Nocturnal Asthma: Mechanisms and Chronotherapy

Increased glucose intolerance related to digoxin treatment in patients with type 2 diabetes mellitus

“…Blood samples from 30 healthy elderly volunteers were used as controls. sTM was measured with an ELISA purchased from Stago, France [3]. The tests were performed by technicians without knowledge of to which group they belonged.…”

“…According to our daily experience this strategy can also be applied for elderly patients without problems, although one may initially start with lower doses. However, we feel that the design does not consider current knowledge of chronotherapy with steroids [2,3]. Single morning doses may be much more efficacious than single doses in the evening and, what is more important, even if the overall risk of local steroids may be small, they produce fewer side-effects when given in the morning.…”

“…This transport of Na + and K + across the cell membrane demands energy that is obtained by hydrolysis of adenosine triphosphate (ATP), the formation of which is coupled to the metabolism of glucose. Insulin also stimulates the cellular uptake of glucose, which is transported together with sodium by secondary active transport [3]. A low intracellular level of sodium stimulates this transport system whereas a high intracellular sodium content results in a reduced uptake of glucose.…”

On the chronotherapy of asthma

“…In general, local application of steroids is a first line strategy in asthma. However, we feel that the design does not consider current knowledge of chronotherapy with steroids 2,3 . Single morning doses may be much more effective than single evening doses and, more importantly, even if the overall risk of local steroids is small, they produce fewer side‐effects when given in the morning.…”