration of endogenous insulin secretion in children wi

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00330.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractIntensive insulin therapy was studied in six children with type 1 diabetes mellitus which was refractory to conventional insulin treatment. The methods used were continuous subcutaneous insulin infusion with a portable pump, and pre‐meal pulse infusion of short‐acting insulin with a pen‐type syringe supplemented with a bolus of long‐acting insulin. The former method was used in three patients for two weeks and in one patient for four months, in hospital, and the latter was used in two patients, starting in hospital and continuing for one year at home. Both these methods achieved better metabolic control than conventional therapy. In addition, insulin requirements decreased with continuous subcutaneous infusion but it had to be discontinued after discharge because of costs and the complexity of the equipment. With pre‐meal pulse infusion, insulin requirements increased compared with conventiona

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00331.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractMultiple insulin injections using the NovoPen, a new device for insulin administration, were given for 12 weeks to seven adolescent patients with insulin‐dependent diabetes mellitus (ages: 13–18 years; duration of diabetes: 4–14 years). Human Actrapid insulin was injected before every meal using the NovoPen, and human Monotard insulin was injected at bed‐time with a conventional syringe.The mean total daily insulin doses at the beginning and end of the study were 1.3 and 1.2 U/kg body weight, respectively. Monotard insulin was increased during the study. Blood HbAl values declined from 16% to 13% in two patients. The incidence of hypoglycemia did not increase and severe hypoglycemia did not develop. No patient reported difficulty in using the NovoPen. Some, however, had problems in administering insulin at school, but they preferred to continue using the device.The results show that, for adolescent patients,.the NovoPen offers advantages in management and may improve diabetic

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00332.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractThe frequency of hypoglycemia and M‐values were measured on 11 intensively treated insulin dependent diabetic children separated into three groups of once‐daily, twice‐daily and multiple daily insulin injection regimens. Despite a similar quality of blood glucose control (Hb Al (%): 10.0 ± 1.5, 10.4 ± 2.6, 10.6 ± 2.5) in each of the above regimens, the M‐values were 26.2 ± 11.7 in the once‐daily, 34.9 ± 17.9 in the twice‐daily and 47.7 ± 14.7 in the multiple daily injection regimen (M ± SD), respectively. A mild biochemical hypoglycemia was found more often in the patients under treatment with twice‐daily and multiple daily injections. Further, though the mean blood glucose profiles in the patients treated with once‐daily and multiple daily injections were very good, marked hypoglycemic blood glucose levels were seen prior to meals, e

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00333.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractThe goal of diabetes therapy is to achieve normal blood glucose (BG) levels to prevent acute and chronic complications. The ascertainment of BG during the day is done using glucometers. There are three major impediments: a) compliance to test for long periods; b) overview of results; c) cost of meter and chemistrips. We have developed systems which help overcome the problem. Treatment by a multidisciplinary team (MDT) including social workers, psychologist and education nurse have increased motivation and the patients perform a mean (± SD) of 2.8 (±2.3) tests/day even in the second year. The development of a computer system (DIACON) enabled a rapid accurate statistical analysis of data on self blood glucose monitoring (SBGM), food intake and insulin dose. The patient feeds the computer the SBGM data and receives histograms and tables presenting the mean ± SD of BG levels for the requested periods. The dietician feeds the dietary data which provides a break‐up into CHO, fats and proteins as well as the distribution in percentage of CHO intake during the day. The physician formulates his recommendation in accordance with data anal

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1987.tb00334.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY