86 results on '"Glucagon test"'
Search Results
2. Is the fear from insulin tolerance test in the evaluation of short stature justified?
- Author
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Hanukoglu, Aaron and Weisglass, Regina
- Abstract
Among growth hormone (GH) provocative tests, insulin tolerance test (ITT) is considered a valuable test in children with short stature to diagnose GH deficiency. However, many pediatric endocrinologists are reluctant to perform it. We conducted a nationwide survey among all the pediatric endocrine clinics' heads in Israel regarding their position on this issue. We found that the number of endocrine units performing ITT is almost nil. Sense of fear from severe hypoglycemia was a dominating cause for not performing ITT. We review the pros and cons of performing ITT versus other tests, especially glucagon test. Glucagon tolerance test is not considered the test of choice by some endocrinologists but recommended by others including in Israel. We also note the influence of a widely cited report published in 1992 (many times inaccurately) on endocrinologists' views. Conclusion: A nationwide survey in Israel revealed a high rate of reluctance to perform ITT. The rationale behind this attitude was a sense of fear of performing the test by many endocrinologists. We discuss the preferences for choosing GH stimulation tests and the pros and cons of alternatives to ITT. The fear of not performing ITT was not always justified. What is Known: • ITT test is considered a gold standard in the evaluation of short stature to diagnose GH deficiency by many endocrinologists. What is New: • High reluctance rate found in Israel to perform ITT, prompted us to evaluate the attitudes of pediatric endocrinologists around the world showing conflicting ideas. • The role of a single paper sometimes misquoted also contributed to these conflicting results. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
3. Glucagon Test Is a Useful Predictor of Withdrawal From Insulin Therapy in Subjects With Type 2 Diabetes Mellitus.
- Author
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Yuichiro Iwamoto, Tomohiko Kimura, Fuminori Tatsumi, Toshitomo Sugisaki, Masato Kubo, Erina Nakao, Kazunori Dan, Ryo Wamata, Hideyuki Iwamoto, Kaio Takahashi, Junpei Sanada, Yoshiro Fushimi, Yukino Katakura, Masashi Shimoda, Shuhei Nakanishi, Tomoatsu Mune, Kohei Kaku, and Hideaki Kaneto
- Abstract
There are many tests for evaluating endogenous insulin secretory capacity. However, there are only a limited number of studies that have examined in detail in clinical practice which method most accurately reflects the ability to secrete endogenous insulin especially in hyperglycemic state. The purpose of this study was to find the endogenous insulin secretory capacity and a possible predictor of insulin withdrawal in subjects with type 2 diabetes requiring hospitalization due to hyperglycemia. In the endogenous insulin secretory test during hospitalization, CPR, CPR index, and DCPR after glucagon loading were all significantly higher in the insulin withdrawal group. On the other hand, there were no difference in fasting CPR index, HOMA-b, SUIT, and 24-hour urinary CPR excretion between the two groups. In the glucagon test of the insulin withdrawal group, the cutoff value of DCPR was 1.0 ng/mL, the withdrawal rate of DCPR of 1.0 ng/mL or more was 69.2%, and the withdrawal rate of less than 1.0 ng/mL was 25.0%. In conclusion, it is likely that glucagon test is the most powerful tool for predicting the possibility of insulin withdrawal as well as for evaluating endogenous insulin secretory capacity in subjects with type 2 diabetes requiring hospitalization due to hyperglycemia. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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4. Assessment of Islet Alpha- and Beta-Cell Function
- Author
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Madsbad, Sten, Holst, Jens J., Krentz, Andrew J., editor, Weyer, Christian, editor, and Hompesch, Marcus, editor
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- 2019
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5. Comparison of a combination test (1 μg ACTH test plus glucagon test) versus 1 μg ACTH test and glucagon test in the evaluation of the hypothalamic-pituitary-adrenal axis in patients with pituitary disorders
- Author
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Kursad Unluhizarci, Emel Oguz Kokoglu, Ayşa Hacioglu, Zuleyha Karaca, and Fahrettin Kelestimur
- Subjects
Low-dose ACTH test ,glucagon test ,pituitary ,adrenal insufficiency ,Medicine ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
ABSTRACT Objective To investigate whether a combination of the low-dose (1 µg) adrenocorticotropin (ACTH) stimulation test and glucagon stimulation test (GST) could overcome the problem of equivocal results with the GST or ACTH test alone in patients with pituitary disorders. Subjects and methods The study included 41 adult patients with pituitary disorders and 20 healthy subjects who underwent evaluation of cortisol response to ACTH, GST, and a combination of both tests. Blood samples for cortisol measurement were obtained at baseline and 30, 60, 90, and 120 minutes after intravenous administration of ACTH 1 μg and 90, 120, 150, 180, 210, and 240 minutes after subcutaneous injection of glucagon 1 mg. The combination test was performed by injecting ACTH 1 µg at the 180-minute time point of the GST, with blood samples for cortisol measurement obtained at 210 and 240 minutes. Results Overall, 28 patients with normal cortisol response to both tests also had a normal cortisol response to the combination test. Ten patients with adrenal insufficiency in both tests also had adrenal insufficiency in the combination test, including a patient who had a peak cortisol value of 12.4 µg/dL (which is the cutoff value for the combination test). Two patients with adrenal insufficiency in the ACTH stimulation test and one patient with adrenal insufficiency in the GST had normal cortisol responses to the combination test. Conclusion By using an appropriate cutoff value, the combination test may offer additional information in patients with equivocal results in the GST and ACTH stimulation test.
- Published
- 2020
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6. Is Non-Stimulated C-Peptide at Diagnosis a Good Predictive Value for Insulin Use at Two Years after Diagnosis in Pediatric Diabetic Patients? .
- Author
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Wei-Chih Chou, Yen-Yin Chou, Yu-Wen Pan, and Meng-Che Tsai
- Subjects
C-peptide ,INSULIN ,GLUTAMIC acid ,DIABETES ,GLUCAGON - Abstract
Background and Objectives: Insulin treatment may be initially required to stabilize patients presenting with metabolic crisis at type 1 and 2 diabetes mellitus (DM) onset. Some patients with type 2 DM may need persistent insulin treatment. This study aimed to examine the predictive performance of non-stimulated C-peptide level at the time of diagnosis for future insulin use in pediatric diabetic patients. Materials and Methods: We reviewed the medical charts of diabetic patients aged 18 years or younger in a medical center in southern Taiwan from January 2000 to December 2019. Clinical and individual data were collected at the time of DM diagnosis. Outcomes were persistent insulin use at the time of diagnosis, as well as at one and two years after diagnosis. Results: The final analysis included a total of 250 patients. The best cut-off point of non-stimulated C-peptide was 0.95 ng/mL, and the predictive indices for the insulin use were 0.84 for sensitivity and 0.94 for specificity at two years after DM diagnosis. Incorporating age at onset and presence of GAD antibodies can further increase the predictive power of non-stimulated C-peptide. Conclusions: The value of non-stimulated C-peptide at diabetic onset was feasible and effective for predicting future insulin treatment up to the time point of two years after diagnosis. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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7. News on Clinical Details and Treatment in PGM1-CDG
- Author
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Schrapers, Esther, Tegtmeyer, Laura C., Simic-Schleicher, Gunter, Debus, Volker, Reunert, Janine, Balbach, Sebastian, Klingel, Karin, Du Chesne, Ingrid, Seelhöfer, Anja, Fobker, Manfred, Marquardt, Thorsten, Rust, Stephan, Baumgartner, Matthias, Series editor, Patterson, Marc, Series editor, Rahman, Shamima, Series editor, Peters, Verena, Series editor, Morava, Eva, Editor-in-chief, and Zschocke, Johannes, Series editor
- Published
- 2016
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8. The Glucagon Test for Evaluation of Insulin Secretion
- Author
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Scheen, A. J. and Lefèbvre, Pierre J., editor
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- 1996
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9. β-Cell Autoantibodies and Their Function in Taiwanese Children With Type 1 Diabetes Mellitus
- Author
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Yi-Ching Tung, Mei-Huei Chen, Cheng-Ting Lee, and Wen-Yu Tsai
- Subjects
autoantibodies ,C-peptide ,glucagon test ,type 1 diabetes mellitus ,Medicine (General) ,R5-920 - Abstract
To understand the importance of autoimmunity in the development of type 1 diabetes in Taiwanese children, we evaluated the presence of β-cell autoantibodies and their correlation with residual β-cell function. Methods: From 1989 to 2006, 157 Taiwanese children with newly diagnosed type 1 diabetes were enrolled in this study. We determined the presence of β-cell autoantibodies, such as glutamic acid decarboxylase autoantibodies (GADAs), insulinoma antigen 2 autoantibodies (IA-2As), and insulin autoantibodies (IAAs). A 6-minute glucagon test was also performed at diagnosis. Results: At diagnosis, 73% of children tested positive for GADAs, 76% for IA-2As and 21% for IAAs. Ninety-two percent of them had at least one of the β-cell autoantibodies detected. Positivity for IAAs was more frequent in patients younger than 5 years than in those older than 5 years (45% vs. 13%). Using multiple regression analysis, the presence of GADAs or IAAs, or age of onset of these patients was an independent factor for residual β-cell function. Younger patients and those with GADAs had less residual β-cell function at disease onset, whereas those with IAAs had more insulin reserve. Conclusion: Autoimmunity plays an important role in the pathogenesis of type 1 diabetes in Taiwanese children, and the presence of IAAs tends to be more common in younger children.
