Jialal I

Carbohydrate Metabolism in African Women with Twin Pregnancy

Carbohydrate metabolism was evaluated in 21 twin pregnancies and in 21 women with singleton pregnancies. The groups were matched for age, weight, parity, and period of gestation. A 100-g oral glucose tolerance test was performed on all 42 subjects. No significant differences in venous plasma glucose responses were found between singleton and twin pregnancies. The only significant difference between the insulin responses of the two groups was a lower plasma insulin concentration at 60 min in the twin group (P < 0.03).

Sex hormone levels in young Indian patients with myocardial infarction.

The finding of abnormal levels of sex hormones in men with coronary artery disease has led to the hypothesis that alterations in sex hormones may represent an important risk factor for myocardial infraction. In this study, the sex hormone profile of 28 young men (aged < 40 years) with myocardial infraction was compared with 28 age-and weight-matched normal men. Although the mean total serum estradiol levels and the free estradiol index of the patients and controls were similar, the mean serum total testosterone levels and the free testosterone index were significantly lowered in the patients with myocrdial infraction (p < 0.01). The ration of serum estradiol to testoster one was significantly increased in the patients (p = 0.0005) and correlated with serum cholestrol, triglycerides, and plasma glucose. A significant inverse correlation was also demonstrated between total testosterone and serum cholesterol and triglycerldes. Hence, the results of this study support the hypothesis that low plasma testosterone and an increased estradiol-to-testosterone ratio may be important risk factorxs for myocardial infarction.

Acute Insulin Response to Glucagon, Tolbutamide, and Glucose in Non-insulin-dependent Diabetes of the Young

Acute insulin release in response to maximal intravenous doses of glucose (0.5 g/kg), tolbutamide (1 g), and glucagon (1 mg) was studied in 10 subjects with non-insulin-dependent diabetes of the young (NIDDY) and 10 age-, sex-, and weight-matched controls. Diabetic subjects had attenuated insulinemic responses to all three stimuli, in comparison with control subjects. However, insulin responses to glucagon and tolbutamide were higher than those obtained with intravenous glucose. This study demonstrates that the pancreatic β-cell is more responsive to nonglucose secretagogues than to glucose stimuli in individuals with NIDDY.

Nephropathy in Indian Patients with Non-insulin-dependent Diabetes in the Young

In 85 patients diagnosed as having non-insulin-dependent diabetes in the young (NIDDY), 6 were found to have nephropathy. The duration of diabetes ranged from 2 to 17 yr; 5 of the 6 patients had retinopathy as evidenced by fluoroscein angiography (3 with proliferative changes). All 6 patients had a 24-h urinary protein excretion >0.5 g and a glomerular filtration rate <80 ml/min. Serum β2-microglobulin levels were increased in all 6 patients, while only 3 had increased serum creatinine levels.

Isolated adrenocorticotrophic hormone (ACTH) deficiency associated with acute adrenal crisis.

A 37 year old black female presented with congestive cardiac failure, 2 months postpartum. She developed spontaneous hypoglycaemia and symptoms of acute adrenal crisis (hypotension, nausea, abdominal pain and tachycardia with small thready pulse), which responded to i.v. dextrose, sodium chloride and hydrocortisone. Biochemical investigations revealed low serum cortisol and plasma adrenocorticotrophic hormone (ACTH) levels. The patient initially showed an impaired cortisol response to intramuscular aqueous tetracosactrin, but an exuberant response after priming with intramuscular tetracosactrin depot. These findings, together with the normal remaining pituitary function, led us to conclude that this patient had isolated ACTH deficiency associated with congestive cardiac failure and acute adrenal crisis.

Obesity Does Not Modulate Insulin Secretion in Indian Patients with Non-insulin-dependent Diabetes in the Young

The insulin response to a 100-g oral glucose load was studied in 40 obese (percent desirable weight ≥ 120%) and 40 nonobese (< 120%) age- and sex-matched Indian patients with non-insulin-dependent diabetes in the young. There were no significant differences between the obese and nonobese patients with respect to their insulin and glucose responses. Thus, it appears that obesity does not exert a significant modulating effect on insulin secretion in patients with fasting hyperglycemia.

Is There a Defect in the Hepatic Extraction of Insulin in Patients with NIDDY

REFERENCES 1 Oehler, J. W.: Meeting the psychosocial and rehabilitative needs of the visually impaired diabetic. JVIB 1978; 72:358-61. 2 Oehler, J. W., and Fitzgerald, R. G.: Group therapy with blind diabetics. Arch. Gen. Psychiatry 1980; 37:463-67. 3 Oehler, J. W.: An exploratory study of psychological reactions to visual loss and blindness in patients with diabetic retinopathy. Doctoral dissertation, Boston University, D.A.8319956. Univ. Microfilms 1980. 4 Oehler, J.: Reactions to complications. In Behavioral and Psychosocial Issues in Diabetes: Proceedings of the National Conference. Hamburg, B. A., Lipsett, L. F., Inoff, G. E., and Drash, A. L., Eds. Washington, D.C., U.S. Government Printing Office, 1980; DHHS Publication No. NlH 80-1993. 5 Oehler, J. W.: Personal and professional reactions to blindness from diabetic retinopathy. The New Outlook for the Blind 1976; 70:237-39. 6 Oehler, J. W.: Self-management of diabetes following vision loss. J. Ophthalmic Nurs. Tech. 1982; 1:20-27. 7 Oehler, J. W.: The role of the ophthalmic nurse in helping the patient adapt to loss of vision. J. Ophthalmic Nurs. Tech. 1982; 1:28-32.