Are low magnesium levels in type 1 diabetes associated with electromyographical signs of polyneuropathy?

OBJECTIVE: Our aim was to study the relationship between the magnesium status in type 1 diabetic patients and disturbances in nerve conduction velocity. Furthermore we wanted to investigate whether repletion of magnesium depletion could improve the decreased nerve conduction velocity measurements. In a cross-sectional study, 154 type 1 diabetic patients were screened for their erythrocyte magnesium content and an electrophysiological measurement of the peripheral nervous system was carried out. In a subsequent intervention study, out of this screened population, 23 type 1 patients, with disturbed nerve conduction velocity measurements and low erythrocyte magnesium levels [< 2.3 mmol/L) were given oral magnesium supplements, during 1 year. Twenty type 1 patients with identical characteristics served as controls. In the cross-sectional study disturbed nerve conduction velocities were found in the older patients, in patients with a longer duration of diabetes and a worse metabolic control. EMG polyneuropathy signs were significantly more frequent in diabetic patients with low erythrocyte Mg. The intervention study demonstrated that under unchanged metabolic control, supplementation with magnesium could improve nerve conduction, especially in younger patients with a shorter duration of diabetes. Erythrocyte Mg was lower in type 1 diabetic patients with polyneuropathy. Mg supplementation increasing Mg RBC might (possibly?) improve nerve conduction measured by electromyography at least in younger patients with a short duration of diabetes and presenting early signs of the neurological complication.

Epidemiology of microalbuminuria in type 1 diabetic patients (IDDM) in the Antwerp University Hospital.

Diabetic nephropathy is the most important cause of increased morbidity and premature mortality in patients with insulin dependent diabetes mellitus. Several longitudinal studies done in different countries have shown that microalbuminuria strongly predicts the development of diabetic nephropathy in insulin dependent diabetes mellitus. Very few data are available about the situation in Belgium. In a retrospective study we analysed the data of 271 insulin dependent diabetic patients attending the University Hospital of Antwerp during the year 1994. Normoalbuminuria was defined as a urinary albumin excretion rate of < or = 20 micrograms/min, microalbuminuria as 20-200 micrograms/min and macroalbuminuria as > 200 micrograms/min. In our population we find an overall prevalence of microalbuminuria of 14%. Patients with microalbuminuria are characterised by an earlier onset and a longer duration of diabetes when compared with patients with normoalbuminuria. Further we find that they have a worse glycemic control, a higher frequency of raised arterial blood pressure and a higher percentage of proliferative retinopathy. These data are comparable with those from other studies done in different countries. They show that patients with microalbuminuria should be regarded as a high risk group and therefore urinary albumin excretion rate should be monitored routinely. Also they stress the importance to strive to a good metabolic control and to an aggressive treatment of arterial hypertension.

Modification of cefixime bioavailability by nifedipine in humans: involvement of the dipeptide carrier system.

We studied the action of nifedipine on the bioavailability of cefixime, a molecule absorbed via the gut wall dipeptide carrier system in the rat, and on the bioavailability of D-xylose, which is absorbed via a pH (and Na(+)-)-dependent transporter. Each compound was administered alone or in combination with 20 mg of nifedipine to eight healthy male volunteers. Nifedipine significantly increased the absorption rate of cefixime (20.7 +/- 4.3 versus 16 +/- 3.5 mg/h in the absence of nifedipine). The absolute bioavailability of cefixime alone was 31% +/- 6% compared with 53% +/- 1% (P < 0.01) in the presence of nifedipine. The observed peak concentrations in serum were significantly different (2.5 +/- 0.3 mg/liter without nifedipine and 3.7 +/- 1.1 mg/liter with nifedipine; P < 0.02). In contrast, nifedipine induced no significant differences in the pharmacokinetic profile of xylose following oral administration. We conclude that (i) cefixime is absorbed in humans by an apparently active process which can be enhanced by a calcium channel blocker, in this case, nifedipine; and (ii) nifedipine does not modify the activity of the pentose transporter.

Plasma free amino acid profiles and nutrition proteins in chronic renal failure; effect of dialysis treatment.

A well preserved nutritional status is beneficial in chronically uremic patients for slowing the pace of deterioration of renal function, and delaying the need for dialysis therapy. The purpose of this study was to assess the nutritional profile of 10 patients in a steady state of advanced CRF, and of 15 patients with terminal renal failure immediately prior to their first hemodialysis session (J0), and 7, 14, 45, 60, days post start of dialysis. Patients were 18 to 65 years old with total plasma proteins ≥ 60g/1. Plasma concentrations of amino acids, nutrition proteins, apolipoproteins A1, and B were evaluated. Non inflammatory reaction was evaluated by determination of alpha-1-acid glycoprotein, and C reactive protein. The data (mean ± 1 SD) were compared with mean values of 15 healthy individuals.