A Microcomputer Program as an Aid in Nutritional Counselling and Follow-Up in Diabetes and Obesity

Abstract

During puberty, growth and circulating SIC increase require normal GH secretion txlt the respective role of GH and sex steroids is still unsettled.This question was adressed by canparing children with low or normal GH secretion &ring PP. 28 children, with PP and similar gonadal activity, were classified into 2 groups according to their GH peak response to AITT : Grcup I > 10 ng/ml, Group I1 < 5 ng/ml. They were carpared to prepubertal hypopituitary cases (Grwp 111). Plasma SmC/IGFI was measured by RIA (m + sem).Group n CA (yr) DA (yr) cm/yr GH peak (ng/ml) SmC (U/ml) I 20 7.1 + 0.5 9.8 20.6 9 + 0.6 24 ~2 . 5 2.01 + 0.17 I1 8 8.2 + 1.1 9.5 + 1.3 6.8 + 0.6 3 50.5 0.71 + 0.14 111 7 11.3 + 1.1 6.9 20.9 1.9 + 0.5 1 + 0.3 0.07 ~0 . 0 1 Ry canparison of II/I it appears thst GH deficiency decreased the mean SmC level (p<O.OO1) and grlwth rate (p<0.05), but both of these values were superior (p<O.OO1) to values observed in group 111 indicating a possible role of sex steroids.In addition a 6 yr old girl (in Group 11) with PP and GH (AITT/sleep) <3ng/ml, Srri: <0.2 U/ml grew 9.5 cm/yr.In conclusion these data shlw that in PP beside the GH effect, growth and possibly circulating SIC m y be directly stirmlated by other factors as sex steroids.CsA inchced prolonged remissions in schlts with IDDM. We report on our experience in children treated with 2 different CsA dosages. CsA was given orally, for 6 mth targetting a CsA trough plaasa level either of 100 ng/ml (group I -n:14) or 200 ng/ml (group I1 -nr14). Both groups were compared to 12 "control" cases of cqsrable glycemic control receiving no CsA. Results were evaluated on insulin requirement and glucagon stirmlated C-peptide. In group I, no major side effects were observed. In grcup 11, blood pressure was elevated in 6. Creatinine levels increased (82 + 12 at 6 mth, vs 62 + 10 mol/l-ns-). All the side effects have been reversible.In group I, )I cases undenvent a total insulin remission for 1-4 mth, 3 cases no remission st all, and 6 a partial remission. In grcup I1 so far (n-7) at 6 mth, 4 cases undenvent a total remission for 2-9 mth and 3 a partial remission. Stimulated C-peptide was hi@er in group 11, canpared to group I (273 + 1.4 vs 1.84 + 1.3 ng /ml respectively at 6 mth). In group 11, both bessl and -stirmlated C-peptide were higher in non insulin treated cases frar the 3rd mth on.In conclusion : In this open trial, CsA has a positive effect on the remission period. A dose effect relationship was deronstrsted. Benefits of a high CsA dosage,inchcing s sustained remission, might be balanced by noticeable side effects. To determine wheter immature or defective glucose CR was responsible of the severe recurrent hypoglycemia (3,6 per patient per yr) observed during CT in 6 preschool diabetic children, we investigated their metabolic and hormonal responses to iv insulin infusion (40 mU kg-1 hr-1). CR was considered adequate since no patient experienced symptoms requiring discontinuation of the test, and (BG) nadirs averaged 42 * 5 mg/dl. Glucose production decreased from...