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- 2009
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10. Comparison of gut hormones and adipokines stimulated by glucagon test among patients with type II diabetes mellitus after metabolic surgery.
- Author
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Chen, Ying-Chieh, Inui, Akio, Chang, En-Su, Chen, Shu-Chun, Lee, Wei-Jei, and Chen, Chih-Yen
- Abstract
Laparoscopic Roux-en-Y gastric bypass (RYGB) achieves a higher remission of type 2 diabetes mellitus (T2DM) than laparoscopic sleeve gastrectomy (SG) in non-morbidly obese patients. However, the mechanisms of the higher remission are unknown. To compare glucagon-provoked acute insulin responses, as well as changes of gut and pancreatic hormones and adipokines between patients with T2DM after RYGB and SG at one year post-operatively, a total of 14 RYGB and 13 SG patients were followed-up and evaluated for glucose metabolism, gut and pancreatic hormones, and adipokines. One year after surgery, 1-mg intravenous glucagon tests were performed. The differences in each hormone at different time points and the area under the curve (AUC) were compared between the two groups. Glucagon-stimulated acute insulin responses were not different between the RYGB and SG groups, nor were they different between the remitters and non-remitters at one year after the metabolic surgery. Plasma des-acyl ghrelin and nesfatin-1 levels significantly decreased at 6 min after glucagon stimulation in the RYGB and SG groups, as well as in the remitters and non-remitters. The glucagon test did not affect intestinal hormones. Plasma resistin was suppressed after intravenous glucagon stimulation in both RYGB and SG groups. In conclusion, intravenous glucagon inhibited plasma levels of des-acyl ghrelin, nesfatin-1, and resistin in T2DM patients at one year after both RYGB and SG, whereas post-glucagon suppression of plasma obestatin and resistin was shown in the remitters but not in the non-remitters. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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11. Comparative analysis of the methods for differential diagnosis of non-diabetic hypoglycemia (NDH): Beta-hydroxybutyrate and glucagon test
- Author
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Marina Yukina, Nurana Nuralieva, and Ekaterina Troshina
- Subjects
Glucagon test ,medicine.medical_specialty ,Beta hydroxybutyrate ,Endocrinology ,business.industry ,Internal medicine ,Medicine ,Hypoglycemia ,Differential diagnosis ,business ,medicine.disease ,Non diabetic - Published
- 2021
12. L-Dopa Is a Potent Stimulator of Cortisol in Short Children.
- Author
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Marakaki, C., Papadimitriou, D.T., Papadopoulou, A., Fretzayas, A., and Papadimitriou, A.
- Subjects
- *
DOPA , *HYDROCORTISONE , *PITUITARY dwarfism , *GLUCAGON , *SERUM - Abstract
Aims: In this study, we evaluated the diagnostic usefulness of oral L-dopa as a stimulatory agent for cortisol. Methods: In27 short children that were evaluated for possible growth hormone deficiency (GHD), the levels of serum GH and cortisol were determined after oral L-dopa administration and after i.m. glucagon administration. We defined cortisol concentrations >18 μg/dl (496 nmol/l) as adequate response. Peak GH concentration <10 ng/ml in both tests defined GHD. Results: Twenty-five out of the 27 children (93%) studied showed a normal cortisol response, i.e. a peak serum cortisol >18 μg/dl in the L-dopa test, whereas 19 children (70%) had a normal cortisol response after stimulation with glucagon. In the children with normal cortisol response in both tests, the mean peak serum cortisol concentration was 28.7 (SD 1.59) after L-dopa and 26.65 (SD 1.26) μg/dl after glucagon administration. There was no statistically significant difference in peak serum cortisol response to L-dopa between GH-deficient and GH-sufficient children [25.90 (SD 4.9) vs. 29.87 (SD 9.9) μg/dl, respectively]. Conclusions: These results clearly suggest that L-dopa administration is a potent stimulus for cortisol secretion at least in short children. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2014
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13. The area of abdominal subcutaneous adipose tissue is independently correlated with C-peptide increment during glucagon load in Japanese patients with type 2 diabetes.
- Author
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Matsumoto, Kazuhisa, Kanazawa, Akio, Ikeda, Fuki, Ohmura, Chie, Shimizu, Tomoaki, Tamura, Yoshifumi, Fujitani, Yoshio, Kawamori, Ryuzo, and Watada, Hirotaka
- Abstract
Overall adiposity is associated with insulin resistance. Decline in insulin sensitivity induces a compensatory increase in insulin secretion from beta cells. The impact of adipose tissue distribution, i.e., visceral versus subcutaneous fat, on beta cell function remains to be elucidated. The aim of this study was to retrospectively investigate the relation between the areas of subcutaneous and visceral fat and the increment in C-peptide levels (CPR) during glucagon load (ΔCPR) in Japanese patients with type 2 diabetes. In 195 Japanese patients with type 2 diabetes, beta cell function was evaluated by ΔCPR, CPR index (100 × fasting CPR divided by fasting glucose), and 24-h urinary C-peptide excretion (U-CPR) during the 1-week hospitalization for diabetes education. Then, we investigated the relationships between markers of beta cell function and the areas of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) determined by abdominal computed tomography. Stepwise multiple regression analyses identified SAT, but not VAT, as an independent variable of both ΔCPR and U-CPR [standard regression coefficient (Std β) = 0.332, P < 0.01 for ΔCPR, and Std β = 0.181, P < 0.05 for U-CPR], and both SAT and VAT were identified as independent variables for CPR index (Std β = 0.253, P < 0.01 for SAT, and Std β = 0.193, P < 0.01 for VAT). Our results indicated that SAT is independently correlated with beta cell function by glucagon test in Japanese patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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14. Detailed studies of growth hormone secretion in cystinosis patients.
- Author
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Besouw, Martine, Dyck, Maria, Francois, Inge, Hoyweghen, Elke, and Levtchenko, Elena
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- *
GLOMERULAR filtration rate , *GLUCAGON , *HUMAN growth , *INBORN errors of metabolism , *RECOMBINANT proteins , *HUMAN growth hormone , *CYSTEINE , *DESCRIPTIVE statistics - Abstract
Background: Cystinosis is an autosomal recessive disorder characterized by intralysosomal cystine accumulation. Growth retardation is more pronounced in cystinosis than in other chronic kidney diseases and is mostly not corrected by cysteamine. Methods: Growth was evaluated in nine cystinosis patients, all treated with cysteamine, both after cysteamine and recombinant human growth hormone (rhGH) therapy initiation. Growth hormone (GH) secretion was studied by nocturnal GH measurements in four of nine patients and by glucagon test in four of nine patients. Results: RhGH was administered to seven of nine patients. At rhGH initiation, height was below −2 SDS in five of seven patients, final height was above −2 SDS in six of seven. In two patients not treated with rhGH, final height remained below −4 SDS despite cysteamine treatment being started at the age of 6.1 and 8.1 years, respectively. Nocturnal GH secretion was normal in all patients. Glucagon tests revealed GH deficiency in one patient; two of four patients had abnormal GH peak timing. Conclusions: We present the first reported case of GH deficiency in cystinosis. Although no overt GH deficiency was detected in other patients, abnormal GH peak timing can indicate a subclinical GH secretion problem. RhGH significantly improved growth in cystinosis patients and should be initiated early in life. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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15. Effectiveness of the glucagon test in estimating islet function for liraglutide treatment in a lean diabetic patient with impaired insulin response to glucose.
