References of "SCHEEN, André"
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See detailAcute functional iron deficiency in obese subjects during very-low-energy all- protein diet.
Grek, V.; BEGUIN, Yves ULg; Weber, G. et al

Poster (1992)

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See detailInsulin secretion and action in various populations with type 2 (non-insulin-dependant) diabetes mellitus
Scheen, André ULg; Paolisso, G.; Castillo, M. et al

in Diabetologia (1992), 16 ( suppl 1)(29), 116

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See detailImprovement of the metabolic clearance rate of insulin after a protein-supplemented fast in obese subjects.
PAQUOT, Nicolas ULg; SCHEEN, André ULg; Salvatore, T. et al

in International Journal of Obesity (1992)

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See detailManagement of non-insulin-dependent diabetes mellitus.
Lefebvre, Pierre ULg; Scheen, André ULg

in Drugs (1992), 44 Suppl 3

The initial management of non-insulin-dependent diabetes mellitus (NIDDM) should include patient education, dietary counselling and, when feasible, individualised physical activity. It is only when such ... [more ▼]

The initial management of non-insulin-dependent diabetes mellitus (NIDDM) should include patient education, dietary counselling and, when feasible, individualised physical activity. It is only when such measures fail that drug therapy should be considered. Dietary management of NIDDM includes a restriction in calories, and these should be appropriately distributed as carbohydrates, lipids and proteins. Supplementation of the diet with soluble fibre and supplementation with magnesium salts if hypomagnesaemia is demonstrated, is recommended. However, supplementation with fish oils or with fish oil-derived omega-3 fatty acids is not currently recommended. Oral drug therapies used in NIDDM include sulphonylurea derivatives, which are a first-line treatment in patients who are not grossly obese, metformin, which is the treatment of choice for obese patients, and alpha-glucosidase inhibitors such as acarbose, which are used mainly to reduce postprandial blood glucose peaks. These types of drugs can be used alone or in combination. Insulin therapy may be required to achieve adequate control of blood glucose levels in some patients. In several instances, it is suggested that insulin therapy be combined with sulphonylureas (essentially when residual insulin secretion is present), with metformin, or with alpha-glucosidase inhibitors. The treatment of disorders associated with NIDDM, such as obesity, hypertension or hyperlipidaemia, requires particular attention in diabetic patients, since some drugs can adversely affect glycaemic control. Oral drugs for the treatment of NIDDM include sulphonylurea derivatives used in first-line treatment in patients who are not grossly obese, metformin, which is often the treatment of choice for obese patients and, more recently, the alpha-glucosidase inhibitors, such as acarbose, which are effective in reducing the postprandial rise in blood glucose. [less ▲]

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See detailAssessment of insulin resistance in vivo: application to the study of type 2 diabetes.
Scheen, André ULg; Lefebvre, Pierre ULg

in Hormone Research (1992), 38(1-2), 19-27

Besides insulin secretion, insulin sensitivity plays a key role in the feedback glucose-insulin closed loop. It can be altered in numerous physiological, pathological and pharmacological conditions. It ... [more ▼]

Besides insulin secretion, insulin sensitivity plays a key role in the feedback glucose-insulin closed loop. It can be altered in numerous physiological, pathological and pharmacological conditions. It can be estimated in vivo using methods that open the feedback loop (insulin suppression test, glucose clamp) or that analyze the closed loop by employing mathematical models of glucose kinetics. The most popular method is the euglycemic hyperinsulinemic glucose clamp. This test should be ideally coupled with a priming-constant infusion of a glucose tracer together with indirect calorimetry. This combination allows to study the glucose kinetics (Ra and Rd, and thus endogenous-mainly hepatic-glucose production) and its metabolism (oxidation or storage as glycogen), respectively. One alternative approach is the frequently sampled intravenous glucose tolerance test where the dynamic changes in plasma insulin and glucose levels are analyzed using the so-called 'minimal model' method. Noninsulin-dependent or type 2 diabetes is characterized by a significant defect in both insulin secretion and action. The insulin resistance is located at the liver site (increased glucose production) and at the peripheral tissues (decreased oxidation and, even more, defective storage of glucose in the muscles). This insulin resistance, which predominates at the postreceptor level, seems to be genetically determined but is worsened by weight excess and by hyperglycemia itself. This contributes to a vicious circle which aggravates progressively the severity of the disease. [less ▲]

