Search

Twenty-nine patients (24 males, 5 females; aged 62.8 +/- 10.1 years) with noninsulin-dependent diabetes mellitus (NIDDM) without gallstones and impaired liver function were included in our study. The patients were categorized by blood sugar control and disease duration. Twelve normal controls (10 males, 2 females; aged 62.8 +/- 12.4 years) were also studied for comparison. The gallbladder filling fraction (FF) and ejection fraction (EF) were calculated following the method of Krishnamurthy et al. The results showed no significant difference (P > 0.5) between (1) NIDDM and normal controls in FF (69.1 +/- 29.4 versus 67.5 +/- 24.0%) and EF (45.0 +/- 23.5 versus 54.8 +/- 10.0%) by a t-test, (2) good and poor blood sugar control in FF (64.9 +/- 30.9 versus 73.7 +/- 26.4%) and EF (42.0 +/- 25.4 versus 54.8 +/- 10.0%) by a Mann-Whitney U test, (3) long and short disease durations in FF (70.9 +/- 29.7 versus 67.9 +/- 28.7%) and EF (37.9 +/- 20.7 versus 50.0 +/- 24.1%) by a Mann-Whitney U test. In conclusion, the results challenge some previous reports and warrant further research.

The oral hypoglycemic agent sulfonylurea (SU) can increase plasma leptin concentrations. Additionally, diabetic subjects frequently have an altered plasma status of selected minerals. However, whether these described plasma parameters are changed in Type 2 diabetic patients who exhibit SU inefficacy has not yet been evaluated. In this preliminary study, fasting blood samples were collected from 16 Type 2 diabetic patients with secondary SU failure. As controls, 16 sex-, age- and adiposity-matched diabetic patients, who had similar diabetic duration and optimal glycemic control by SU, were also recruited. The results show that plasma values of leptin, C-peptide, calcium, magnesium, copper, and zinc did not significantly differ in these diabetic patients with or without secondary SU failure. However, the gender effect on plasma leptin level and the correlations between leptin and adiposity and C-peptide were retained. This study indicates that there is no relation between SU inefficacy and the plasma status of leptin and selected minerals.

Bone mineral density (BMD) in 38 male patients with noninsulin-dependent diabetes mellitus (NIDDM) was measured by dual photon absorptiometry (DPA) using a MSE OsteoTech 300 scanner. The BMD of the second to fourth lumbar vertebrae was measured and the mean density was presented as g cm-2. The patients were distinguished according to the following three criteria: (1) blood sugar control was good or poor; (2) the duration of diabetes was long or short; (3) renal function was evaluated by effective renal plasma flow (ERPF) as good or poor. The results showed about half the cases of NIDDM had lower BMD. The patients with poor blood sugar control, longer disease duration and poor renal function had lower BMD. However, the difference between any two groups distinguished by the three criteria is not significant. We think that the causes of osteoporosis in patients with NIDDM may not be explained by only a single factor.

In this study, we collected twenty NIDDM patients with impaired sensation and clinically suspected angiopathy over both lower extremities. All the patients underwent testing by means of the ultrasonic Doppler technique and were separated into two groups, group 1 with impaired blood flow, and group 2 with no significant impairment of blood flow. Ten normal persons were also included in this study (group 3). The results of the 133Xe muscle clearance test showed that the Q value of group 1 was 0.85 +/- 0.24 [mean +/- SE, ml (100g tissue min-1)], 1.05 +/- 0.31 in group 2 and 1.78 +/- 0.23 in group 3 of normal controls. After statistical analysis, there were significant differences in groups 1 and 2 relative to group 3 (p0.05), respectively. This preliminary result indicates that the 133Xe muscle clearance test may be an effective and convenient method to evaluate angiopathy of lower extremities in patients with NIDDM.

The Xe-133 clearance method is used to measure muscle blood flow in the lower limbs to establish normal values and evaluate the variance between different sex and age groups in healthy Chinese. 99 healthy volunteers were included in this study and divided into three groups according to age and two groups according to sex. Group I:40 y/o, 34 persons; Group II: 41-60 y/o, 30 persons; Group III:60 y/o, 35 persons; male group: 51 persons; and female group: 48 persons. Intramuscular injection of Xe-133 saline solution in the anterior tibial muscle of the right leg was performed in all the volunteers to calculate muscle blood flow. The muscle blood flow is 3.21 +/- 1.29 ml/100 gm/min in Group I, 3.19 +/- 1.28 in Group II, 2.71 +/- 1.17 in Group III, 3.09 +/- 1.38 in male, and 2.96 +/- 1.24 in female. There was no significant difference in Groups I and II, or in the male and female groups using the Student's t test for unpaired data. However, a mild difference was observed between Groups I and III, and between Groups II and III (P values of 0.09 and 0.11 respectively). We conclude that there is no variance of muscle blood flow in the lower limbs between different sexes and the effect of aging on peripheral muscle blood flow is not significant before 60 in healthy Chinese.

