Experiencia clínica con un inhibidor de la alfa glucosidasa (acarbosa) en el tratamiento de la diabetes no insulinodependiente: estudio multicéntrico / Multicentric study on the effect of an alpha glucosidase inhibitor in the treatment of non insulin dependent diabetes

Diabetic patients received acarbose, 150 mg/day durign four weeks and this dose was increased to 300 mg/day durign 3 months. Afterwards, patients were followed for a period of 12 weeks without acarbose. Fasting and post-prandial blood glucose and glycosilated hemoglobin were measured sequentially durign the study. Results: Eighty five patients were recruited for the study but 64 complied with the treatment protocol. The age of these patients was 56 ñ 8.8 years old, their diabetes duration was 7.8 ñ 8.8 years and their body mass index was 27.6 ñ 3.6 kg/m². During acarbose treatment, glycosilated hemoglobin decreased from 8.36 ñ 1.33 to 7.71 + 1.7 percent (p < 0.001), fasting blood glucose decreased from 173 ñ 48 to 159 ñ 59 mg/dl (p < 0.03) and post-prandial blood glucose decreased from 254 ñ 80 to 241 ñ mg/dl (NS). After discontinuing acarbose glycosilated hemoglobin and blood glucose levels returned to basal levels. Body weight and blood pressure did not change during the treatment period. Fifty nine patients bad gastrointestinal symptoms (meteorism, flatulence and abdominal distention) that were mild in 59 percent and moderate in 39 percent. Episodes of hypoglycemia were not observed. Conclusions: Acarbose, associated to sylphonylureas is an effective drug to reduce blood glucose and glycosilated hemoglobin levels in patients with non insulin dependent diabetes

Crecimiento en niños con diabetes mellitus insulino-dependiente / Growth of children with insulin dependent diabetes mellitus

Objetivo: establecer la talla del niño al momento del diagnóstico de la diabetes mellitus insulina-dependiente (DMID) y determinar si el tratamiento actual promueve un crecimiento normal. En el momento de diagnosticar la afección, el puntaje Z de la talla de 81 niños con DMID (+0.05ñ1.20) no era significativamente diferente que el de un grupo control de 81 niños sanos (-0,26ñ1,04; p<0,06). De los niños diabéticos, 45 (20 hombres y 25 mujeres) fueron seguidos durante 6,8ñ3,4 años. El puntaje Z de la talla de los niños diabéticos fue menor (-0.50ñ1,23) comparado con los controles (+0.15ñ0,77, p<0,031), pero en las niñas (-0,91ñ0,63) no se observó diferencias con el grupo control (-0,73ñ0,63;p=0,53). El puntaje Z de la talla final alcanzado por los niños diabéticos de ambos sexos fue menor que el de la talla inicial de ellos mismos (p<0,02); sin embargo, en promedio la talla disminuyó moderadamente, no menos de 1 DE. Conclusiones: la talla de los niños con diabetes mellitus dependiente de insulina es normal cuando se hace el diagnóstico de la enfermedad. El tratamiento actual se asocia con una repercusión moderada de aquella sobre el crecimiento lo que no alcanza a asumir significado patológico

Sensibilidad a la insulina: ausencia de diferencias sexuales al expresarla en función de la masa magra / Insulin sensitivity: absence of sexual differences when expressed as a function of lean body mass

The hyperinsulinemic, euglycemic clamp techinque was used to test the hypothesis that - when expressed per kiligram of lean body mass - there is a sex-difference in peripheral insulin-mediated glucose disposal (M), as proposed in the literature. Lean body mass wass assessed with tetrapolar bioelectric impedance analysis. We studied 15 normal subjects (volunteers with normal glucose tolerance and body mass indices between 20-25 Kg/m2) of both sexes, 9 women and 6 men, of age-groups, 20-30 year-old and 40-50 year-old. Men and women were similarly aged (33.3 ñ 3.8 and 33.3 ñ 3.8 years, respectively). body mass indices were similar in both sexes (22.5 ñ 0.6 in women and 23.6 ñ 0.7 in men, NS) but percentages of fat mass were not (294 ñ 1.2 in women and 20.6 ñ 1.6 in men, p < 0.001). As no difference in M (mg of glucose metabolized per kilogram of body weight per minute) between age-groups was found (6.4 ñ 0.8 snf 6.8 ñ 1.2 mg/Kg/min, Ns) the data from these 2 age-groups were pooled. When M values obtained in both sexes were compared no differences were found (7.1 ñ 1.5 mg/Kg/min in women and 6.3 ñ 0.6 in men, NS). Similarly, when M was expressed in function of the prevailing insulin levels attained during steady-state, M/l, no differences were disclosed (8.98 ñ 2 mg/Kg/min/µIU insulin in women and 7.8 ñ 1.2 in men, NS). When M was expressed per kilogram of lean body mass, Mmm, the values were similar in both sexes (8.99 ñ 1.86 m/kg lean body mass/min in women and 8.94 ñ 0.8 in men, NS). Finally, another maneuver commonly used to normalize MJ in function of metabolic size, expresing it per square meter of body surface, Ma, failed to disclose a sex-differnce (225.5 ñ 20.6 mg/m2/min in women and 263.5 ñ 52.8 in men, NS). We conclude that no sex-difference exists in M when expressed per kilogram of lean body mass, thus contradicting previous data published elsewhere