Treatment of EARLY DIABETES

511 Pages·1979·12.43 MB·English

by  R. A. Camerini-Davalos (auth.), Rafael A. Camerini-Davalos, Bernard Hanover (eds.)

Treatment of
EARL Y DIABETES
ADV ANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY
Editorial Board:
Nathan Back State University 0/ New York at Buffalo
N. R. Di Luzio Tulane University School 0/ Medicine
Ephraim Katchalski The Wei::mann Institute of Science
David Kritchevsky Wistar Institute
Abel Lajtha New York State Research Institute for Neurochemistry and Drug Addiction
Rodolfo Paoletti University 0/ Milan
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Treatment of
EARLY DIABETES
Edited by
Rafael A. Camerini-Davalos
and
Bernard Hanover
Diabetes Center
New York Medical College
New York, New York
PLENUM PRESS • NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
International Symposium on Early Diabetes, 4th, Algarve, 1978.
Treatment of early diabetes.
(Advances in experimental medicine and biology; v. 119)
"Sponsored by the Diabetes Center of New York Medical College."
Includes index.
1. Diabetes - Congresses. I. Camerini-Davalos, Rafael A., 1916- 11. New
York Medical College, Flower and Fifth Avenue Hospitals. Diabetes Center.
IlI. Tide. IV. Series.
RC660.A1I59 1978 616.4'62'06 79-16121
ISBN 978-1-4615-9112-2 ISBN 978-1-4615-9110-8 (eBook)
DOI 10.1007/978-1-4615-9110-8
Proceedings of the Fourth International Symposium on Early Diabetes,
sponsored by the Diabetes Center of New Yo rk Medical College,
held in Algarve, Portugal, November 7-11, 1978.
© 1979 Plenum Press, New York
Softcover reprint ofthe hardcover 1st edition 1979
A Division of Plenum Publishing Corporation
227 West 17th Street, New York, N.Y. lOOl1
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted,
in any form or by any means electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without wriUen permission from the Publisher
Preface
To obey the precepts of therapeutic rationality, we should
avoid treating the "effect" when there is a way to attack the cause.
But what is the cause of diabetes?
Diabetes is a molecular disease, that is, a disease in which
important cellular components are seriously impaired. Eventually,
the activities or the products arising from the impairment find
expression in various ways, finally culminating in the abnormalities
of diabetes.
How early is early enough to attempt to delay this sequence of
events? What will provide us with the basis to explore ways and
means of halting the progression of the pathological process? What
are the new approaches for the treatment of early diabetes?
The Fourth International Symposium on Early Diabetes, sponsored
by the Diabetes Center of the New York Medical College, held in
Algarve, Portugal in November 1978, from which this book evolved,
attempted to answer some of these questions.
A list of the participants, including their affiliations, will
be found preceding the index.
Rafael A. Camerini-Davalos
v
Acknowledgments
To our sponsors, U.S.V. Pharmaceutical Corp., Pfizer Pharmaceuticals,
Ames Company, Hoechst, Frankfurt; supporters, Boehringer, Manheim,
Laboratoires Servier, Nordisk Laboratory, The Upjohn Company, Eli
Lilly and Company, F. Hoffman La Roche; and contributors, Bayer A.
G. Leverkusen, McNeil, Novo Research Institute, ICI Belgium, Hope
for Diabetics Foundation, New York, we express our appreciation for
the financial support which made possible the Fourth International
Symposium on Early Diabetes.
THE ORGANIZING COMMITTEE
Rafael A. Camerini-Davalos, M.D.
Stefan S. Fajans, M.D.
Norbert Freinkel, M.D.
J.J. Hoet, M.D.
Ernst Pfeiffer, M.D.
vii
Contents
EARLY DIABETES: DEFINITION, PRESENT CONCEPT
Early Diabetes. Concept. Terminology. • • • • • • • • • 1
R.A. Camerini-DavaZos
Early Stages of Diabetes: Definitions and Present
Concepts •••• 7
S.S. Fajans
Prediabetes in the Pima Indians • • • • 13
P.J. Savage~ R.F. Hamman and P.H. Bennett
The Prognosis of Insulin Dependent Diabetes
Mellitus and the Importance of Supervision • 21
T. Deckert and M. Larsen
Discussion • • • • • • 29
GENETIC INFLUENCES ON ISLET CELL FUNCTION
HLA System
HLA and the Genetic Aspects of the Predisposition
to Juvenile Diabetes Mellitus. A Follow-Up 33
P. Rubenstein and N. Suciu-Foca
