[Usefulness of glycated hemoglobin (HbA1c) as a predictive factor in GDM pregnancies]. / Ocena przydatnosci oznaczania hemoglobiny glikowanej (HbA1c) w cukrzycy ciazowej.

OBJECTIVES: The aim of the study was to examine if the glicated haemoglobin (HbA1C) is useful as an indicator of disturbances of the carbohydrate metabolism in women who suffered from Gestational Diabetes Mellitus (GDM), and for prediction of the macrosomic infants. MATERIAL AND METHODS: The examination was performed on 163 GDM women, who were treated in Diabetic Care Unit (1996-98) in Research Institute CZMP in Lódz. GDM was diagnosed between 20 and 32 week of gestation, on the ground of 50 g Glucose Challenge Test (GCT) and 2-hour glucose tolerance test (75OGTT), according to WHO. HbA1C was examined during the first visit in hospital. All women were distributed into two groups: 120--treated with diet alone (G1), 43--treated also with insulin (G2). All the parameters were statistically analized. RESULTS: Patients from G2 group were older and had higher glucose values in all diagnostic tests then patients from G1 group. The average HbA1C level in the whole GDM group was 5.9 +/- 1.0% (min. 4.3%; max 9.6%) and was substantially higher in G2 (6.5 +/- 0.9%) then G1 (5.7 +/- 1.0%): p < 0.05. The HbA1C level correlated with fasting glycemia and 1-hour 50GCT (p < 0.05) and did not correlated with 2-hour 75OGTT. We found the relationship between newborns body weight and 2-hour 75OGTT only in G2 group, but newborns body weight did not correlated with HbA1C level. There were no correlation between GDM duration and HbA1C level. CONCLUSIONS: 1. Glycosylated haemoglobin can not be the indicator of appearance the fetuses macrosomy. 2. The increased HbA1C level is predictive value for insulin treatment. 3. Body weight of children from insulin treated GDM mothers is connected with fasting and 2-hour 75OGTT glucose level.

Changes in fluidity and composition of erythrocyte membranes and in composition of plasma lipids in type I diabetes.

Changes in the fluidity and composition of human erythrocyte membranes and in the composition of plasma in Type I (insulin-dependent) diabetes were investigated. The increased microviscosity of diabetic erythrocyte membranes provide unambiguous proof of the structural deterioration of erythrocyte membranes in diabetes. It seems most likely that enhancement of the membrane cholesterol/phospholipid ratio is the main reason for decreased membrane fluidity in diabetes. A distinct correlation between membrane cholesterol/phospholipid ratio, plasma cholesterol content and membrane fluidity was found. Composition and structural changes in erythrocyte membranes and compositional changes in plasma lipids may contribute to the development of diabetic complications in diabetes.

[Pathogenesis of hyperglycemia in diabetes mellitus type II (insulin-independent)]. / Patogeneza hiperglikemii w cukrzycy typu II (insulinoniezaleznej).

The most important causes of hyperglycaemia in the course of diabetes mellitus type 2 are discussed. Those include: insulin secretion disorders, resistance to the insulin and overproduction of glucose in the liver. Affected secretory function of B cells in the pancreatic islets results, first of all, from the primary genetic error and secondary regulatory disorders, chiefly hyperglycaemia. Resistance to the insulin caused by decreased insulin activity in the muscle tissue and adipose tissue includes so-called receptor and postreceptor defects. Mechanism of these disorders is partially explained. Overproduction of glucose in the liver is probably secondary to the above metabolic disturbances and decides on the basic hyperglycaemia. Pathogenetic aspects of the insulin independent diabetes mellitus therapy with particular reference to the role of sulfonylurea derivatives are also discussed.

[Usefulness of the fluorescein dilaurate test in patients after acute pancreatitis]. / Zastosowanie testu z laurynianem fluoresceiny u osób po przebytym ostrym zapaleniu trzustki.

30 patients, 1 to 6 years acute pancreatitis, complaining on epigastric pains, weight loss, flatulence and diarrhea were examined. Temmler Werke Pancreolauryl-Test was performed following manufacturer's instructions. In 14 patients (46.7%), the result of the test revealed pancreatic exocrine failure. Those results were verified and confirmed in 80% by secretin-ceorulein test. Non-invasive, technically uncomplicated and reliable pancreolauryl-test seems to be useful for screen estimation of pancreatic exocrine function impairment in patients after the acute pancreatitis.