Fifty-seven children who attended a diabetes camp were divided into five groups on the basis of retrospective evaluation of the management of their diabetes mellitus over the previous three or more months. Shortly after their arrival at camp, fasting blood samples were obtained for the measurement of glucose and the quantitation of Hb AI and for hemoglobin typing. Samples were obtained from 12 normal (nondiabetic) camp personnel at the same time. The Hb AI components were measured by the “macrocolumn” procedure of Trivelli et al., by the colorimetric procedure of Flukinger and Winterhalter, and by a new microcolumn procedure employing columns and reagents provided by Isolab, Inc. As might be expected from a number of previous reports by other investigators, there was no significant correlation of the percentage of Hb AI with single fasting blood sugar values. Hb AI tended to decrease as the management of diabetes became more adequate according to clinical ratings. Comparison of the Hb AI (Hb AIa+b+c) determinations showed an acceptable correlation of percentages obtained by the relatively laborious macrocolumn procedure and the more facile microcolumn procedure, indicating that the latter would be clinically useful. Values of Hb AIc obtained by the colorimetric procedure, which has been proposed as a procedure suitable for the clinical laboratory, did not correlate well with Hb AIc values determined by the macrocolumn technique, nor did these show as good an inverse relationship to the ratings of the management of diabetes.
In this study metal-conjugated concanavalin A (Con A) and Bandieraea simplicifolia isolectin II (BSA II) have been applied to sections from kidneys of control rats and rats which had untreated diabetes for 70 days or for 200 days. Lectin binding was measured by atomic absorption spectrophotometric analysis of ferritin-iron or hemocyanin-copper. Con A binding increased significantly with diabetes; was totally blocked by alpha-D-mannoside; was not inhibited by fructose lysine; and was enhanced by NaHB4 preincubation. BSA II binding also increased significantly with diabetes.
Serial studies were made of glucose utilization and insulin and growth hormone secretion following intravenous glucose tolerance tests given to 16 patients during recovery from acute cerebrovascular disease. Three groups of patients were identified based on the pattern of change of glucose utilization during the first month of convalescence. A small group showed a persistent defective insulin response to glucose and appeared to have had pre-existing unrecognized adult-onset diabetes mellitus. The two other groups showed either an immediate suppression of glucose utilization or delayed development of glucose intolerance associated with an increase in total insulin secretion. Both of these responses returned to normal by the end of the fourth week. Growth hormone secretion correlated with the severity of the stroke. Alterations in glucose metabolism and insulin secretion seem to occur in most patients following recovery from stroke and undoubtedly reflect transient hormonal or metabolic changes related to either acute stress or tissue injury, depending on the interval after the onset of the vascular episode.
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