The aim of the present study was to investigate the secretion and hepatic removal of insulin in the healthy offspring of type 2 (non-insulin-dependent) diabetic subjects. For this purpose, we examined the insulin and C-peptide responses to a 75 g oral glucose tolerance test in a group of 55 healthy subjects each having one parent with type 2 diabetes mellitus, and in a group of 55 individuals without a family history of diabetes. All the 110 subjects in the study were ambulatory volunteers, in good general health, and with normal glucose tolerance. The two groups were carefully matched for sex, age, and body weight. Glucose and insulin concentrations as well as incremental areas were similar in the two groups. C-peptide levels and incremental areas were almost identical. C-peptide to insulin molar ratios both in fasting state and after glucose load, as well as relations between C-peptide and insulin incremental areas did not differ in the two groups. In conclusion, the healthy offspring of only one non-insulin-dependent diabetic parent show a normal beta-cell response to glucose, and normal removal of insulin by the liver.
We report the results of a survey on erectile dysfunction (ED) conducted in 400 Italian Diabetes Centres in 1998. A questionnaire consisting of 10 items was sent to the Centres recorded by the Italian Association of Diabetologists and the Italian Society of Diabetology; 400 Centres returned the completed questionnaire (58%). Forty-nine percent of the Centres declared that they investigated ED systematically but less than half of them (46%) had done it autonomously. The percentage of Centres performing intracavernous injection (ICI) was 84%. This maneuvre was most commonly performed by diabetologists (61%), followed by urologists (29%) and andrologists (18%) (categories are not mutually exclusive). ICI was also the most common type of treatment (85%), followed by oral (32%) and topic (7%) therapies (categories are not mutually exclusive). Slightly more than half of the interviewed Centres (51%) did not investigate ED routinely, attributing this to structural problems, lack of specific training and the availability of more specialised Centres as the main reasons for this. However, the majority of Centres expressed interest in managing ED. Among the available tests for ED, ICI was the most frequently employed. While most Centres seek the collaboration of external specialists to diagnose ED, the diabetologist is the physician who most frequently performs ICI. We conclude that Italian diabetologists need specific training to reach a greater degree of autonomy in the management of ED in their patients.
The response of glucose, FFA and immunoreactive insulin to intravenous glucose and glucagon was examined in 6 apparently healthy subjects aged 67-77 years at 08(00) and 18(00) with a 3 day interval. The subjects, fasted 12 h before each test, received 0.5 g/kg of glucose i.v. and, 40 min after glucose, 1 mg glucagon i.v. The results confirmed, also in aged subjects, an impaired glucose tolerance in the afternoon test, as previously reported in the adult subject. The insulin response was delayed in the afternoon test, but the total incremental area was not significantly reduced. There was not a clearcut difference in the pattern of FFA response. The results could be a further confirmation of the central role of insulin response as a cause of impaired glucose tolerance in the afternoon also in subjects aged over 65 years.
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