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See detailDevices for the treatment of diabetes: today.
Scheen, André ULg

in Artificial Organs (1992), 16(2), 163-6

Although single or multiple daily subcutaneous injections of insulin with syringes are the mainstay of insulin delivery techniques for the treatment of diabetes mellitus, several other methods are now ... [more ▼]

Although single or multiple daily subcutaneous injections of insulin with syringes are the mainstay of insulin delivery techniques for the treatment of diabetes mellitus, several other methods are now available. The present paper will review the main problems occurring with the classical subcutaneous insulin therapy and the possible solutions given by the use of new devices, including more particularly insulin jet injectors, pens, and portable pumps. This review has to be considered as an introduction to the presentations of this symposium devoted to implantable pumps, glucose sensors, and artificial pancreas, respectively. [less ▲]

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See detailFrom obesity to type 2 diabetes.
Scheen, André ULg

in Acta Clinica Belgica. Supplementum (1992), 14

Obesity is a well-known risk factor for the development of non-insulin-dependent diabetes mellitus (NIDDM). Both insulin resistance and concomitant B-cell dysfunction are necessary for the development of ... [more ▼]

Obesity is a well-known risk factor for the development of non-insulin-dependent diabetes mellitus (NIDDM). Both insulin resistance and concomitant B-cell dysfunction are necessary for the development of NIDDM. Insulin resistance, probably genetically determined but worsened by obesity, appears to be the primary defect that leads to impaired glucose tolerance. However, B-cell dysfunction plays a critical role during progressive deterioration from mild impaired glucose tolerance to severe NIDDM. [less ▲]

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See detailInsulin effects on glucose kinetics in non-insulin-dependent diabetic patients with secondary failure to hypoglycaemic agents: role of different modes and rates of delivery.
Paolisso, G.; Sgambato, S.; Varricchio, M. et al

in European Journal of Medicine (The) (1992), 1(5), 261-7

OBJECTIVES: This study aimed at investigating the effects of pulsatile and continuous insulin delivery on glucose kinetics in non-insulin-dependent (type 2) diabetic patients with secondary failure to ... [more ▼]

OBJECTIVES: This study aimed at investigating the effects of pulsatile and continuous insulin delivery on glucose kinetics in non-insulin-dependent (type 2) diabetic patients with secondary failure to oral hypoglycaemic agents. METHODS: Seven type 2 diabetic patients underwent a 585 minute glucose-controlled glucose intravenous infusion using the Biostator. The endogenous pancreas secretion was inhibited by somatostatin. Three experiments were performed in each patient on different days and in random order. In all cases, glucagon was replaced (58 ng/min). The amounts of insulin infused were: a) 0.15 mU/kg x min continuously; b) 0.20 mU/kg x min continuously and c) 1.0 mU/kg x min in 2 minute pulses every 13 minutes. D-[3-3H]-glucose infusion allowed determination of glucose kinetics. RESULTS: Infusion of identical amounts of insulin (A vs C) demonstrated that pulsatile insulin delivery exerted greater metabolic effects (higher glucose infusion rate and, mainly at the beginning of the experiment, lower endogenous glucose production) than continuous infusion; furthermore pulsatile insulin delivery (C) exerted metabolic effects similar to those of a greater dose of insulin (B) infused continuously. CONCLUSIONS: In type 2 diabetic patients with secondary failure to oral hypoglycaemic agents, pulsatile insulin delivery exerts greater metabolic effects than continuous hormone delivery. [less ▲]

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See detailSquatting to standing: an unusual but powerful postural manoeuvre to investigate human arterial blood pressure regulation
Pochet, T. F. J.; Gérard, Paul; Fossion, Anny et al

in Archives of Physiology & Biochemistry (1992), 100(5), 31-51

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See detailFluoxetine therapy in obese diabetic and glucose intolerant patients.
Kutnowski, M.; Daubresse, J. C.; Friedman, H. et al

in International Journal of Obesity & Related Metabolic Disorders (1992), 16 Suppl 4

A double-blind placebo-controlled trial was conducted, involving 97 obese diabetic and glucose intolerant patients receiving either 60 mg fluoxetine daily (47 patients) or a placebo (50 patients); a ... [more ▼]

A double-blind placebo-controlled trial was conducted, involving 97 obese diabetic and glucose intolerant patients receiving either 60 mg fluoxetine daily (47 patients) or a placebo (50 patients); a similar calorie-restricted diet was prescribed to all patients. Weight loss was significantly higher in the fluoxetine-treated patients, whose diabetic status improved. Drop-out rate was not significantly different for both groups of patients. [less ▲]