- Author
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Iizuka, Katsumi, Tomita, Reiko, Horikawa, Yukio, and Takeda, Jun
- Abstract
A 52-year-old lean woman was admitted to hospital for a medical examination in July 2010. A 75 g oral glucose test (75 g OGTT) revealed postprandial hyperglycemia (above 200 mg/dl at 120 min) and she was diagnosed with diabetes mellitus. She was negative for diabetes-related autoantibodies. The 75 g OGTT also revealed a very low insulinogenic index (I.I.) of 0.024 μU/ml/mg/dl; however, her plasma C-peptide immunoreactivity (CPR) response to glucagon was preserved (0.94 and 5.56 at 0 and 6 min, respectively). At the same time, she also suffered from Fe-deficiency anemia due to endometriosis, for which treatment with leuprorelin was initiated after hospitalization in August 2010. Meanwhile, her postprandial plasma glucose level continued to increase. Subsequently, on November 30, 2010, alogliptin therapy at a dose of 6.25 mg was initiated, which was increased to 25 mg on December 28, 2010. Leuprorelin therapy was discontinued on January 14, 2011; however, her plasma glucose level remained high despite the alogliptin therapy. Administration of 0.3 mg liraglutide was initiated on March 15, 2011, and the dose was increased to 0.6 mg on June 7, 2011. The plasma glucose level, glycosylated hemoglobin (HbA1c) level, and 1.5 anhydroglucitol level gradually improved, as did her I.I. Moreover, fasting plasma glucagon levels were suppressed by liraglutide. Her fasting serum CPR to plasma glucose ratio and homeostasis model assessment (HOMA-R) were low both before and after liraglutide administration. These results suggest that the fasting CPR to glucose ratio may underestimate residual islet function in lean patients with high insulin sensitivity. Thus, a glucagon test may be useful to estimate residual islet function when administering liraglutide treatment in lean diabetes patients. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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16. Beta-cell autoantibodies and their function in Taiwanese children with type 1 diabetes mellitus.
- Author
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Tung, Yi-Ching, Chen, Mei-Huei, Lee, Cheng-Ting, and Tsai, Wen-Yu
- Subjects
AUTOANTIBODIES ,PANCREATIC beta cells ,DIABETES in children ,TAIWANESE people ,GLUTAMATE decarboxylase ,DIAGNOSIS of diabetes ,DISEASES ,AGE distribution ,COMPARATIVE studies ,TYPE 1 diabetes ,ISLANDS of Langerhans ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,EVALUATION research - Abstract
Background/purpose: To understand the importance of autoimmunity in the development of type 1 diabetes in Taiwanese children, we evaluated the presence of beta-cell autoantibodies and their correlation with residual beta-cell function.Methods: From 1989 to 2006, 157 Taiwanese children with newly diagnosed type 1 diabetes were enrolled in this study. We determined the presence of beta-cell autoantibodies, such as glutamic acid decarboxylase autoantibodies (GADAs), insulinoma antigen 2 autoantibodies (IA-2As), and insulin autoantibodies (IAAs). A 6-minute glucagon test was also performed at diagnosis.Results: At diagnosis, 73% of children tested positive for GADAs, 76% for IA-2As and 21% for IAAs. Ninety-two percent of them had at least one of the beta-cell autoantibodies detected. Positivity for IAAs was more frequent in patients younger than 5 years than in those older than 5 years (45% vs. 13%). Using multiple regression analysis, the presence of GADAs or IAAs, or age of onset of these patients was an independent factor for residual beta-cell function. Younger patients and those with GADAs had less residual beta-cell function at disease onset, whereas those with IAAs had more insulin reserve.Conclusion: Autoimmunity plays an important role in the pathogenesis of type 1 diabetes in Taiwanese children, and the presence of IAAs tends to be more common in younger children. [ABSTRACT FROM AUTHOR]- Published
- 2009
- Full Text
- View/download PDF
17. Evaluation of β-cell function in diabetic Taiwanese children using a 6-min glucagon test.
- Author
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Yi-Ching Tung, Jing-Sheng Lee, Wen-Yu Tsai, and Pei-Hung Hsiao
- Subjects
- *
PANCREATIC beta cells , *GLUCAGON , *C-peptide , *DIABETES in children - Abstract
This study evaluates the effects of glucagon 30 μg/kg (maximal 1 mg) on β-cell function in children by C-peptide determined before and 6 min after intravenous administration. From 1990 to 2005, 118 Taiwanese children with newly diagnosed diabetes mellitus (98 children with type 1 and 20 children with type 2) and 29 normal Taiwanese children were enrolled in this study. Fasting and 6-min post-glucagon C-peptide levels were analyzed. In the pre-pubertal group, the median fasting serum C-peptide levels were 0.2 and 0.8 nmol/l in type 1 diabetes and normal children, respectively. These levels rose to 0.3 and 1.9 nmol/l after glucagon stimulation. In the pubertal group, the median fasting serum C-peptide levels were 0.3, 1.0 and 0.9 nmol/l in type 1 diabetes, type 2 diabetes and normal children, respectively. They rose to 0.4, 2.5 and 2.7 nmol/l after glucagon stimulation. Both fasting and post-glucagon C-peptide levels in type 1 diabetes patients were significantly lower than those of normal children and children with type 2 diabetes. The optimal cut-off values to distinguish type 1 diabetes patients from those with type 2 as determined by the receiving operating characteristic curve were 0.7 and 1.1 nmol/l, respectively. The sensitivities of both C-peptide values were 93%. The post-glucagon C-peptide level was more powerful in distinguishing type 1 diabetes from type 2 diabetes with higher specificity (95% vs. 85%). The 6-min glucagon test is valuable in assessing β-cell function in children and can help pediatricians in the differential diagnoses of diabetes mellitus in children. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
18. The hypothalamo-pituitary-adrenal axis in chronic fatigue syndrome and fibromyalgia syndrome.
- Author
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Tanriverdi, F., Karaca, Z., Unluhizarci, K., and Kelestimur, F.
- Subjects
- *
HYPOTHALAMIC-pituitary-adrenal axis , *PHYSIOLOGICAL stress , *FIBROMYALGIA , *CHRONIC fatigue syndrome , *PATIENTS - Abstract
The hypothalamo-pituitary-adrenal (HPA) axis plays a major role in the regulation of responses to stress. Human stress-related disorders such as chronic fatigue syndrome (CFS), fibromyalgia syndrome (FMS), chronic pelvic pain and post-traumatic stress disorder are characterized by alterations in HPA axis activity. However, the role of the HPA axis alterations in these stress-related disorders is not clear. Most studies have shown that the HPA axis is underactive in the stress-related disorders, but contradictory results have also been reported, which may be due to the patients selected for the study, the methods used for the investigation of the HPA axis, the stage of the syndrome when the tests have been done and the interpretation of the results. There is no structural abnormality in the endocrine organs which comprise the HPA axis, thus it seems that hypocortisolemia found in the patients with stress-related disorder is functional. It may be also an adaptive response of the body to chronic stress. In this review, tests used in the assessment of HPA axis function and the HPA axis alterations found in CFS and FMS are discussed in detail. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
