Reversal of neuropathic and gastrointestinal complications related to diabetes mellitus in adolescents with improved metabolic control

White, Neil H.; Waltman, Stephen R.; Krupin, Theodore; Santiago, Julio V.

doi:10.1016/s0022-3476(81)80954-7

Cited by 67 publications

(25 citation statements)

References 14 publications

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“…adolescents and reversal in abnormalities of ocular fluorophotometry, it is also known that insulin alone is incapable of bringing about a reversal or regeneration of a consistent or transient nature in diabetic animal models [31][32][33][34]. PCCS treatment in diabetic mice brought about a gradual reduction in random blood glucose levels as opposed to sham-treated or heatinactivated PCCS-treated controls.…”

Section: Discussionmentioning

confidence: 99%

Existence of Islet Regenerating Factors within the Pancreas

Kanitkar¹,

Bhonde²

2004

Rev Diab Stud

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■ AbstractReduction in the functional mass of β-cells is a common denominator in most forms of diabetes. Since the replicative potential of β-cells is limited, the search for factors that trigger islet neogenesis becomes imperative. Here we tested the hypothesis that regenerating factors for the pancreas are either secreted by or present within the pancreatic milieu itself. For this purpose, we intraperitoneally injected pancreatic cell culture supernatant (PCCS), from normal pancreas, into streptozotocin(STZ)-induced diabetic mice for 15 consecutive days. The PCCS-treated mice showed sustained reversal in 77.77% of experimental diabetic mice as evidenced by restoration of normoglycemia, increase in serum insulin levels and occurrence of neo islets in histopathological studies during a two month follow up, as opposed to the control diabetic mice which remained hyperglycemic throughout. In order to examine the potential of PCCS to bring about the regeneration of islets, we treated intra-islet precursor cells with PCCS in vitro, which led to the neogenesis of islets as evidenced by dithiozone and insulin immunostaining. These findings substantiate our hypothesis and make the search for regenerative factors converge towards the pancreas and its immediate surroundings. Such regenerative approaches, in combination with other therapeutic strategies to promote islet neogenesis may, in future, provide a cure and/or better means for the control and management of diabetes.

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Section: Discussionmentioning

confidence: 99%

Existence of Islet Regenerating Factors within the Pancreas

Kanitkar¹,

Bhonde²

2004

Rev Diab Stud

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“…Careful regimen management, producing good metabolic control, favors longevity 3 and may even reverse the presence of short-term complications. 4 Given the importance of maintaining regimen adherence and metabolic control, investigators have begun to search for factors, including psychosocial variables, that influence adherence and control. The rationale for this search is that if such factors (e.g., family discord, health beliefs) can be identified, treatments to improve adherence and control can emphasize changes in those areas.…”

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confidence: 99%

Adherence to IDDM Regimens: Relationship to Psychosocial Variables and Metabolic Control

et al. 1983

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Thirty-four adolescents (ages 12-14 yr) with IDDM completed a questionnaire assessing regimen adherence over the previous week and psychosocial measures potentially related to adherence. Four aspects of the IDDM regimen were studied: insulin injections, dietary patterns, glucose testing, and exercise. Psychosocial variables included (1) Social Learning Theory measures of diabetes-specific family behaviors and barriers to adherence and (2) more general measures of family interaction. Glycosylated hemoglobin levels were predicted accurately (R = 0.68) from a combination of three adherence measures. The psychosocial measures were not directly related to metabolic control, but they were associated with adherence. Degree of adherence to one aspect of the IDDM regimen was not related to adherence to other aspects of the regimen and different psychosocial variables predicted adherence to different regimen components. The diabetes-specific measures were generally more predictive of adherence than were the more global measures. Implications and limitations of this cross-sectional, correlational study were discussed.

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“…Treatment with aldose reductase inhibitors to interfere with sorbitol accumulation has not demonstrated clinical utility, and most other treatments (eg, vitamin and mineral supplementation) are nonspecific, not very effective, or designed merely for symptomatic relief or lessening of anxiety or depression. Improved glycemic control, as in the DCCT, has been demonstrated to be beneficial if the neuropathy is not far advanced [67].…”

Section: Neuropathymentioning

confidence: 99%

Complications of pediatric and adolescent type 1 diabetes mellitus

Brink¹

2001

Curr Diab Rep

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Type 1 diabetes mellitus is potentially associated with serious microvascular and macrovascular complications, although these are usually subclinical during the pediatric and adolescent years. There is no "grace" period for the beginnings of such complications. Duration of diabetes, glycemic control, age, and pubertal stage are critical factors contributing toward development of such problems. Other risk factors include family history (genetic predisposition), hyperlipidemia, hypertension, and smoking. The Diabetes Control and Complications Trial (DCCT) proved the importance of glycemic control and emphasized the ability of improved glucose control to prevent or decrease retinopathy, nephropathy, and neuropathy using a multidisciplinary same-philosophy-of-care approach plus targeted glucose and hemoglobin A(1c) values. Other natural history and intervention studies support the findings of the DCCT. Although our current tools are not perfect, they allow us to decrease microangiopathic complications very significantly if we educate our patients and their family members. Metabolic control counts.

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Reversal of neuropathic and gastrointestinal complications related to diabetes mellitus in adolescents with improved metabolic control

Cited by 67 publications

References 14 publications

Existence of Islet Regenerating Factors within the Pancreas

Existence of Islet Regenerating Factors within the Pancreas

Adherence to IDDM Regimens: Relationship to Psychosocial Variables and Metabolic Control

Complications of pediatric and adolescent type 1 diabetes mellitus

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