1,721,433 research outputs found
The combined treatment with insulin and sulfonylurea in non-insulin-dependent diabetic patients with secondary failure. Rationale and guidelines.
No full textWe propose that combined therapy with insulin plus sulfonylurea can be a useful approach for the treatment of those patients with NIDDM who fail to respond to diet or therapy with OHA (secondary failure). The use of relatively small doses of insulin can correct hypoinsulinemia due to impairment of endogenous insulin secretion, reduce basal hepatic glucose production and lower fasting plasma glucose concentration. Reduction of glucose level in plasma can favor the action of sulfonylurea drugs which can both stimulate insulin secretion in response to the meal and, perhaps, improve peripheral insulin sensitivity. The permissive effect of sulfonylurea drugs on insulin action can also avoid the use of large pharmacological amounts of insulin and reduce the risk of related side effects such as hypoglycemia and weight gain. The overall amelioration of prevalent plasma glucose concentrations can avoid the toxic effect of hyperglycemia on the β cell and possibly on the peripheral tissues. Based on these considerations, in patients with NIDDM who do not respond to OHA one should start a combined treatment with insulin and sulfonylurea agents and evaluate its effect on metabolic control before shifting to the traditional program of insulin therapy
Plurimetabolic syndrome: association of diabetes, dyslipidemia, and arterial hypertension
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Protein metabolism in glucagonoma.
No full textAlthough protein wasting and reduced amino acid concentrations are common findings in glucagonoma patients, the mechanisms underlying these alterations are unclear. Therefore, we studied basal postabsorptive leucine, phenylalanine and tyrosine turnover following L-[D3]-Leucine, L-[D5]-Phenylalanine and L-[D2]-Tyrosine i.v. infusions in one male and one female patient with glucagonoma, compared with healthy control volunteers. Plasma amino acid concentrations were reduced (-40 to 80%, delta >2 SD vs. control subjects) in both patients. Plasma leucine, phenylalanine and tyrosine rates of appearance in patients with glucagonoma were similar to values in the control subjects, except leucine rate of appearence in the female patient with glucagonoma (+ approximately 30%, delta >2 SD). In contrast, the intracellular leucine rate of appearence, reflecting protein degradation, was considerably increased in both patients (+60-80%, delta >2 SD). Phenylalanine hydroxylation was moderately higher only in the male patient with glucagonoma (+ approximately 30%, delta >2 SD). Leucine, phenylalanine and tyrosine clearances (+100-300%), as well as phenylalanine hydroxylative clearance (+75-100%) were also increased in the patients. In conclusion, whole-body protein breakdown is enhanced in patients with glucagonoma compared with healthy control subjects. Phenylalanine hydroxylative clearance is also higher. Reduced plasma amino acid concentrations are probably due, at least in part, to their increased clearance. These alterations could contribute to the determination of the catabolic state of the glucagonoma syndrome
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
From impaired glucose tolerance (IGT) to non-insulin dependent diabetes mellitus (NIDDM). Retrospective analysis of 632 observations
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