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Kazuya Higashino - One of the best experts on this subject based on the ideXlab platform.
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Effect of Glucose Infusion on the renal transport of purine bases and oxypurinol.
Nephron, 1995Co-Authors: Yuji Moriwaki, Tetsuya Yamamoto, Sumio Takahashi, Michio Suda, Kazuya HigashinoAbstract:The effect of Glucose Infusion on renal handling of purine bases and oxypurinol was examined in 6 normal subjects. Five hundred milliliters of 1.1 M Glucose solution were administered intravenously in 1 h. Fractional clearances of uric acid, xanthine and oxypurinol were significantly increased during Glucose Infusion, but that of hypoxanthine was not changed, while a 1-hour Infusion of 500 ml of 1.1 M mannitol had no effect on the fractional clearances of purine bases and oxypurinol. These data indicate that the effect of Glucose Infusion on the renal clearances of uric acid, xanthine and oxypurinol was not related to osmotic diuresis but induced by glycosuria and/or hyperglycemia. Accordingly, the glycosuria- and/or hyperglycemia-induced decrease in the biological half-life of oxypurinol must be considered in the administration of allopurinol to gouty patients with uncontrolled diabetes mellitus.
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Renal clearances of purine bases and oxypurinol during Glucose Infusion.
Advances in experimental medicine and biology, 1994Co-Authors: Yuji Moriwaki, Tetsuya Yamamoto, Sumio Takahashi, Yumiko Nasako, Toshikazu Hada, Kazuya HigashinoAbstract:Glucose Infusion causes increased excretion of uric acid1, 2, suggesting a functional relationship between the renal handling of uric acid and Glucose. Furthermore, some functional association between the renal transport of uric acid, oxypurines and oxypurinol have been suggested3, 4. However, the effect of Glucose Infusion on the renal transport of oxypurines and oxypurinol, an allopurinol metabolite, has not yet been investigated, to our knowledge. Therefore, we examined the response of renal clearances of purine bases and oxypurinol to intravenous Glucose Infusion.
S Efendic - One of the best experts on this subject based on the ideXlab platform.
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randomized trial of insulin Glucose Infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction digami study effects on mortality at 1 year
Journal of the American College of Cardiology, 1995Co-Authors: Klas Malmberg, S Efendic, Lars Ryden, Johan Herlitz, Peter Nicol, Anders Waldenstrom, Hans Wedel, Lennart WelinAbstract:Objectives. We tested how insulin-Glucose Infusion followed by multidose insulin treatment in diabetic patients with acute myocardial infarction affected mortality during the subsequent 12 months of follow-up. Background. Despite significant improvements in acute coronary care, diabetic patients with acute myocardial infarction still have a high mortality rate. Methods. A total of 620 patients were studied : 306 randomized to treatment with insulin-Glucose Infusion followed by multidose subcutaneous insulin for ≥3 months and 314 to conventional therapy. Results. The two groups were well matched for baseline characteristics. Blood Glucose decreased from 15.4 ± 4.1 to 9.6 ± 3.3 mmol/liter (mean ± SD) in the Infusion group during the 1st 24 h, and from 15.7 ± 4.2 to 11.7 ± 4.1 among control patients (p < 0.0001). After 1 year 57 subjects (18.6%) in the Infusion group and 82 (26.1%) in the control group had died (relative mortality reduction 29%, p = 0.027). The mortality reduction was particularly evident in patients who had a low cardiovascular risk profile and no previous insulin treatment (3-month mortality rate 6.5% in the Infusion group vs. 13.5% in the control group [relative reduction 52%, p = 0.046] ; 1-year mortality rate 8.6% in the Infusion group vs. 18.0% in the control group [relative reduction 52%, p = 0.020]). Conclusions. Insulin-Glucose Infusion followed by a multidose insulin regimen improved long-term prognosis in diabetic patients with acute myocardial infarction.
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feasibility of insulin Glucose Infusion in diabetic patients with acute myocardial infarction a report from the multicenter trial digami
Diabetes Care, 1994Co-Authors: K Malmberg, S Efendic, Lars RydenAbstract:OBJECTIVE To investigate the effect of insulin-Glucose Infusion on metabolic control and hypoglycemie episodes and its feasibility and safety in patients with diabetes and myocardial infarction (MI) compared with conventional treatment. RESEARCH DESIGN AND METHODS Of 327 patients with suspected acute MI, 158 were randomized to insulin-Glucose Infusion for at least 24 h and 169 received conventional therapy. We determined the 24-h blood Glucose profile in the Infusion group, the degree of metabolic control, hypoglycemie events, and in-hospital complications within the two study groups. RESULTS Blood Glucose fell from 14.6 ± 2.9 to 9.2 ± 2.9 mM during the first 24 h in patients receiving insulin-Glucose and from 15.8 ± 4.3 to 12.0 ± 4.4 mM in control patients ( P P P CONCLUSIONS The protocol outlined in this study gives more rapid and better metabolic control than does conventional treatment. This treatment seems to be a feasible alternative for clinical attempts. Before it can be recommended for general use, the impact on mortality needs to be evaluated.