19. Random C-peptide in the classification of diabetes.
- Author
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Berger, B., Stenström, G., Sundkvist, G., and Stenström, G
- Subjects
- *
C-peptide , *DIAGNOSIS of diabetes , *GLUCAGON , *TYPE 2 diabetes , *PEPTIDE hormones , *CARBOHYDRATE intolerance , *MEDICAL research , *COMPARATIVE studies , *DIABETES , *FASTING , *TYPE 1 diabetes , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *EVALUATION research , *RETROSPECTIVE studies , *RECEIVER operating characteristic curves - Abstract
Objective: To clarify whether random C-peptide is a valuable test in the classification of diabetes.Research Design and Methods: All C-peptide measurements conducted in the diabetic population of Skaraborg (280,539 inhabitants and 3.2% diabetes) between 1995 and 1998 (3,115 samples) were considered, but only patients with well-defined diabetes type (1,449 samples from 1,093 patients) were analyzed for the correlation between diabetes type and C-peptide concentration. Serum C-peptide was measured after fasting over night (fCP), after glucagon stimulation (gCP), and randomly (rCP) without considering previous meals at an ordinary visit to the diabetic clinic (rCP). Receiver Operating Characteristic (ROC) curves were constructed to illustrate the power of the different C-peptide protocols and to determine the optimal cut-off values.Results: Although all three tests had high discriminative power, the ROC curves demonstrated that rCP was superior to fCP and gCP in discriminating type 1 from type 2 diabetes. The optimal cut-off value for rCP was 0.50 nmol/L, for fCP 0.42 nmol/L, and for gCP 0.60 nmol/L.Conclusions: rCP is more powerful than fCP and gCP in distinguishing type 1 from type 2 diabetes and can therefore be recommended as a classification tool, particularly in outpatients. [ABSTRACT FROM AUTHOR]- Published
- 2000
- Full Text
- View/download PDF
20. Glucagon Test Is a Useful Predictor of Withdrawal From Insulin Therapy in Subjects With Type 2 Diabetes Mellitus.
- Author
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Iwamoto Y, Kimura T, Tatsumi F, Sugisaki T, Kubo M, Nakao E, Dan K, Wamata R, Iwamoto H, Takahashi K, Sanada J, Fushimi Y, Katakura Y, Shimoda M, Nakanishi S, Mune T, Kaku K, and Kaneto H
- Subjects
- C-Peptide, Glucagon, Humans, Insulin therapeutic use, Diabetes Mellitus, Type 2 drug therapy, Hyperglycemia drug therapy
- Abstract
There are many tests for evaluating endogenous insulin secretory capacity. However, there are only a limited number of studies that have examined in detail in clinical practice which method most accurately reflects the ability to secrete endogenous insulin especially in hyperglycemic state. The purpose of this study was to find the endogenous insulin secretory capacity and a possible predictor of insulin withdrawal in subjects with type 2 diabetes requiring hospitalization due to hyperglycemia. In the endogenous insulin secretory test during hospitalization, CPR, CPR index, and ΔCPR after glucagon loading were all significantly higher in the insulin withdrawal group. On the other hand, there were no difference in fasting CPR index, HOMA-β, SUIT, and 24-hour urinary CPR excretion between the two groups. In the glucagon test of the insulin withdrawal group, the cutoff value of ΔCPR was 1.0 ng/mL, the withdrawal rate of ΔCPR of 1.0 ng/mL or more was 69.2%, and the withdrawal rate of less than 1.0 ng/mL was 25.0%. In conclusion, it is likely that glucagon test is the most powerful tool for predicting the possibility of insulin withdrawal as well as for evaluating endogenous insulin secretory capacity in subjects with type 2 diabetes requiring hospitalization due to hyperglycemia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Iwamoto, Kimura, Tatsumi, Sugisaki, Kubo, Nakao, Dan, Wamata, Iwamoto, Takahashi, Sanada, Fushimi, Katakura, Shimoda, Nakanishi, Mune, Kaku and Kaneto.)
- Published
- 2022
- Full Text
- View/download PDF
21. The comparison of combination test either with 1 μg acth test and glucagon test for the evaluation of hypothalamo-pituitary-adrenal axis in patients with pituitary disorders
- Author
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Fahrettin Kelestimur, Kursad Unluhizarci, Zuleyha Karaca, Fatih Tanriverdi, and Emel Oguz Kokoglu
- Subjects
medicine.medical_specialty ,Glucagon test ,Endocrinology ,Pituitary disorder ,business.industry ,Internal medicine ,Hypothalamo pituitary adrenal axis ,Medicine ,In patient ,business - Published
- 2018
22. Hipoglucemias en un caso con insulinomas benignos múltiples.
- Author
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Goransky, Lidia, Manrique, Jorge, Gurtman, Angel, and Balze, Felipe
- Abstract
Copyright of Acta Diabetologica Latina is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 1973
- Full Text
- View/download PDF
23. Il test al glucagone nei soggetti diabetici: Suo significato e sue modificazioni dopo trattamento con glibenclamide.
- Author
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Adezati, Luciano, Prando, Romano, Pagliaini, Roberto, Lorenzi, Franco, Fresco, Giovanni, and Amore, Raffaele
- Abstract
Copyright of Acta Diabetologica Latina is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 1969
- Full Text
- View/download PDF
24. Is Non-Stimulated C-Peptide at Diagnosis a Good Predictive Value for Insulin Use at Two Years after Diagnosis in Pediatric Diabetic Patients?
- Author
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Chou WC, Chou YY, Pan YW, and Tsai MC
- Subjects
- Autoantibodies, C-Peptide, Child, Glutamate Decarboxylase, Humans, Insulin therapeutic use, Diabetes Mellitus, Type 1 diagnosis, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 drug therapy
- Abstract
Background and Objectives : Insulin treatment may be initially required to stabilize patients presenting with metabolic crisis at type 1 and 2 diabetes mellitus (DM) onset. Some patients with type 2 DM may need persistent insulin treatment. This study aimed to examine the predictive performance of non-stimulated C-peptide level at the time of diagnosis for future insulin use in pediatric diabetic patients. Materials and Methods : We reviewed the medical charts of diabetic patients aged 18 years or younger in a medical center in southern Taiwan from January 2000 to December 2019. Clinical and individual data were collected at the time of DM diagnosis. Outcomes were persistent insulin use at the time of diagnosis, as well as at one and two years after diagnosis. Results : The final analysis included a total of 250 patients. The best cut-off point of non-stimulated C-peptide was 0.95 ng/mL, and the predictive indices for the insulin use were 0.84 for sensitivity and 0.94 for specificity at two years after DM diagnosis. Incorporating age at onset and presence of GAD antibodies can further increase the predictive power of non-stimulated C-peptide. Conclusions : The value of non-stimulated C-peptide at diabetic onset was feasible and effective for predicting future insulin treatment up to the time point of two years after diagnosis.
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- 2021
- Full Text
- View/download PDF
25. Comparison of a combination test (1 μg ACTH test plus glucagon test) versus 1 μg ACTH test and glucagon test in the evaluation of the hypothalamic-pituitary-adrenal axis in patients with pituitary disorders.
- Author
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Unluhizarci K, Kokoglu EO, Hacioglu A, Karaca Z, and Kelestimur F
- Subjects
- Adrenocorticotropic Hormone, Adult, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Glucagon, Pituitary Diseases diagnosis
- Abstract
Objective: To investigate whether a combination of the low-dose (1 μg) adrenocorticotropin (ACTH) stimulation test and glucagon stimulation test (GST) could overcome the problem of equivocal results with the GST or ACTH test alone in patients with pituitary disorders., Methods: The study included 41 adult patients with pituitary disorders and 20 healthy subjects who underwent evaluation of cortisol response to ACTH, GST, and a combination of both tests. Blood samples for cortisol measurement were obtained at baseline and 30, 60, 90, and 120 minutes after intravenous administration of ACTH 1 μg and 90, 120, 150, 180, 210, and 240 minutes after subcutaneous injection of glucagon 1 mg. The combination test was performed by injecting ACTH 1 μg at the 180-minute time point of the GST, with blood samples for cortisol measurement obtained at 210 and 240 minutes., Results: Overall, 28 patients with normal cortisol response to both tests also had a normal cortisol response to the combination test. Ten patients with adrenal insufficiency in both tests also had adrenal insufficiency in the combination test, including a patient who had a peak cortisol value of 12.4 μg/dL (which is the cutoff value for the combination test). Two patients with adrenal insufficiency in the ACTH stimulation test and one patient with adrenal insufficiency in the GST had normal cortisol responses to the combination test., Conclusion: By using an appropriate cutoff value, the combination test may offer additional information in patients with equivocal results in the GST and ACTH stimulation test.
