A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria.

A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria. Abstract Text:

Larry A Weinrauch,Andrew J Burger,Franz Aepfelbacher,Annette T Lee,Ray E Gleason,John A D'Elia,Larry A Weinrauch,Andrew J Burger,Franz Aepfelbacher,Annette T Lee,Ray E Gleason,John A D'Elia,

We hypothesized that correction of insulin deficiency by pulsatile intravenous insulin infusion in type 1 diabetes mellitus patients with nephropathy preserves renal function by mechanisms involving cardiac autonomic function, cardiac mass, or efficiency, or by hemostatic mechanisms. The control group (8 patients) received subcutaneous insulin (3-4 injections per day). The intravenous infusion group (10 patients) received three 1-hour courses of pulsed intravenous insulin infusion on a single day per week in addition to subcutaneous insulin. Laboratory measurements included 2-dimensional Doppler echocardiography, 24-hour ambulatory monitoring with heart rate variation analysis, platelet aggregation and adhesion, plasma fibrinogen, factor VII, von Willebrand factor, fibrinolytic activity, plasminogen activator inhibitor, and viscosity measured at baseline and 12 months. Blood pressure control was maintained preferentially with angiotensin-converting enzyme inhibitors. Ratio of carbon dioxide production to oxygen utilization was measured with each infusion and showed rapid increase from 0.8 to 0.9 (P = .005) at weekly treatments through 12 months. We observed an annualized decrease in creatinine clearance of 9.6 mL/min for controls vs 3.0 mL/min for infusion patients. Annualized fall in blood hemoglobin was 1.9 vs 0.8 g/dL, respectively (P = .013). There were no differences between the control and infusion group with respect to glycohemoglobin, advanced glycated end products, cholesterol, or triglycerides. No differences between the study groups for hemodynamic or hemostatic factors were evident. Blood pressures were not significantly different at baseline or 12 months. We conclude that although preservation of renal function with attenuation of loss of blood hemoglobin during 12 months of intravenous insulin infusion was associated with improvement in the efficiency of fuel oxidation as measured by respiratory quotient, this occurred without differences in metabolic/hemostatic factors, cardiac autonomic function, cardiac wall, or chamber size. Our hypothesis that preservation of renal function in type 1 diabetes mellitus patients with proteinuria by weekly pulsed insulin infusion involves mechanisms from the autonomic nervous system, cardiac size, and function, or elements of hemostasis was not confirmed.

A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria. Publishing Authors By Initials

LA Weinrauch,AJ Burger,F Aepfelbacher,AT Lee,RE Gleason,JA D'Elia,LA Weinrauch,AJ Burger,F Aepfelbacher,AT Lee,RE Gleason,JA D'Elia,

For similar abstracts research abstracts see: abstracts research

PUBMED ID PMID:

MEDLINE DATE:

A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Metabolism: clinical and experimental

VOLUME: 56

Page Numbers: 1453-7

Journal Abbreviation: Metab. Clin. Exp.

ISSN: 0026-0495

DAY: 22

MONTH: Nov

YEAR: 2007

A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 375267

A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria. Keywords Mesh Terms:

KEYWORDS:

MESH TERMS:

Chemical & Substance for Abstract: A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria.

AFFILIATION: Joslin Diabetes Center, Boston, MA, USA. lweinrauch@hms.harvard.edu

Country: United States

AGENCY:

GRANT:

ACRONYM:

MEDLINETA: Metabolism

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria Related Publications

• A pilot study to test the effect of pulsatile insulin infusion on cardiovascular mechanisms that might contribute to attenuation of renal compromise in type 1 diabetes mellitus patients with proteinuria.
• A statistical modelling approach for the analysis of TMD chronic pain data.
• A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses. IX. therapy and prognosis.
• A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses. X. Mortality, suicide and life-cycles.
• Anxiety and problem solving in middle-aged and elderly adults.
• Cardiovascular autonomic neuropathy in HIV-positive African patients.
• Current and Future Antiretroviral Treatment Options in Paediatric HIV Infection.
• Electrodermal activity in relation to basal and postdexamethasone levels of thyroid stimulating hormone and basal levels of thyroid hormones in major depressive patients and healthy subjects.
• Location choices of family practice residency graduates.
• Music perception in cochlear implant recipients: comparison of findings between HiRes90 and HiRes120.
• Patients with multiple admissions in a community mental health service in Western Norway.
• The symptoms of autonomic dysfunction in HIV-positive Africans.
• The use of antibiotics in the treatment and prevention of infection in HIV-infected children.
• Unilateral electroconvulsive therapy.
• [Familial tinea caused by Trichophyton verrucosum]
• [Mobbing--even among nurses]
• [Not Available.]
• [Not Available.]
• [Regionalized responsibility for the community mental health service]
• [The urinary apparatus in cancer of the uterine cervix.]