It is known that patients with hyperthyroidism have a lower zinc content in their erythrocytes, and that this decrement returns to normal after treatment with anti-thyroid drugs. This study was designed to investigate the alteration of body zinc levels in thyroid disorder. Two groups of out-patients associated with hyperthyroidism or hypothyroidism, and a group of normal healthy controls were collected. Zinc contents in the blood, hair and 24-hour urine samples were determined by a flame atomic absorption spectrometer. The results showed that patients with hyperthyroidism had a lower erythrocyte zinc level and an increased urinary zinc excretion (p0.05). The hypothyroidism had a higher hair zinc content and a decrement in urinary zinc excretion (p0.05). Body zinc levels, excluding the plasma zinc, held a certain correlation to the plasma thyroid hormones levels. The urinary zinc levels showed a more parallel variation in the thyroid disorders (p0.05). This data indicates that the alteration of urinary zinc levels might be a useful index for thyroid disorder evaluation. Body zinc could also play a physiological role in the metabolic regulation(s) of a thyroid disorder.

Zinc is known to have important effects on insulin activity, to increase the body fat deposition, and thyroid hormones conversion (T4 to T3). It is also known to have intestinal absorption competition between zinc and copper. This study was to investigate the blood zinc and copper concentrations in NIDDM and obesity, the relationships among metals, insulin, and thyroid hormones were also determined. Blood samples of diabetic, obese, and healthy individuals were collected between 9-10 AM, and the blood levels of zinc, copper, insulin, T4 and T3 were assayed. The results showed that diabetics and obese individuals had higher insulin and T3 levels than healthy controls, but there was no difference in T4. The obese had lower serum zinc concentration. There were low levels of copper both in serum and erythrocyte, and a low erythrocyte zinc concentration in NIDDM. Blood zinc concentration was inversely related to T3 level in diabetics and obese individuals. It is suggested that zinc, insulin and T3 may have considerable correlations in the thermoregulation on NIDDM and obesity, and the true mechanisms still need more further studies in the future.

Foot infection is a common cause of hospitalization for diabetic patients. Our study aimed to analyze patients' age, sex, the primary sites of infection, presenting features, outcome, bacteriologic studies and their clinical significance in diabetic foot infections. The age of our diabetic patients with foot infections ranged from 43 to 82 years, with a mean of 62.5 years; fifty-two of them were males and twenty-eight were females. The male to female ratio was 1.9:1, but there was no statistically significant difference between the sexes (p greater than 0.05). The commonest age group was the seventh decade of life (47.5%), followed by the sixth decade (32.5%). The commonest primary site of infection was the toes (53.8%), followed by foot area other than toe (25%) and the leg area was the least frequent (21.2%). Cellulitis combined with other foot lesions presented in 78.8% of these patients, foot ulcers in 75% of them, gangrenous change in 68%, necrotizing cellulitis or fasciitis in 16.3%, abscess formation in 12.5% and osteomyelitis in 7.5%. The legs were amputated in 53 patients (66.3%), usually below the knee (in 47.5%). We found that patients with a long history of DM had statistically significantly higher rate of amputation (p less than 0.01) than patients with only a brief history. Bacterial cultures from the infected foot lesions yielded numerous organisms in 58.8% of cases and a single organism in 31.1% of cases. Proteus mirabilis was the commonest organism isolated, followed by E. coli, Pseudomonas aeruginosa. The commonest month of the onset of diabetic foot infection was January, followed by February.

Insulinoma is a rare disease, which frequently causes hypoglycemic symptoms and signs or even shock. However, other diseases that produce similar symptoms and signs should firstly be ruled out. We describe a 63 years old male veteran who suffered from repeated episodes of seizure and conscious disturbance upon fasting, on and off for 8 years. Serial examinations led to the suspicion that this might be a case of insulinoma; the suspicion was later confirmed by pathologic examination after the tumor had been excised, and his problems disappeared. After six years, a follow-up examination showed that his condition was still stable.