- Published
- 2021
- Full Text
- View/download PDF
26. Comparison of GHRH + arginine vs glucagon test for the evaluation of growth hormone secretion status in a cohort of adults with Prader-Willi syndrome (PWS)
- Author
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Gabau Elisabet, Cobo Jesus, Rigla Mercedes, Caixas Assumpta, Hurtado Marta, Laia Casamitjana, Albert Lara, Berlanga Eugenio, Corripio Raquel, Cano Albert, Pareja Rocio, and Giménez-Palop Olga
- Subjects
medicine.medical_specialty ,Glucagon test ,Endocrinology ,Arginine ,business.industry ,Internal medicine ,Cohort ,medicine ,business ,Growth hormone secretion - Published
- 2017
27. Dilemma on Classifying Diabetes Mellitus in Adolescence: A Case Report and Review of Literature
- Author
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Wei Liang Chen, Chien Ming Lin, Shih Yao Liu, Chung Ching Wang, Kao Hsian Hsieh, Chien Hsing Lee, Li Wei Wu, Che Ming Chiang, and Chih Chien Wang
- Subjects
Latent autoimmune diabetes of adults ,Pediatrics ,medicine.medical_specialty ,endocrine system diseases ,Diabetic ketoacidosis ,business.industry ,nutritional and metabolic diseases ,Type 2 Diabetes Mellitus ,Overweight ,medicine.disease ,Diabetes treatment ,Glucagon test ,Diabetes mellitus ,Medicine ,medicine.symptom ,Medical prescription ,business - Abstract
Diabetic ketoacidosis (DKA) is one of the most serious complications of diabetes mellitus (DM) that is prone to occur in children with type 1 DM (T1DM). We report a 17-year-old overweight girl who was treated with multiple oral antihyperglycemic drugs under the initial impression of type 2 DM (T2DM). Nevertheless, severe euglycemic DKA happened after the additional prescription of sodium-glucose cotransporter 2 inhibitors for two months. Consequently, T1DM was diagnosed on the basis of insulinopenic status in glucagon test and the presence of islet autoantibodies. This case highlighted the importance of precise classification before diabetes treatment in adolescence. A literature review is aimed to help clinicians differentiate various types of DM more specifically in clinical practice
- Published
- 2017
28. <smlcap>L</smlcap>-Dopa Is a Potent Stimulator of Cortisol in Short Children
- Author
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Andrew Fretzayas, Dimitrios T Papadimitriou, Anna Papadopoulou, Chrisanthi Marakaki, and Anastasios Papadimitriou
- Subjects
endocrine system ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Short stature ,nervous system diseases ,stomatognathic diseases ,Glucagon test ,Endocrinology ,Dopamine ,Internal medicine ,Pediatrics, Perinatology and Child Health ,Medicine ,medicine.symptom ,business ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug - Abstract
Aims: In this study, we evaluated the diagnostic usefulness of oral L-dopa as a stimulatory agent for cortisol. Methods: In 27 short children that were evaluated for possible growth hormone deficiency (GHD), the levels of serum GH and cortisol were determined after oral L-dopa administration and after i.m. glucagon administration. We defined cortisol concentrations >18 μg/dl (496 nmol/l) as adequate response. Peak GH concentration Results: Twenty-five out of the 27 children (93%) studied showed a normal cortisol response, i.e. a peak serum cortisol >18 μg/dl in the L-dopa test, whereas 19 children (70%) had a normal cortisol response after stimulation with glucagon. In the children with normal cortisol response in both tests, the mean peak serum cortisol concentration was 28.7 (SD 1.59) after L-dopa and 26.65 (SD 1.26) μg/dl after glucagon administration. There was no statistically significant difference in peak serum cortisol response to L-dopa between GH-deficient and GH-sufficient children [25.90 (SD 4.9) vs. 29.87 (SD 9.9) μg/dl, respectively]. Conclusions: These results clearly suggest that L-dopa administration is a potent stimulus for cortisol secretion at least in short children.
- Published
- 2014
29. Clonidine and glucagon stimulation for testing growth hormone secretion in children and adolescents: Can we make it with fewer samples?
- Author
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Christoforidis, A., Triantafyllou, P., Slavakis, A., and Katzos, G.
- Published
- 2013
- Full Text
- View/download PDF
30. Detailed studies of growth hormone secretion in cystinosis patients
- Author
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Maria Van Dyck, Inge Francois, Martine T.P. Besouw, Elena Levtchenko, Elke Van Hoyweghen, and Faculteit Medische Wetenschappen/UMCG
- Subjects
Male ,Nephrology ,medicine.medical_specialty ,Time Factors ,Hormone Replacement Therapy ,Cysteamine ,Cystinosis ,Cystine ,CHILDREN ,Glucagon test ,Glucagon ,NEPHROPATHIC CYSTINOSIS ,chemistry.chemical_compound ,INSUFFICIENCY ,Nephropathic Cystinosis ,Chronic kidney disease ,Internal medicine ,Humans ,Medicine ,Hormone replacement therapy ,Child ,Growth hormone ,Growth Disorders ,Human Growth Hormone ,business.industry ,Infant ,medicine.disease ,Body Height ,Growth hormone secretion ,Circadian Rhythm ,DEFICIENCY ,Treatment Outcome ,Endocrinology ,chemistry ,Case-Control Studies ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,business ,Biomarkers - Abstract
Cystinosis is an autosomal recessive disorder characterized by intralysosomal cystine accumulation. Growth retardation is more pronounced in cystinosis than in other chronic kidney diseases and is mostly not corrected by cysteamine.Growth was evaluated in nine cystinosis patients, all treated with cysteamine, both after cysteamine and recombinant human growth hormone (rhGH) therapy initiation. Growth hormone (GH) secretion was studied by nocturnal GH measurements in four of nine patients and by glucagon test in four of nine patients.RhGH was administered to seven of nine patients. At rhGH initiation, height was below -2 SDS in five of seven patients, final height was above -2 SDS in six of seven. In two patients not treated with rhGH, final height remained below -4 SDS despite cysteamine treatment being started at the age of 6.1 and 8.1 years, respectively. Nocturnal GH secretion was normal in all patients. Glucagon tests revealed GH deficiency in one patient; two of four patients had abnormal GH peak timing.We present the first reported case of GH deficiency in cystinosis. Although no overt GH deficiency was detected in other patients, abnormal GH peak timing can indicate a subclinical GH secretion problem. RhGH significantly improved growth in cystinosis patients and should be initiated early in life.
- Published
- 2012
31. Hiperinsulinismo endógeno: revisão e seguimento de 24 casos
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Marcia Nery, João Soares Felício, Larissa Kalinin, Marcel Cerqueira César Machado, Bernardo Liberman, M Semer, and Carlliane Lima e Lins Pinto Martins
- Subjects
Endogenous Hyperinsulinism ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Insulin ,medicine.medical_treatment ,General Medicine ,Autoimmune hypoglycemia ,Hypoglycemia ,Elevated plasma insulin ,medicine.disease ,Glucagon test ,Endocrinology ,Internal medicine ,Concomitant ,Medicine ,business ,Insulinoma - Abstract
Em decorrência do hiperinsulinismo endógeno (HHE), a hipoglicemia é diagnosticada em um indivíduo sintomático com níveis baixos de glicose plasmática, concomitante a valores elevados de insulina plasmática e peptídeo-C. Entre as causas de HHE, estão as doenças das células-b das ilhotas pancreáticas, o uso de secretagogos e a hipoglicemia autoimune. Neste artigo de revisão, estudamos 24 pacientes com hipoglicemia decorrente de hiperinsulinismo endógeno com a finalidade de descrever os aspectos de diagnóstico e tratamento. Nosso estudo mostrou que, após a realização do teste de jejum de 12h (minijejum) em três dias diferentes, todos os pacientes preencheram os critérios diagnósticos de HHE. Adicionalmente, encontramos que 11 dos 12 pacientes (91,7%) que realizaram o teste do glucagon apresentaram níveis de glicose no tempo 120 minutos menores que 50 mg/dL e inferiores ao valor basal. O teste do minijejum (3 amostras) e o teste do glucagon poderiam ser úteis para evitar a realização do jejum prolongado no diagnóstico do hiperinsulinismo endógeno.