HLA Studies in Diabetics • • • • • • • • • • • • 41
L.P. Ryder~ M. Christy~ J. Nerup, P. PZatz,
A. Svejgaard and M. Thomsen
Discussion • • • 49
Familial Patterns of Inheritance
On the Genetic Heterogeneity of Juvenile
Hyperglycemia • • • • • • • • • • • • • • 51
J. Barbosa and M.M. Chern
ix
x CONTENTS
Familial Patterns of Inheritance of Diabetes
Mellitus. Maturity-Onset Type Diabetes of Young
People (MODY) • • • • • • • • • • • • • 59
M.C. Cloutier and S.S. Fajans
Discussion • • • • • • . . . . . • 67
METABOLIC ASPECTS OF ISLET CELL FUNCTION
Phosphate Trans10cations During Secretory
Stimulation of Pancreatic Islets • • • • • 71
N. Freinkel
The Role of Phosphoenolpyruvate and Lactate
Production in Insulin Secretion • • • • • • 79
C.J. Hedeskov and K. Capito
Effects of Insu1inotropic Agents on Cationic Fluxes
in Islet Cells • • • • • • • • • • • 85
W.J. Malaisse~ A. Sener and A. Herchuelz
Glucose-Induced Changes of the Membrane Potential
of Pancreatic B-Ce11s: Their Significance for the
Regulation of Insulin Release • • • • • • • 97
H.P. Meissner and M. Preissler
Discussion • • • • 109
ABNORMAL DEVELOPMENT OF THE PANCREAS
Effect of Maternal Carbohydrate Intolerance on the
Development of the Autonomic Innervation of the
Fetal Rat Pancreas ••••••••• 115
M. de Gasparo~ P. de Herdt and J.J. Hoet
Discussion 123
ENVIRONMENTAL FACTORS INFLUENCING ISLET CELL FllICTION
Nutritional
Suppression of Insulin Secretion by Protein
Deprivation in Obesity • • • • • • • • • • • • • • • 125
D.E. Schteingart~ A.K. McKenzie~ R.S. Victoria
and H.S. Tsao
CONTENTS xi
Discussion 133
Viruses
Virus-Induced Diabetes Mellitus: Infection of
Mice with Variants of Encepha1omyocarditis Virus,
Coxsackievirus B4, and Reovirus Type 3 •• 137
A.L. Notkins~ J. Yoon~ T. Onode~a and
A.B. Jenson
Autoimmunity
Immunological Aspects of Diabetes Mellitus . . . . . . . 147
W. J. Irvine
Detection and Possible Functional Influence of
Antibodies Directed Against the Pancreatic Islet
Cell Surface • • • • • • • • • • • • • • • • • • 157
A. LePnma~k~ T. Kanatsuna~ A.H. Rubenstein
and D.F. Steine~
Discussion • • • • • • 165
PATTERNS OF INSULIN SECRETION
Heterogeneity of Insulin Responses in Maturity-
Onset Type Diabetes (MOD) and in Maturity-Onset
Type Diabetes of Young People (MODY) • • • • • • 171
S.S. Fajans
Progression of Early Diabetes • • • • • • • 177
W. Oppe~ann~ C.A. VeZasao~ A.S. Reddi~
B. Hanove~ and R.A. Came~ini-Davatos
Insulin Resistance and Insulin Secretion in
Patients with Chemical Diabetes: Implications
Concerning the Pathogenesis of Idiopathic
Diabetes Mellitus •••••• • • • • • • • • 187
G.M. Reaven
Inquiries into the Pathogenesis of Gestational
Diabetes • • • • • • • • • • • • • 201
B.E. Metzge~ and N. F~einkeZ
Effect of Intravenous Glucose, Leucine and '
Arginine on Concentration of Insulin in Maternal
and Umbilical Cord Serum • • • • • • • • • • • • • • • • 209
S. G~asso~ G. PaZumbo~ S. RugoZo~ R. Vigo
and G. Turnino
CONTENTS
Discussion 213
MECHANISM OF SALVAGING BETA CELL FUNCTION
Beta Cell Dysfunction in Maturity-Onset Diabetes:
Reversible Loss of Glucose-Induced Insulin
Secretion with Retention of Response to Arginine • 219
P.J. Savage~ L.J. Bennion~ E.V. FZock and
P.H. Bennett
Improvement of Insulin Secretion in Diabetics by
a Prostaglandin Synthesis Inhibitor 227
R.P. Robertson~ M. Chen~ J.R. McRae and
S.A. Metz
Discussion • • 233
DIET THERAPY
Decreased Food Intake
Effect of Diet Limitation on Development of
Diabetes in Non-Hyperphagic Prediabetic Chinese
Hamsters • • • • • • • • • 237
C. Gerritsen and M.C. BZanks
Riboflavin in CHO Metabolism
The Role of Riboflavin in Carbohydrate Metabolism 243
A.S. Reddi~ P.K. Ho and R.A. Camerini-DavaZos
Discussion 251
Responses to Different Complex Carbohydrates
Effect of Variations in Carbohydrate Intake on
Plasma Glucose, Insulin and Triglyceride Responses
in Normal Subjects and Patients with Chemical
Diabetes • • • • 253
G.M. Reaven
High Carbohydrate, High Fiber Diets for Patients
with Diabetes • • • • • • • • • • • • • • • 263
J.W. Anderson
Dietary Fiber and Diabetic Therapy: A Progressive
Effect with Time • • • • • • • • • • • • • • • • • • • • 275
D.J.A. Jenkins~ T.M.S. WoZever~ R. Nineham~
S. Bacon~ R. Smith and T.D.R. Hockaday