Action of Prednisone in Insulin-resistant Diabetes

Oakley, Wilfrid; Field, James B.; Sowton, G. E.; Rigby, Barbara; Cunliffe, A. C.

doi:10.1136/bmj.1.5138.1601

Cited by 42 publications

(18 citation statements)

References 12 publications

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“…The rise of insulin-binding antibody titres observed in our experiments agrees to a certain extent with clinical observations whereby cases of chronic insulin resistance caused by anti bodies were either not influenced by the hormones (27,29,35,36) or actually showed a deterioration (7,14,38). It has even been assumed that insulin resistance due to antibodies is triggered by ACTH or corticosteroid treatment (18).…”

Section: Discussionsupporting

confidence: 78%

Influence of Prednisolone and ACTH on the Formation of Insulin-Binding Antibodies

Kerp¹,

Sihler²,

Raju³

et al. 1967

Int Arch Allergy Immunol

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Section: Discussionsupporting

confidence: 78%

Influence of Prednisolone and ACTH on the Formation of Insulin-Binding Antibodies

Kerp¹,

Sihler²,

Raju³

et al. 1967

Int Arch Allergy Immunol

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“…(Submitted for publication March 1, 1961; accepted April 21, 1961) Insulin unresponsiveness may be associated with a multitude of conditions and reflect diverse etiologies (1). In most cases of chronic insulin resistance it has been possible to demonstrate insulin antagonists in the plasma which have many of the characteristics of antibodies (2)(3)(4). The resistance to insulin has usually been attributed to these antibodies, but several cases of insulin resistance associated with increased amounts of insulin in the plasma have been reported (5)(6)(7)(8).…”

mentioning

confidence: 99%

Insulin-Resistant Diabetes Associated With Increased Endogenous Plasma Insulin Followed by Complete Remission

Field¹,

Johnson²,

Herring³

1961

J. Clin. Invest.

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Insulin unresponsiveness may be associated with a multitude of conditions and reflect diverse etiologies (1). In most cases of chronic insulin resistance it has been possible to demonstrate insulin antagonists in the plasma which have many of the characteristics of antibodies (2-4). The resistance to insulin has usually been attributed to these antibodies, but several cases of insulin resistance associated with increased amounts of insulin in the plasma have been reported (5-8). In these cases tissue unresponsiveness was postulated as the cause for the resistance. In all of these cases circulating insulin could be demonstrated only at a time when the patients were receiving large doses of exogenous insulin, and therefore the insulin in the plasma probably represented injected insulin. We recently have had occasion to study a patient with severe insulin resistance whose plasma contained large amounts of insulin 3 months after her last known injection. Over the ensuing 18 months she had a gradual but complete remission of both diabetes and insulin unresponsiveness. The purpose of this paper is to report studies on this case which indicate that the insulin-like activity in her plasma did, in fact, represent endogenous insulin and that the cause for her insulin resistance was probably due to decreased tissue responsiveness to the hormone. The explanation for her remission is unknown, although there are occasional reports in the literature of spontaneous remission in severe diabetics (9). As far as we know this is the first reported case of insulin-resistant diabetes associated with greatly increased levels of endogenous insulin. METHODSThe rat hemidiaphragm. studies were done as follows.Fed rats weighing between 120 and 170 g were killed by a blow on the head; the diaphragms were removed as rapidly and with as little trauma as possible. Each hemidiaphragm was trimmed, blotted, weighed on a torsion balance and then put into a flask holding 2 ml of incubation medium which contained 0.5 ml of 1,000 mg per 100 ml glucose in Krebs-Ringer bicarbonate buffer (pH 7.4), variable amounts up to 1 ml of dialyzed plasma to be tested, and enough Krebs-Ringer bicarbonate buffer to make the final volume 2 ml.

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“…Zur B ehandlung der chronischen Insulinresistenz werden in zahl reichen Fällen Corticosteroide m it gutem Erfolg verw endet [16,51,56]. Der glukoneogenetische Effekt der Steroide kann im Beginn der Behandlung die Stoffwechsellage noch weiter verschlechtern [16,51], so daß eine solche B ehandlung nicht ungefährlich ist.…”

Section: Hemmung Der Insulim Virkung Bei Normalpersonen Sowie Bei Essunclassified

“…Der glukoneogenetische Effekt der Steroide kann im Beginn der Behandlung die Stoffwechsellage noch weiter verschlechtern [16,51], so daß eine solche B ehandlung nicht ungefährlich ist. Sie muß m inde stens (40-60 m g/d Prednison in absteigender Dosierung) über 14 Tage streng durchgeführt werden, weil oft erst nach 9-10 Tagen ein Erfolg ein tritt.…”

Section: Hemmung Der Insulim Virkung Bei Normalpersonen Sowie Bei Essunclassified

Insulin-Antagonisten, Insulin-Antikörper, Insulin-Resistenz. Beziehungen zwischen Fett- und Kohlenhydratstoffwechsel. Die Erfassung prädiabetischer Zustände

Oberdisse¹,

Jahnke²,

Daweke³

1965

Digestion

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Action of Prednisone in Insulin-resistant Diabetes

Cited by 42 publications

References 12 publications

Influence of Prednisolone and ACTH on the Formation of Insulin-Binding Antibodies

Influence of Prednisolone and ACTH on the Formation of Insulin-Binding Antibodies

Insulin-Resistant Diabetes Associated With Increased Endogenous Plasma Insulin Followed by Complete Remission

Insulin-Antagonisten, Insulin-Antikörper, Insulin-Resistenz. Beziehungen zwischen Fett- und Kohlenhydratstoffwechsel. Die Erfassung prädiabetischer Zustände

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