- Published
- 2012
32. β-Cell Autoantibodies and Their Function in Taiwanese Children With Type 1 Diabetes Mellitus
- Author
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Wen-Yu Tsai, Yi-Ching Tung, Mei-Huei Chen, and Cheng-Ting Lee
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,autoantibodies ,medicine.medical_treatment ,glucagon test ,medicine.disease_cause ,Gastroenterology ,Autoimmunity ,chemistry.chemical_compound ,Insulin-Secreting Cells ,Internal medicine ,Diabetes mellitus ,Humans ,Medicine ,Child ,Insulinoma ,Medicine(all) ,lcsh:R5-920 ,Type 1 diabetes ,business.industry ,C-peptide ,Insulin ,Age Factors ,Autoantibody ,Infant ,food and beverages ,General Medicine ,medicine.disease ,Diabetes Mellitus, Type 1 ,chemistry ,Child, Preschool ,Immunology ,Female ,Age of onset ,lcsh:Medicine (General) ,business ,type 1 diabetes mellitus - Abstract
Background/Purpose To understand the importance of autoimmunity in the development of type 1 diabetes in Taiwanese children, we evaluated the presence of β-cell autoantibodies and their correlation with residual β-cell function. Methods From 1989 to 2006, 157 Taiwanese children with newly diagnosed type 1 diabetes were enrolled in this study. We determined the presence of β-cell autoantibodies, such as glutamic acid decarboxylase autoantibodies (GADAs), insulinoma antigen 2 autoantibodies (IA-2As), and insulin autoantibodies (IAAs). A 6-minute glucagon test was also performed at diagnosis. Results At diagnosis, 73% of children tested positive for GADAs, 76% for IA-2As and 21% for IAAs. Ninety-two percent of them had at least one of the β-cell autoantibodies detected. Positivity for IAAs was more frequent in patients younger than 5 years than in those older than 5 years (45% vs . 13%). Using multiple regression analysis, the presence of GADAs or IAAs, or age of onset of these patients was an independent factor for residual β-cell function. Younger patients and those with GADAs had less residual β-cell function at disease onset, whereas those with IAAs had more insulin reserve. Conclusion Autoimmunity plays an important role in the pathogenesis of type 1 diabetes in Taiwanese children, and the presence of IAAs tends to be more common in younger children.
- Published
- 2009
33. News on Clinical Details and Treatment in PGM1-CDG
- Author
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Gunter Simic-Schleicher, Anja Seelhöfer, Ingrid Du Chesne, Stephan Rust, Laura C. Tegtmeyer, Esther Schrapers, V. Debus, Manfred Fobker, Janine Reunert, Sebastian T. Balbach, Thorsten Marquardt, and Karin Klingel
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,Pediatrics ,medicine.medical_specialty ,Glycosylation ,Glycogen ,business.industry ,Disease ,Aortic Valve Insufficiency ,medicine.disease ,Bioinformatics ,Article ,chemistry.chemical_compound ,Glucagon test ,chemistry ,PGM1 ,medicine ,Glycogen storage disease ,Phosphoglucomutase ,business - Abstract
Phosphoglucomutase 1 deficiency has recently been reported as a novel disease that belongs to two different classes of metabolic disorders, congenital disorders of glycosylation (CDG) and glycogen storage diseases.This paper focuses on previously reported siblings with short stature, hypothyroidism, increased transaminases, and, in one of them, dilated cardiomyopathy (DCM). An intronic point mutation in the PGM1-gene (c.1145-222 GT) leads to a complex alternative splicing pattern and to almost complete absence of PGM1 activity.Exercise-induced muscle fatigue, chest pain, and rhabdomyolysis persisted into adulthood. Fainting occurred during the first minutes of strong exercise due to glucose depletion and serum heart troponin was increased. A second wind phenomenon with an improvement in exercise capacity after some minutes of training was observed. Regular aerobic training improved fitness and helped to avoid acute damage. DCM improved during therapy.Glycosylation deficiency was most prominent in childhood. Glycosylation improved with age and further improved with oral galactose supplementation even in adulthood. Optimal improvement of glycosylation-dependent phenotypes should be achieved by early and permanent galactose treatment.However, in case of mutations in ZASP, DCM can develop as a consequence of impaired binding of PGM1 to the heart-specific isoform of ZASP, independently of overall glycosylation efficiency. Thus, even if mutations in PGM1 impair the function of the ZASP-PGM1 complex, supplementation of galactose cannot be expected to restore that function. Therefore, knowledge of PGM1 deficiency in a patient should prompt surveillance of early signs of DCM and specific treatment if necessary.
- Published
- 2015
34. Assessing adrenal function in primary care settings with a single sample subcutaneous glucagon test
- Author
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Dexiang Gao, Rebecca Ratliff, Michael S. Kappy, and Amanda Drake
- Subjects
Blood Glucose ,Male ,Hypothalamo-Hypophyseal System ,endocrine system ,medicine.medical_specialty ,Time Factors ,Adolescent ,Hydrocortisone ,Pituitary Diseases ,Adrenal Gland Diseases ,Radioimmunoassay ,Pituitary-Adrenal System ,Dwarfism ,Single sample ,Primary care ,Sensitivity and Specificity ,Glucagon ,Immunoenzyme Techniques ,Glucagon test ,Adrenocorticotropic Hormone ,Hexokinase ,Internal medicine ,Adrenal Glands ,Humans ,Medicine ,Adrenal function ,Child ,Growth Disorders ,Dose-Response Relationship, Drug ,Primary Health Care ,business.industry ,Adrenal gland ,digestive, oral, and skin physiology ,Infant, Newborn ,Infant ,Fasting ,Hormones ,Dose–response relationship ,medicine.anatomical_structure ,Endocrinology ,Case-Control Studies ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Objective To test the efficacy of the low-dose glucagon test in assessing adrenal gland function. Study design Subcutaneous glucagon was used to assess the hypothalamo-pituitary-adrenal gland (HPA) axis in 215 healthy children. Concordance of this test with the low-dose intravenous ACTH test was established for 42 children. Glucagon testing was conducted for 150 minutes after subcutaneous glucagon administration and for 30 minutes after 1 μg intravenous ACTH. Results Mean peak serum cortisol concentrations were 22.4 ± 0.6 μg/dL (SEM) after subcutaneous glucagon and 20.0 ± 0.6 μg/dL after intravenous ACTH. Specificity of 95% was found at peak cortisol concentrations of 9.5 and 12.5 μg/dL for the glucagon and ACTH tests, respectively. Concordance between the glucagon and ACTH tests was 90.5%. Conclusions The glucagon test was found to be as good a test of the HPA axis as the ACTH test and had a 90.5% concordance with it. The ease of performing the glucagon test, namely, obtaining a single sample of blood 150 minutes after the subcutaneous administration of glucagon, makes it a useful method of assessing the HPA axis in primary care settings.
- Published
- 2006
35. Evaluation of β-cell function in diabetic Taiwanese children using a 6-min glucagon test
- Author
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Tung, Yi-Ching, Lee, Jing-Sheng, Tsai, Wen-Yu, and Hsiao, Pei-Hung
- Published
- 2008
- Full Text
- View/download PDF
36. Glucagon stimulation test for the diagnosis of GH deficiency in adults
- Author
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Conceição, F. L., da Costa e Silva, A., Costa, A. J. Leal, and Vaisman, M.
- Published
- 2003
- Full Text
- View/download PDF
37. Frequency of pheochromocytoma in adrenal incidentalomas and utility of the glucagon test for the diagnosis
- Author
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Bernini, G. P., Vivaldi, M. S., Argenio, G. F., Moretti, A., Sgrò, M., and Salvetti, A.
