Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
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Exp. Clin. Endocrinol. Diabetes · Jan 1998
Influence of metabolic control and duration of disease on microvascular dysfunction in diabetes assessed by laser Doppler anemometry.
A reduced and delayed postocclusive reactive hyperaemia has been demonstrated in diabetic patients using videophotometric capillaroscopy and laser Doppler fluxmetry. The aim of the present study was to examine by means of the new technique of laser Doppler anemometry whether impairment of skin microcirculation differs between type 1 and type 2 diabetic patients especially with regard to metabolic control and duration of diabetes. Sixteen type 1 and 19 type 2 diabetic patients were investigated and subdivided in patients with "good" (HbA1c < 7.5%) or "bad" (HbA1c > 7.5%) metabolic control and in patients with a diabetes duration of less or more than 10 years. ⋯ In type 2 diabetes time to peak CBV (46.8 +/- 8.5 s vs. 16.4 +/- 2.2 s, p < 0.001) was also prolonged already in the first 10 years of the disease. However with regard to metabolic control a reduced peak CBV (0.54 +/- 0.04 mm/ s vs. 0.70 +/- 0.04 mm/s, p < 0.05) and a prolonged time to peak CBV (56.6 +/- 14.8 s vs. 13.7 +/- 2.7 s, p < 0.01) was found in type 2 diabetes only in the group of patients with HbA1c > 7.5%. The results indicate that in type 2 diabetes actual metabolic control might be of greater importance for the microvascular dysfunction than in type 1 diabetes and that the skin capillary circulation is impaired already in the first 10 years of both diabetes types.
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Exp. Clin. Endocrinol. Diabetes · Jan 1997
Comparative StudyThe KID study IV: effects of inpatient rehabilitation on the frequency of glucose self-monitoring, quality of further primary care, on time being unable to work and on everyday psychic strain of type I and type II diabetics--a one-year follow-up. Kissingen Diabetes Intervention Study.
The Kissingen Diabetes Intervention Study (KID) evaluated 1,050 diabetic patients of the German Federal Insurance Institution for Salaried Employees (BfA) admitted for inpatient rehabilitation in a single-center, prospective, longitudinal study which was carried out to collect data concerning the structure of the patient cohort, socioeconomic factors, psychological data and state of medical care by consecutively registered random tests. These results have already been published. We will now report on the outcome 6 and 12 months after inpatient treatment. ⋯ This was seen in the categories anxiety, depression, fear of hypoglycemias in the case of type I diabetics, restriction of leisure time activities, relationship with the partner and acceptance of disease. Only in the categories patient-physician relationship and professional strain was an improvement found. These alterations are still demonstrable after 6 and 12 months.
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The high prevalence of obesity and its well documented association with the cardiovascular risk factors diabetes mellitus, dyslipidemia and hypertension represents a major problem for the general health status of industrialized societies. Although numerous studies have shown that genetic factors have a major influence on the regulation of energy homeostasis and the susceptibility to obesity, the genes and predisposing mutations involved are insufficiently understood. Among several known rodent models of obesity due to single gene mutations, mice homozygous for the obese (ob) gene exhibit massive early-onset obesity, hyperphagia, non-insulin-dependent diabetes mellitus, defective thermoregulation and infertility. ⋯ A mutation in the leptin receptor gene is responsible for the obese phenotype of db/db mice. Plasma leptin in humans is positively correlated with body fat mass, suggesting that leptin resistance rather than leptin deficiency is a common feature of human obesity. This review briefly summarizes the current status of the rapidly growing evidence that leptin plays an important role in the regulation of body weight and fat deposition.