Very Low Calorie Diet (VLCD) is known to induce not only weight loss, but also an improvement of metabolic control, in obese type II diabetics. In order to evaluate the therapeutical efficacy of cycles of VLCD shorter than those previously described, 29 obese type II diabetics and 31 obese nondiabetic subjects were entered as inpatients and prescribed a 450 kcal/day diet for 15 days. Metabolic results obtained were similar to those achieved with longer cycles of VLCD, showing that 15 days are sufficient to induce a BMI decrease in diabetic (BMI from 35.3 +/- 4.8 to 33.3 +/- 4.6 after VLCD) and nondiabetic patients (BMI from 40.5 +/- 7.4 to 38.1 +/- 7.2 after VLCD), a desired fall of blood glucose levels and the decrease of daily insulin needs in insulin-treated patients. Glucagon tests were performed before and after VLCD in order to study possible modifications of insulin secretion. Although we did not observe any significant increase of C-peptide basal or peak levels (nM/ml) either in diabetic (basal levels before VLDC: 1.2 +/- 0.4 and peak levels 2.4 +/- 0.7; basal after VLCD 1.23 +/- 0.6 and peak 2.6 +/- 0.7) and nondiabetic patients (basal levels before VLDC 1.0 +/- 0.3 and peak levels 2.5 +/- 0.4; basal after VLCD 0.9 +/- 0.3 and peak 2.4 +/- 0.6). The rise of the C-peptide/glycemia ratio is an index of an improvement of insulin biological activity, which could be partly responsible for the therapeutical effects of VLCD.(ABSTRACT TRUNCATED AT 250 WORDS)
The behavior of blood glucose, plasma free fatty acids and cortisol has been studied after insulin administration in subjects with diabetes mellitus without known complications and with normal plasma cortisol circadian rhythm. The mean plasma cortisol response to hypoglycemia in the diabetic subjects was below that of the normal controls, but not statistically significant. The slower rise to normal in the diabetic group was probably due to the lesser degree of hypoglycemia. DIABETES 77:124-26, March, 1968.Intravenous administration of insulin in the normal subject is followed by rapid decrease in the blood levels of glucose and plasma free fatty acids (FFA). 1>2 Hypoglycemia stimulates the hypothalamic-pituitary axis with a consequent increase in plasma levels of cortisol, 3 growth hormone, 4 -5 epinephrine 6 and norepinephrine. 7 Increased secretion of these hormones serves to restore blood sugar toward normal levels 8 and to elevate plasma FFA, 9 " 11 The increase in plasma cortisol resulting from the intravenous insulin injection is dependent on the integrity of the hypothalamic-pituitary-adrenal structures. 3 -12 Therefore an increase of this hormone after induced hypoglycemia has been used as a test of the function of the hypofhalamic-pituitary-adrenal axis. 3 ' 13 There have been many studies of adrenal function in diabetes mellitus, 14 " 20 but we are not aware of investigations of the above regulatory pathways. Accordingly, we have examined the levels of blood sugar and plasma FFA and cortisol after intravenous injection of insulin in diabetic patients. In the same persons the circadian rhythm of plasma cortisol has been observed also because its variations may influence the response to hypoglycemic stress, 21 and because alterations in diabetes with vascular complication have been described. 22 METHODSCrystalline insulin (o.i I.U. per kg. body weight) was given intravenously at 9:00 a.m. to twelve diabetic patients aged twenty-three to seventy years. Ten apparently normal subjects, aged eighteen to fifty-six years, served as controls. The diabetic patients were judged to be under control from treatment with a standard diet (25 calories per kg. of body weight per day) composed of 45 per cent protein, 40 per cent carbohydrate and 15 per cent fat. None had been treated with insulin, and only a few had received tolbutamide. None had detectable vascular complications. After receiving the intravenous insulin, eight of the patients had tachycardia, tremor, perspiration and a decrease in blood sugar of more than 50 mg. per 100 ml. The patients were fasting for over twelve hours prior to testing.Venous blood samples were obtained before and 15, 30, 45, 60, 90, 120 min. after insulin. Prior to testing, the behavior of plasma cortisol was examined during the day by collecting specimens at 8, 12, 16, and 24 hrs. from diabetic subjects, and subsequently compared with those of fifteen normal subjects.Plasma cortisol was measured by a fluorimetric method (Tarquini and Toccafondi 23 ) in the control sample prior to insu...
Serum proteins from cord blood of 27 infants of diabetic and 16 infants of normal women of comparable gestational age (38–39 weeks) were studied by immunoelectrophoresis. In accord with our previous finding of elevated serum glycoprotein levels in newborn infants of diabetic mothers, a well-defined precipitation arc in the beta-one globulin region, inside the concavity of the transferrin arc, was identified in these infants as hemopexin, because it (a) stained intensively for carbohydrate, (b) did not bind hemoglobin but did bind hemin, and (c) formed a single benzidine-positive line with anti-hemopexin serum.
The fatty acid composition of adipose tissue from subjects with cerebral thrombosis and IHD was studied. We found a difference in the fatty acid composition between the two groups. The subjects with cerebral thrombosis showed an increase of saturated and a decrease of monounsaturated fatty acids. The biological significance of this is obscure.
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