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See detailAtherosclerosis risk factors and macroangiopathy in type 1 versus type 2 diabetic patients
PAQUOT, Nicolas ULg; Malempré, g; Scheen, André ULg et al

Poster (1991, October)

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See detailAbsence de benefice de l'administration intermittente de l'insuline lors d'un traitement par pompe a perfusion sous-cutanee chez le diabetique de type-1.
Lilet, Henri ULg; Krzentowski, G.; Bodson, Arthur et al

in Diabète & Métabolisme (1991), 17(3), 363-72

Our study is based on two constatations: 1) Hyperinsulinaemia, a possible atherogenic factor, is frequent under continuous subcutaneous insulin infusion. 2) Pulsatile intravenous insulin delivery improve ... [more ▼]

Our study is based on two constatations: 1) Hyperinsulinaemia, a possible atherogenic factor, is frequent under continuous subcutaneous insulin infusion. 2) Pulsatile intravenous insulin delivery improve the insulin's hypoglycaemic activity. To test if equivalent metabolic control can be obtained with a reduced intermittent subcutaneous infused insulin dose, we compared nocturnal metabolic control of 8 c-peptide negative type 1 diabetic patients under three experimental conditions: Continuous usual dose test (1.0 +/- 0.1 u/h); Intermittent half dose test (1.0 +/- 0.1 u/h, 30 min/h); Continuous half dose test (0.5 +/- 0.05 u/h) Five parameters were monitored: blood glucose, plasma free insulin and beta-hydroxy-butyrate, free fatty acid and glycerol plasma level. No significant differences were found between intermittent and continuous half-dose tests. We conclude that, in our experimental conditions, intermittent subcutaneous insulin infusion does not reduce the metabolic degradation induced by insulin dose reduction. [less ▲]

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See detailEffets du blocage des recepteurs beta-adrenergiques sur l'hyperlactacidemie induite par des exercices d'intensites differentes.
Scheen, André ULg; Camus, G.; Fossion, Anny ULg

in Archives Internationales de Physiologie, de Biochimie et de Biophysique (1991), 99(4), 331-4

The effects of beta-adrenergic blockade on the exercise-induced hyperlactatemia (Lap) have been studied in 31 adult male subjects [age: 25 +/- 1 years; body weight: 69 +/- 1 kg; VO2max: 54 +/- 1 ml O2.kg ... [more ▼]

The effects of beta-adrenergic blockade on the exercise-induced hyperlactatemia (Lap) have been studied in 31 adult male subjects [age: 25 +/- 1 years; body weight: 69 +/- 1 kg; VO2max: 54 +/- 1 ml O2.kg-1.min-1 (mean values +/- SEM)] randomly divided in 3 groups. All exercises were performed on a 10% inclined treadmill. In group 1 (n = 11), the subjects were walking during 20 minutes at 5 km.h-1 (55.6 +/- 1.4% VO2max). In group 2 (n = 10), they were running during 9 minutes at 8 km.h-1 (79.4 + 1.5% VO2max). The subjects of the third group (n = 10) were submitted to a 4 minutes run at 9.5 km.h-1 92 +/- 1.6% VO2max). These exercises were performed 1 hour after ingestion of a placebo or a single dose of 40 mg propranolol, in a double-blind randomized order. Blood samples were drawn at regular time intervals from an antecubital vein. Exercise tachycardia was reduced by about 20% (P less than 0.001) by propranolol in each group. Lap was significantly reduced by 15% by propranolol (P less than 0.005) at the lowest exercise intensity (55.6% VO2max), remained unchanged at 79.4% VO2max and was significantly enhanced by 16% during the recovery period following the run at 92% VO2max. These results clearly showed that the effects of acute beta-adrenergic blockade on Lap depend on exercise intensity. [less ▲]

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See detailLa cellule beta dans le diabète de type II: coupable ou victime?
SCHEEN, André ULg; Paquot, Nicolas ULg; Lefebvre, P. J.

in Journées Annuelles de Diabetologie de l'Hôtel-Dieu (1991)

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See detailLe traitement pharmacologique de l'obésité.
PAQUOT, Nicolas ULg; SCHEEN, André ULg; Lefebvre, P.