- Published
- 1997
- Full Text
- View/download PDF
38. Growth Response to Growth Hormone (GH) Therapy in Children with and without GH Deficiency
- Author
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M. Wegdee, F. A. Al Khalaf, Ashraf T Soliman, N. Al Humeedi, M. Al Ali, and M. Al Zyoud
- Subjects
medicine.medical_specialty ,Pediatrics ,business.industry ,medicine.medical_treatment ,General Medicine ,medicine.disease ,Growth hormone ,Clonidine ,Growth hormone deficiency ,Glucagon test ,Insulin-like growth factor ,Endocrinology ,Internal medicine ,medicine ,General hospital ,business ,Clinical record ,GH Deficiency ,medicine.drug - Abstract
The diagnosis of growth hormone deficiency (GHD) needs consideration of both clinical and biological aspects such as auxological data, GH provocative tests and active metabolites of GH including IGF-I and IGFBP-3. In children with GHD, recombinant human GH (rhGH) replacement therapy has been used worldwide with minimal serious side effects. This study aimed to report the results of an investigations for GHD, to describe the growth responses to rhGH in deficient children compared to those without GH deficiency, to evaluate the relationship between clinical and biochemical responses, and to describe the experience of diagnosis and treatment with rhGH at Hamad General Hospital, the main hospital in Qatar where most short children are referred for further investigation. The clinical records of 116 short children were reviewed retrospectively. Forty-six failed the clonidine test and 42 of these also failed the glucagon test and were confirmed with GHD. These and 16 children without GDH were treated with rhGH (25 gg/kg/ day) and were evaluated in terms of growth response, HtSDS, changes of IGF-I concentration and the relationship between these parameters. Treatment with GH of short children with GHD does produce a satisfactory growth response but the HtSDS gain was significantly higher in those with GHD compared to children without GHD. Measurement of IGF-I was found not to be a useful diagnostic test in GHD.
- Published
- 2011
39. Endoscopic Biliary Drainage —The Effectiveness of Biliary Drainage in Consideration of the Hepatic Functional Reserve
- Author
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Yutaka Yoshihama, Tsugio Higuchi, and Youichi Kon
- Subjects
medicine.medical_specialty ,Biliary drainage ,business.industry ,Decompression ,medicine.medical_treatment ,Gastroenterology ,Prosthesis ,Surgery ,Glucagon test ,medicine ,Radiology, Nuclear Medicine and imaging ,Obstructive jaundice ,In patient ,Percutaneous transhepatic biliary drainage ,Biliary decompression ,business - Abstract
The present study was designed to determine whether it is possible to estimate the effectiveness of biliary decompression, the duration of functioning patency of the prosthesis and the prognosis after drainage using the hepatic functional reserve (HFR) as an index, in patients with malignant obstructive jaundice in which endoscopic biliary drainage (EBD) or percutaneous transhepatic biliary drainage (PTBD) is performed. Evaluation of HFR was based on the plasma cyclic AMP level at 10 min. in the glucagon test (cyclic AMP10). Furthermore, with respect to HFR, the effectiveness of biliary decompression by EBD was compared with that by PTBD. The criteria of bilirubin decreasing rate “b”, proposed by Shimizu et al. to determine the effectiveness of biliary decompression by PTBD were revaluated in comparison to that of EBD. The following results were obtained. 1 Cyclic AMP10 was useful to estimate the effectiveness of biliary decompression by EBD and PTBD. 2 No relationship was found between cyclic AMP10 and the duration of functioning patency of the prosthesis, which led to the inference that patency may be dependent on various factors in addition to HFR. 3 In terms of the reaction of cyclic AMP10, the prognosis was worse in the poor reaction group than in the good reaction group. It was considered that the reaction of cyclic AMP10 is useful to estimate prognosis. 4 The effectiveness of biliary decompression by EBD was better than that of PTBD in patients with nearly equal cyclic AMP10. 5 In evaluating the effectiveness of biliary, decompression by EBD, it seems to be necessary to modify the standard set points of the criteria of bilirubin decreasing rate “b”, proposed by Shimizu et al. and used with PTBD.
- Published
- 1993
40. Glucagon test protocol
- Author
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C. Laird Birmingham and Janet Treasure
- Subjects
Protocol (science) ,Glucagon test ,medicine.medical_specialty ,Eating disorders ,business.industry ,Medicine ,business ,Psychiatry ,medicine.disease ,Clinical psychology - Published
- 2010
41. Medical management
- Author
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Janet Treasure and C. Laird Birmingham
- Subjects
medicine.medical_specialty ,EARLY SATIETY ,business.industry ,Day care ,Serum phosphate ,medicine.disease ,Eating disorders ,Glucagon test ,Residential care ,Anesthesia ,Family medicine ,medicine ,Cardiac chest pain ,Medical nutrition therapy ,business - Published
- 2010
42. Exocrine and endocrine functional reserve in the course of chronic pancreatitis as studied by maximal stimulation tests
- Author
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Cavallini, G., Bovo, P., Zamboni, M., Bosello, O., Filippini, M., Riela, A., Brocco, G., Rossi, L., Pelle, C., Chiavenato, A., and Scuro, L. A.
- Published
- 1992
- Full Text
- View/download PDF
43. Assessment and Treatment of Impaired Insulin- Secretion and Action in Type 2 Diabetes
- Author
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Dorkhan, Mozhgan
- Subjects
insulin secretion ,proinsulin ,insulin tolerance test ,adiponectin ,thyroid associated ophthalmopathy ,insulin resistance ,Type 2 diabetes ,insulin glargine ,Endocrinology and Diabetes ,glucagon test ,natriuretic peptides ,thiazolidinediones - Abstract
Type 2 diabetes (T2D) is a disease characterised by varying degrees of defect in insulin secretion and insulin sensitivity and associated with increased morbidity and mortality. Optimal glycaemic control reduces the progression of diabetic complications. Over time, there is a steady deterioration of glycaemic control that raises the need for effective therapy targeted at the underlying defects in order to achieve treatment goals. The methods available for assessment of insulin secretion and insulin sensitivity have not been suitable for use in clinical practice. The introduction of thiazolidinediones (TZDs) targeting the insulin resistance component of T2D has been promising but accompanied with some adverse effects, mainly fluid retention and heart failure. In this thesis, a simple method for independent measurement of β-cell function and insulin sensitivity at the same time (combined glucagon-insulin tolerance test, GITT) has been developed (Paper I). We also evaluated the effect of a TZD (pioglitazone) and a long-acting insulin (glargine) as add-on in the treatment of patients with T2D, not achieving glycaemic goals when treated with classic anti-diabetic agents on glycaemic control, insulin sensitivity, β-cell function and markers of increased cardiovascular load (Papers II &IV). We also investigated the effect of pioglitazone on eye protrusion (Paper III). GITT showed good reproducibility and the index of insulin sensitivity derived from the GITT showed good correlation with the M-value from the euglycaemic clamp. The test also showed good discriminating capacity between individuals with varying degrees of glucose tolerance (Paper I). Both pioglitazone and insulin glargine were effective in reducing HbA1c levels in combination with other oral glucose lowering agents but pioglitazone caused fluid retention and increased levels of natriuretic peptides suggesting increased cardiac load (Papers II & IV). While pioglitazone improved insulin sensitivity and lipids, insulin glargine resulted in improved β-cell function (Paper IV). Pioglitazone also caused an increase in eye protrusion in a subgroup of patients, probably by causing an increase in retrobulbar adipogenesis (Paper III). Taken together, these results can hopefully help clinicians in the choice of novel add-on treatment and in monitoring of untoward side effects. GITT seems to be a promising tool for assessing insulin secretion and action in clinical practice.
