The present study focussed on the impact of heavy muscular work upon metabolic homeostasis in insulin dependent (type I) diabetics in situations involving a certain degree of hyper- and hypoinsulinemia. 20 juvenile type I-diabetics were compared with 6 nondiabetic healthy subjects. The diabetics were studied in states of hypo-(trial A) and hyperinsulinemia (trial B) at the start of the exercise. Differences in insulin availability resulted from the different times that had elapsed from the last insulin injection (3 hours in trial A and 1 hour in trial B) before the ergometer test started at 7 a.m. Six diabetics out of 20 patients were studied in both trials A and B to establish the reproducibility of metabolic reactions to the exercise. Bicycle ergometer tests were carried out in the upright position at 5 graded steps of 50 W, 75 W, 100 W, 125 W and a load near to exhaustion. Rest periods of five minutes were allowed between these work periods for taking blood samples before and after each work load. Plasma glucose, FFA, glycerol, lactate, alanine, IRI and HCP concentrations were investigated. The blood pressure at rest and during exercise was measured, and the physical working capacity (PWC170) was calculated according to Wahlund on the basis of the heart rate response to exercise. The results of the exercise tests reflect clearly the different metabolic reactions to heavy muscular work despite the relatively slight differences in insulin availability at the start: --Exhausting muscular work during the hypoinsulinemic state resulted in hyperglycemia and exaggerated lipolysis. --Heavy muscular work in a hyperinsulinemic state resulted in a reduced blood glucose level and antilipolytic reactions in comparison to nondiabetics. These findings suggest the great necessity of an adequate insulin availability during heavy muscular work in juvenile type I-diabetics.

Forschung und Behandlung --Karlsburg und Garz, Bereich Klinik Karlsburg (Institutsdirektor und Leiter der Klinik : Prof. Dr. reed. habil. H. Bibergeil) und Bereich experimentelle Diabetesforscbung (damaliger Leiter : Doz. Dr. reed. habil. I-I. G. Lippmann) Eingegangen am 18. Dezember 1969 Effects of the intravenous infusion of nicotinic acid on blood concentrations of substrates, metabolites and hormones in juvenile-onset diabetesSummary. The effect of a 30 min infusion of nicotinic acid on the blood levels of glucose, pyruvate, lactate, FFA, glycerol, cateeholamines, and 1 l-OH-cortieosteroids was investigated over 180 rain in 73 insulin-dependent diabetics with different clinical states of metabolism and in 7 healthy subjects. The action of nicotinic acid on insulin secretion was measured in vivo in some diabetic and some healthy subjects by means of ILA. Studies on insulin secretion in vitro were done by measuring the insulin release from isolated islets of mouse pancreas. The insulin content of the incubation medium was estimated with the radio-immunological method. --It was shown that nicotinic acid in vitro stimulates insulin release from B cells significantly. In vivo the rise of serum ILA after nicotinic acid infusion was only deteetable in healthy subjeets and in diabetics of the stable type. Furthermore, a negative correlation was demonstrated between the peak of the FFA-rebound induced by nicotinic acid and the stimulatory effect of the drug on insulin secretion. The behaviour of blood glucose during infusion of nicotinic acid together with the daily insulin dosage permitted a metabolic distinction to be made between diabetics of the stable and unstable ('brittle') type.

No abstract

No abstract

Das Krankheitsbild der Acapthosis nigricans ist bis heute noch weitgehend ungeklärt. In der Gesamtheit der Fälle beobachtet man bei etwa 500/o das Auftreten maligner Tumoren zusammen mit den das Krankheitsbild prägenden Hauterscheinungen.Bis 1952 hatte 011endorff-Curth 480 Fälle gesammelt (26). Joulia und Dubarry (17) geben eine Ubersicht im Jahre 1954 über 400 Fälle in der Weltliteratur. Fladung und Heite (7) fanden bei Durchsicht der Literatur wesentlich mehr als 437 Publikationen, mußten dabei jedoch eine nicht geringe Anzahl von Doppelzählungen feststellen. Die Zahl der bis heute publizierten Einzelfälle übersteigt nach unserer Zählung aber sicher schon das halbe Tausend. Verlauf sformen, Atiologie und GeneseWenn auch heute noch die gültige Lehrbuchmeinung vornehmlich zwei Formen unterscheidet (4, 8, 9, 18, 39) und Bohnstedt (4) sie etwa so zusammenfaßt, daß die benigne