in Médecine et Hygiène (1991), 49

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See detailDiabète, hypertension artérielle et angiopathie: comparaison chez les patients diabétiques insulino-dépendants et non insulino-dépendants.
PAQUOT, Nicolas ULg; SCHEEN, André ULg; Malembré, G. et al

in Archives des Maladies du Coeur et des Vaisseaux (1991), 84(suppl 1), 35

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See detailPulsatile insulin delivery has greater metabolic effects than continuous hormone administration in man: importance of pulse frequency.
Paolisso, G.; Scheen, André ULg; Giugliano, D. et al

in Journal of Clinical Endocrinology and Metabolism (1991), 72(3), 607-15

The aim of this study was to see if the greater effect of insulin on hepatic glucose output when insulin is given using 13-min pulses in man remains when the same amount of insulin is delivered using 26 ... [more ▼]

The aim of this study was to see if the greater effect of insulin on hepatic glucose output when insulin is given using 13-min pulses in man remains when the same amount of insulin is delivered using 26-min pulses. The study was performed on nine male healthy volunteers submitted to a 325 min glucose-controlled glucose iv infusion using the Biostator. The endogenous secretion of pancreatic hormones was inhibited by somatostatin. Three experiments were performed in each subject on different days and in random order. In all cases glucagon was replaced (58 ng min-1). The amounts of insulin infused were identical in all instances and were 0.2 mU kg-1 min-1 (continuous), 1.3 mU kg-1 min-1, 2 min on and 11 min off (13-min pulses) or 2.6 mU kg-1 min-1, 2 min on and 24 min off (26-min pulses). Blood glucose levels and glucose infusion rate were monitored continuously by the Biostator, and classic methodology using D-[3-3H] glucose infusion allowed to study glucose turnover. When compared with continuous insulin, 13-min insulin pulses induced a significantly greater inhibition of endogenous glucose production. This effect disappeared when insulin was delivered in 26-min pulses. We conclude that, in man, an adequate pulse frequency is required to allow the appearance of the greater inhibition of pulsatile insulin on endogenous glucose production. [less ▲]

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See detailImprovement of insulin-induced glucose disposal in obese patients with NIDDM after 1-wk treatment with d-fenfluramine.
Scheen, André ULg; Paolisso, G.; Salvatore, T. et al

in Diabetes Care (1991), 14(4), 325-32

OBJECTIVE: To study the short-term effects of the serotoninergic anorectic drug d-fenfluramine on insulin-induced glucose disposal. RESEARCH DESIGN AND METHODS: A randomized double-blind placebo ... [more ▼]

OBJECTIVE: To study the short-term effects of the serotoninergic anorectic drug d-fenfluramine on insulin-induced glucose disposal. RESEARCH DESIGN AND METHODS: A randomized double-blind placebo-controlled crossover trial with 1-wk treatment periods (2 x 15 mg/day d-fenfluramine) was conducted. Twenty obese subjects, 10 with normal oral glucose tolerance and 10 with non-insulin-dependent diabetes mellitus (NIDDM), were all treated with a weight-maintaining diet. Euglycemic-hyperinsulinemic glucose clamps with measurement of glucose kinetics with D-[3-3H]glucose were performed at either two (patients without NIDDM, 0.05 and 0.10 U.kg-1.h-1) or three (patients with NIDDM, 0.05, 0.10, and 0.50 U.kg-1.h-1) insulin delivery rates. RESULTS: In the nondiabetic subjects, no significant changes in any metabolic or hormonal parameter were measured in the basal state or during the clamp despite a slight reduction in body weight (-1.2 +/- 0.5 kg, P less than 0.05). In the diabetic patients, no significant changes in body weight or basal plasma insulin levels were observed, but fasting blood glucose levels (8.0 +/- 0.8 vs. 9.4 +/- 1.1 mM, P less than 0.005) and plasma free fatty acid concentrations (1150 +/- 227 vs. 1640 +/- 184 microM, P less than 0.05) were significantly reduced after d-fenfluramine compared with placebo. During the clamp, insulin metabolic clearance rate (MCR) was similar after both placebo and d-fenfluramine; endogenous (hepatic) glucose production was similarly and almost completely suppressed, whereas glucose disposal was remarkably enhanced after d-fenfluramine (average increase of glucose MCR 35 +/- 12%, P less than 0.02). CONCLUSIONS: Whatever the mechanism(s) involved, a 1-wk treatment with d-fenfluramine induces better blood glucose control and improves insulin sensitivity in obese patients with NIDDM independent of significant weight reduction; this last effect is not present in obese subjects with normal oral glucose tolerance. [less ▲]

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