- Published
- 2008
44. Comparison of the short ACTH stimulation test with the insulin tolerance/glucagon test
- Author
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Paul M. Stewart, Michael C. Sheppard, and P. M. Clark
- Subjects
medicine.medical_specialty ,Glucagon test ,Endocrinology ,medicine.diagnostic_test ,business.industry ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,medicine ,ACTH stimulation test ,business ,Insulin tolerance - Published
- 1998
45. Glucagon-glucose (GG) test for the estimation of the insulin reserve in diabetes
- Author
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Ryoya Komatsu, Tatsuo Matsuyama, Shigeki Fujii, Yasuko Nishioeda, Teruo Omae, and Hiroyuki Miki
- Subjects
Adult ,Blood Glucose ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Glucagon ,Prediabetic State ,chemistry.chemical_compound ,Glucagon test ,Islets of Langerhans ,Endocrinology ,Internal medicine ,Diabetes mellitus ,Diet, Diabetic ,Internal Medicine ,Medicine ,Humans ,Hypoglycemic Agents ,Insulin ,Glucose tolerance test ,medicine.diagnostic_test ,C-Peptide ,C-peptide ,business.industry ,General Medicine ,Glucose Tolerance Test ,Middle Aged ,medicine.disease ,Pathophysiology ,Diabetes Mellitus, Type 1 ,Glucose ,chemistry ,Diabetes Mellitus, Type 2 ,Oral hypoglycemic agents ,business - Abstract
The residual B-cell function was examined by means of the plasma C-peptide response 6 min after a combined injection of glucagon and glucose (GG test) or conventional glucagon test (G test) in four insulin-dependent diabetic patients (IDDM group), in 18 diabetic patients treated with insulin (Insulin group), 31 treated with oral hypoglycemic agents (SU group) and 27 treated with diet only (Diet group) and in 22 borderline cases. By GG test, 6-min C-peptide values of the IDDM group were 0.27 +/- 0.05 nM (n = 4) and were significantly lower than those of the Insulin group (0.89 +/- 0.09 nM, n = 12), the SU group (1.42 +/- 0.10 nM, n = 13), the Diet group (2.47 +/- 0.22 nM, n = 11) and the borderline cases (3.38 +/- 0.22 nM, n = 11). Patients with a 6-min C-peptide concentration below 0.75 nM by GG test appeared to be insulin-requiring patients. In the G test, plasma C-peptide concentrations at 6 min were 0.35 +/- 0.08 nM in the IDDM group (n = 2), 0.72 +/- 0.20 nM in the Insulin group (n = 7), 1.08 +/- 0.09 nM in the SU group (n = 20), 1.40 +/- 0.19 nM in the Diet group (n = 17) and 2.05 +/- 0.21 nM in the borderline cases (n = 12). Some of the Diet group patients showed extremely low C-peptide responses. When comparing the GG test and G test in individual cases, a greater C-peptide response was seen with the GG test in all cases except for IDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1992
46. Glycogen Storage Disease Diagnosed in Adults
- Author
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Roland T. Jung, D Hopwood, Ian D. Waddell, J S Pears, and Ann Burchell
- Subjects
medicine.medical_specialty ,Glucose tolerance test ,Glycogen ,medicine.diagnostic_test ,business.industry ,General Medicine ,Disease ,medicine.disease ,Glucagon ,Adult life ,Glucagon test ,chemistry.chemical_compound ,Liver metabolism ,Endocrinology ,chemistry ,Internal medicine ,medicine ,Glycogen storage disease ,business - Abstract
Glycogen storage diseases are usually identified in childhood. We present the clinical, biochemical and histological features of 10 patients first diagnosed in adult life. Five had glycogen storage disease type 1a, one type 1c, two type IX, and in two patients there were previously unreported abnormalities of hepatic glucose-6-phosphatase system activity. Of the latter, one patient had an inhibitor of liver glucose-6-phosphatase (pseudo-1b glycogen storage disease) the other having abnormal glucose-6-phosphatase activity and microsomal pyrophosphate transport. A glucagon test is suggested as a useful screening procedure. Glycogen storage disease should be considered in adults with symptoms suggesting hypoglycaemia.
- Published
- 1992
47. Hazard of Glucagon Test in Diabetic Patients: Hypertensive crisis in asymptomatic pheochromocytoma
- Author
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Atsuko Tanaka, Keigo Yasuda, Noriyuki Takeda, Mayumi Yammoto, and Yoshiaki Minamori
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.disease ,Hypertensive crisis ,Asymptomatic ,Hazard ,Pheochromocytoma ,Glucagon test ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Medical emergency ,medicine.symptom ,business - Published
- 1992
48. Frequency of Pheochromocytoma in Adrenal Incidentalomas and Utility of the Glucagon Test for the Diagnosis
- Author
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G. P. Bernini, M. S. Vivaldi, Gf Argenio, M. Sgrò, A. Moretti, and Antonio Salvetti
- Subjects
Adult ,Male ,endocrine system ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Urology ,Adrenal Gland Neoplasms ,Blood Pressure ,Diagnostic accuracy ,Pheochromocytoma ,Glucagon ,Glucagon test ,Catecholamines ,Endocrinology ,Adrenal masses ,Internal medicine ,medicine ,Humans ,In patient ,Normal range ,Aged ,Aged, 80 and over ,Plasma samples ,business.industry ,Incidentaloma ,Middle Aged ,medicine.disease ,Etiology ,Female ,business - Abstract
To investigate the frequency of pheochromocytoma in patients with incidentally discovered adrenal masses (incidentalomas) and to evaluate the sensitivity, specificity and diagnostic accuracy of the Glucagon test in comparison with resting plasma catecholamines, 89 patients with adrenal incidentalomas (age range 23-80 yr; 41 males and 48 females) were studied. Fifty-seven patients were normotensive (SBP 130+/-1.8 mmHg; DBP 80+/-0.7 mmHg, mean+/-SE) and 32 had stable hypertension (SBP 155+/-3.3 mmHg, DBP 93+/-1.4 mmHg): no patient complained of typical signs or symptoms of pheochromocytoma. Resting plasma samples for noradrenaline and adrenaline determination and, at appropriate intervals, the Glucagon test (1 mg i.v.), were performed in all subjects. Diagnosis of pheochromocytoma was made on the basis of humoral evaluations and/or surgical intervention in 6 patients (6.7%), of whom 3 hypertensives and 3 normotensives. Resting plasma catecholamines revealed 5 out of 6 patients with pheochromocytoma: in 3 cases both catecholamines were above the normal range, in 1 only adrenaline was elevated and in 1 case only noradrenaline. Similarily, the glucagon test identified 5/6 pheochromocytomas: in 3 patients the response was abnormal for both catecholamines, in 1 only for adrenaline and in 1 case only for noradrenaline. The sensitivity, specificity, and diagnostic accuracy of resting plasma catecholamines and of the glucagon test were comparable: 83.3%, 96.3%, and 95.5%, respectively. In conclusion, the frequency of pheochromocytoma in adrenal incidentalomas is not negligible, and since the diagnostic accuracy of the Glucagon test is the same of that of resting plasma catecholamines, the former does not appear to offer additional advantages in the diagnosis of incidentally discovered pheochromocytomas.
- Published
- 1998
49. Residual β cell function in insulin-dependent diabetes: evaluation by circadian determination of C-peptide immunoreactivity
- Author
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Canivet, B., Harter, M., Viot, G., Balarac, N., and Krebs, B. P.
- Published
- 1980
- Full Text
- View/download PDF
50. Studies on the standardization of the glucagon test
- Author
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Tohoru Kimura, Akira Takada, and Shujiro Takase
- Subjects
Glucagon test ,medicine.medical_specialty ,Endocrinology ,Hepatology ,Standardization ,business.industry ,Internal medicine ,medicine ,business - Abstract
グルカゴン負荷試験の簡便・標準化を企図して,その負荷量,採血時間などについて検討をした.1,5,10または20μg/kgのグルカゴンを同一人に投与し,血漿cyclic AMP (c-AMP)の反応を比較したが,10μg/kgの負荷で最も強い反応がみられ,10μg/kg負荷時の10分値が肝細胞機能総量を反映する諸検査と最もよい相関を示した.10μg/kg負荷時のc-AMPのpeakは10~15分の間にあったが,10分値と15分値には大差はなく,他の検査との相関では10分値が最も良好であった.以上のことより,グルカゴン負荷試験としては10μg/kg負荷時の10分値,ないしはpeak値を求めるのが最も適当で,簡便な方法であると考えられた.
- Published
- 1985
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