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Glucose Infusion instead of preoperative fasting reduces postoperative insulin resistance
Journal of The American College of Surgeons, 1994Co-Authors: Olle Ljungqvist, Anders Thorell, Mark Gutniak, T Haggmark, S EfendicAbstract:In severe catabolic states, such as burn injury, sepsis and accidental injury, a state of marked insulin resistance is encountered. Insulin resistance is also present after elective surgical treatment, more pronounced with increasingly greater magnitude of operation performed. Results of recent animal experiments have shown that even short periods of food deprivation, reducing carbohydrate reserves, alter responses to stress. This notion resulted in our questioning the rationale of carbohydrate depletion associated with overnight preoperative fasting. Twelve patients undergoing elective open cholecystectomy were randomly given no Infusion (control group) or 5 milligrams per kilogram per minute of Glucose Infusion (Glucose group) during preoperative overnight fasting. Insulin sensitivity (M value, milligram per kilogram per minute) was determined using the hyperinsulinemic normoglycemic clamp (plasma insulin level, 65 microunits per milliliter and blood Glucose level, 4.5 millimoles per liter) before and the first postoperative day. Preoperative insulin sensitivity was similar in the two groups. Postoperatively, M values decreased by 55 +/- 3 percent (control group) and by 32 +/- 4 percent (Glucose group) (p < 0.01). Plasma levels of insulin, c-peptide, glucagon, growth hormone, catecholamines and cortisol in connection with clamps were similar in both groups preoperatively and postoperatively. The present results indicate that active preoperative carbohydrate preservation may improve postoperative metabolism because postoperative occurrence of insulin resistance was reduced with preoperative Glucose Infusion.
David Jones - One of the best experts on this subject based on the ideXlab platform.
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the effect of Glucose Infusion on Glucose kinetics during a 1 h time trial
Medicine and Science in Sports and Exercise, 2004Co-Authors: James M Carter, Asker E Jeukendrup, Christopher H Mann, David JonesAbstract:PURPOSE AND METHODS: To investigate the effect of Glucose Infusion on Glucose kinetics and performance, six endurance cyclists (VO2max = 61.7 +/- 2.0 (mean +/- SE) mL x kg(-1) x min(-1)) completed two performance trials in which they had to accomplish a set amount of work as quickly as possible (991 +/- 41 kJ). Subjects were infused with either Glucose (20% in saline; carbohydrate (CHO)) at a rate of 1 g x min(-1) or saline (0.9% saline; placebo (PLA)). It was hypothesized that time trial performance would be unaffected by the Infusion of Glucose, as endogenous stores of CHO would not be limiting in the PLA trial. RESULTS: Plasma Glucose concentration increased from 4.8 +/- 0.1 mmol x L(-1) to 5.9 +/- 0.3 mmol x L(-1) during the PLA trial and from 4.9 +/- 0.1 mmol x L(-1) at rest to 12.4 +/- 1.1 mmol x L(-1) during the CHO trial. These values were significantly higher at all time points during the CHO trial compared with PLA (P < 0.001). In the final stages of the time trial, Rd in the PLA trial was 49 +/- 5 micromol x kg(-1) x min(-1) compared with 88 +/- 7 micromol x kg(-1) x min(-1) in the CHO trial (P < 0.05). Despite these differences, there was no difference in performance time between PLA and CHO (60.04 +/- 1.47 min, PLA, vs 59.90 +/- 1.49 min, CHO, respectively). Infused carbohydrate oxidation in the last 25% of the CHO trial was at least 675 +/- 120 micromol x kg(-1) and contributed 17 +/- 4% to total carbohydrate oxidation. CONCLUSION: The results demonstrate that Glucose Infusion had no effect on 1-h cycle time-trial performance, despite an increased availability of plasma Glucose for oxidation and evidence of increased Glucose uptake into the tissues.
Bernard Portha - One of the best experts on this subject based on the ideXlab platform.
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Effect of prolonged in vivo Glucose Infusion on insulin secretion in rats with previous Glucose intolerance.
Endocrinology, 1992Co-Authors: Catherine Thibault, Marie-claude Laury, Danielle Bailbe, Alain Ktorza, Bernard PorthaAbstract:This work was designed to investigate the effect of an additional hyperglycemia on the subsequent in vivo insulin secretion in rats with various degrees of Glucose intolerance. Four groups of rats received a unique injection of a low concentration of streptozotocin (STZ): 20, 27, 30, or 35 mg/kg corresponding, respectively, to STZ 20, STZ 27, STZ 30, or STZ 35 rats. Control rats were injected with citrate buffer. In all STZ groups, impaired Glucose tolerance and insulin secretion were observed. These defects were roughly proportional to STZ concentration. Three weeks after STZ administration, hyperglycemia (17 mM) was produced by a 48-h Glucose Infusion via an indwelling catheter. Insulin secretion in response to Glucose was investigated 3 h after stopping Glucose Infusion, by performing iv Glucose tolerance tests. Insulin secretion in response to Glucose doubled in control rats previously submitted to Glucose Infusion, and still more in rats with mild Glucose intolerance (three and four times higher in S...
