RESUMEN
In 9 healthy subjects we evaluated the effect of a constant ranitidine infusion (100 mg) on glucose (mg/dl), insulin (microU/ml) and C-peptide (ng/ml) serum levels promoted by oral glucose tolerance test (75 g). Ranitidine significantly increased the area under concentration/time curves for glucose and insulin but not that of C-peptide. Our data indicate that ranitidine does not affect pancreatic insulin release nor peripheral glucose utilization and are consistent with the hypothesis that ranitidine influences the hepatic clearance of glucose and insulin both of which undergo high first-pass liver extraction.
Asunto(s)
Glucemia/análisis , Péptido C/sangre , Glucosa/farmacología , Insulina/sangre , Ranitidina/farmacología , Administración Oral , Adulto , Prueba de Tolerancia a la Glucosa , Humanos , Infusiones Parenterales , MasculinoAsunto(s)
Enfermedades Renales/etiología , Cirrosis Hepática/complicaciones , Dihidroergotoxina/uso terapéutico , Dopamina/uso terapéutico , Endotoxinas/sangre , Furosemida/uso terapéutico , Hemodinámica , Humanos , Enfermedades Renales/diagnóstico , Enfermedades Renales/tratamiento farmacológico , Enfermedades Renales/fisiopatología , Cirrosis Hepática/fisiopatología , Neurotransmisores/fisiología , Fentolamina/uso terapéutico , Presorreceptores/fisiopatología , Pronóstico , Prostaglandinas/sangre , Circulación Renal , Sistema Renina-Angiotensina , SíndromeRESUMEN
When considering urogenital complaints occurring during diabetic autonomous neurotherapy , three clinical situations are important due to their frequency and the clinical situation, the considerable effect they have on quality of life. In addition they may also be responsible for severe complications as in the case of diabetic cystopathy . This syndrome is the cause of considerable subjective disturbances even though it may be diagnosed instrumentally in its early, completely asymptomatic stage. The complaint evolves inevitably towards bladder denervation, chronic urinary retention and more or less severe septic complications. Retrograde ejaculation may lead to the loss of procreative ability as in the case of neurogenic impotence in diabetics. These three autonomous neuropathic situations occur quite frequently, especially in older subjects who have suffered from diabetes for more than ten years. Often the three syndromes are interconnected or linked to autonomous or peripheric neuropathic complaints affecting other areas. The few therapeutic measures practised have not proved very conclusive. Only a diligent examination of signs and symptoms with the aim of early diagnosis and the maintenance of good glycometabolic balance are considered to be at all effective as preventive measures.
Asunto(s)
Neuropatías Diabéticas/patología , Vejiga Urinaria Neurogénica/complicaciones , Adulto , Anciano , Diabetes Mellitus Tipo 1/complicaciones , Disfunción Eréctil/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cateterismo Urinario , Incontinencia Urinaria/etiología , Trastornos Urinarios/etiología , Trastornos Urinarios/terapiaRESUMEN
The clinical conditions due to damage to the peripheral sympathetic nervous system during diabetic neuropathy mainly involve alterations to subcutaneous vasomotility , temperature body regulation and exudation, which may take form of hyper or hypoactivity. Gustatory exudation and local anhydrosis are described in detail as well as the connection with aggravating factors like long duration, poor balance and early onset of diabetes mellitus . Change in the relevant cardiovascular reflexes, commonly used in diagnosing diabetic neuropathy, are also analysed with a discussion of their physiopathological background and clinical significance. Finally the painless infarct, sudden death and abnormal response to hypoglycaemia, that are the common features of diabetic neuropathy, are also described.