Klas Malmberg - One of the best experts on this subject based on the ideXlab platform.
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Role of insulin-Glucose Infusion in outcomes after acute myocardial infarction: the diabetes and insulin-Glucose Infusion in acute myocardial infarction (DIGAMI) study.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2004Co-Authors: Klas MalmbergAbstract:To review the Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) study for findings regarding effects on morbidity and mortality. The DIGAMI trial was an intervention study that tested the hypothesis that initial intensive metabolic control by insulin-Glucose Infusion for at least 24 hours followed by long-term treatment with subcutaneously administered insulin improved the prognosis in patients with diabetes and acute myocardial infarction. Overall, the intensive approach reduced the long-term relative mortality (at 3.4 years of follow-up) by 25% in the insulin-treated group. Improved long-term survival was especially evident in the prestratified group of patients without prior insulin treatment, in whom the 3.4-year mortality reduction was 45%. Furthermore, a close correlation was noted between high blood Glucose level at admission and mortality among the patients in the control group; this relationship was attenuated by intensive insulin treatment. The DIGAMI study supports the theory that intensive metabolic care in patients with diabetes who have had an acute myocardial infarction improves the prognosis. The study, however, could not answer whether this result was due to the initial insulin-Glucose Infusion or to the long-term subcutaneous treatment with insulin. This question is currently being addressed in the DIGAMI-2 study.
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Role of insulin-Glucose Infusion in outcomes after acute myocardial infarction: the diabetes and insulin-Glucose Infusion in acute myocardial infarction (DIGAMI) study.
Endocrine Practice, 2004Co-Authors: Klas MalmbergAbstract:Objective: To review the Diabetes and InsulinGlucose Infusion in Acute Myocardial Infarction (DIGAMI) study for findings regarding effects on morbidity and mortality. Results: The DIGAMI trial was an intervention study that tested the hypothesis that initial intensive metabolic control by insulin-Glucose Infusion for at least 24 hours followed by long-term treatment with subcutaneously administered insulin improved the prognosis in patients with diabetes and acute myocardial infarction. Overall, the intensive approach reduced the long-term relative mortality (at 3.4 years of follow-up) by 25% in the insulin-treated group. Improved long-term survival was especially evident in the prestratified group of patients without prior insulin treatment, in whom the 3.4-year mortality reduction was 45%. Furthermore, a close correlation was noted between high blood Glucose level at admission and mortality among the patients in the control group; this relationship was attenuated by intensive insulin treatment. Conclusion: The DIGAMI study supports the theory that intensive metabolic care in patients with diabetes who have had an acute myocardial infarction improves the prognosis. The study, however, could not answer whether this result was due to the initial insulin-Glucose Infusion or to the long-term subcutaneous treatment with insulin. This question is currently being addressed in the DIGAMI-2 study. (Endocr Pract. 2004;10[Suppl 2]:13-16) BACKGROUND
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randomized trial of insulin Glucose Infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction digami study effects on mortality at 1 year
Journal of the American College of Cardiology, 1995Co-Authors: Klas Malmberg, S Efendic, Lars Ryden, Johan Herlitz, Peter Nicol, Anders Waldenstrom, Hans Wedel, Lennart WelinAbstract:Objectives. We tested how insulin-Glucose Infusion followed by multidose insulin treatment in diabetic patients with acute myocardial infarction affected mortality during the subsequent 12 months of follow-up. Background. Despite significant improvements in acute coronary care, diabetic patients with acute myocardial infarction still have a high mortality rate. Methods. A total of 620 patients were studied : 306 randomized to treatment with insulin-Glucose Infusion followed by multidose subcutaneous insulin for ≥3 months and 314 to conventional therapy. Results. The two groups were well matched for baseline characteristics. Blood Glucose decreased from 15.4 ± 4.1 to 9.6 ± 3.3 mmol/liter (mean ± SD) in the Infusion group during the 1st 24 h, and from 15.7 ± 4.2 to 11.7 ± 4.1 among control patients (p < 0.0001). After 1 year 57 subjects (18.6%) in the Infusion group and 82 (26.1%) in the control group had died (relative mortality reduction 29%, p = 0.027). The mortality reduction was particularly evident in patients who had a low cardiovascular risk profile and no previous insulin treatment (3-month mortality rate 6.5% in the Infusion group vs. 13.5% in the control group [relative reduction 52%, p = 0.046] ; 1-year mortality rate 8.6% in the Infusion group vs. 18.0% in the control group [relative reduction 52%, p = 0.020]). Conclusions. Insulin-Glucose Infusion followed by a multidose insulin regimen improved long-term prognosis in diabetic patients with acute myocardial infarction.