M Bjørgaas

Publications (13)22.79 Total impact

• Article: Relationship between pedometer-registered activity, aerobic capacity and self-reported activity and fitness in patients with type 2 diabetes.

  M Bjørgaas, J T Vik, A Saeterhaug, L Langlo, T Sakshaug, R M Mohus, V Grill
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  ABSTRACT: The aim of this study is to investigate the relationship between pedometer-registered activity, aerobic capacity (VO(2 max)) and self-reported activity and fitness in patients with type 2 diabetes before and after a 12-week exercise programme. Twenty-nine men with type 2 diabetes (age=57.4 (7.8) years, BMI=31.7 (2.8) kg/m(2)) underwent exercise testing, registered pedometer activity and reported their physical fitness and activity in a questionnaire. Participants were randomly allocated to an exercise (EX) group (n=15) or a control (CO) group (n=14). Participants in EX group were offered supervised exercise twice a week for 12 weeks. At the end of the study, participants again underwent exercise testing, fasting blood tests and registration of pedometer activity. At baseline, pedometer activity correlated with VO(2 max) (r=0.43, p=0.02) and with perceived physical fitness (r=0.48, p=0.02). After, but not before, intervention, pedometer activity and VO(2 max) additionally correlated with perceived everyday activity (r=0.62, p<0.01 and r=0.49, p=0.03, respectively). Both EX and CO groups tended to increase pedometer activity. In EX group, weight decreased by 2.7% (p=0.01), VO(2 max) increased 10.6% (p=0.03) and HbA1c decreased by 5.2% from baseline (p=0.02). In EX group, an increase in pedometer activity correlated with a fall in HbA1c (r=0.84, p<0.01) and in diastolic blood pressure (r=0.77, p=0.025). Pedometer activity correlates with VO(2 max) in type-2 diabetic patients. Our exercise programme was well tolerated; it produced favourable effects on body weight, aerobic capacity and metabolic control. The use of pedometer may lead to more realistic assessment of perceived everyday physical activity.
  Diabetes Obesity and Metabolism 11/2005; 7(6):737-44. · 3.38 Impact Factor
• Article: Circulatory responses to hypoglycaemia in diabetic and non-diabetic children.

  M Bjørgaas, K Aasarød
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  ABSTRACT: The purpose of this study was to investigate the circulatory responses to hypoglycaemia in diabetic and non-diabetic children and to determine whether these changes were associated with hormone levels or clinical variables. Plasma glucose levels in 18 diabetic and 15 control children were gradually lowered to 2.5 (0.3) mmol/L (mean (SD)) and 2.9 (0.2) mmol/L, respectively. Blood pressure and heart rate were recorded at 10-min intervals, and blood samples were taken for hormone analysis. Systolic pressure increased from 110.1 (10.0) to 115.0 (11.2) mmHg (p = 0.008) in the diabetic children and from 116.9 (12.0) to 121.6 (12.7) mmHg (p = 0.049) in the controls. Diastolic pressure decreased from 61.9 (6.7) to 55.5 (7.6) mmHg (p < 0.001) in the diabetic children and from 66.5 (6.3) to 55.1 (5.1) mmHg (p < 0.001) in the controls. The increase in pulse pressure during hypoglycaemia was significantly smaller in the diabetic children (10.6 (5.5) vs. 15.7 (7.7) mmHg, p = 0.04). The final systolic and pulse pressure correlated with the final adrenaline level in the controls (r = 0.66, p = 0.008 and r = 0.70, p = 0.003, respectively). In the non-diabetic as well as the diabetic group, the increase in pulse pressure correlated with the increase in adrenaline (r = 0.66, p = 0.008 and r = 0.50, p = 0.03, respectively). It is concluded that systolic pressure increases and diastolic pressure decreases during hypoglycaemia in children. The smaller increase in pulse pressure observed in the diabetic children is probably related to a significantly smaller increase in adrenaline in this group.
  Scandinavian Journal of Clinical and Laboratory Investigation 01/2003; 63(3):233-8. · 1.38 Impact Factor
• Article: [Hypoglycemia--a dreaded complication of diabetes].

  M Bjørgaas
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  ABSTRACT: Hypoglycaemia is a common side effect of insulin therapy in type 1 diabetes. In patients with type 2 diabetes treated with blood-glucose lowering agents of the sulphonylurea group, hypoglycaemia is less frequent than in insulin-treated patients. In most patients strict metabolic control increases the risk of hypoglycaemia, but this risk may be reduced if patients are offered individualised insulin treatment in combination with active support and education. Previously experienced hypoglycaemic episodes and lack of endogenous insulin production are risk factors for repeated episodes. Patients with longstanding diabetes and loss of warning symptoms have increased risk of severe hypoglycaemic episodes, which may lead to loss of consciousness or convulsions. Driving performance is significantly disrupted at relatively mild hypoglycaemia, and persons with diabetes should not start driving when their blood glucose is in the 4-5 mmol/l range without prophylactic treatment. They ought to have carbohydrate-rich snacks easily available in the car and should stop driving if they feel hypoglycaemic. Repeated episodes of severe hypoglycaemia seem to be associated with cognitive dysfunction. When deciding the targets of blood-glucose lowering therapy, the risk of severe hypoglycaemia must be weighed against the beneficial effects of good metabolic control.
  Tidsskrift for Den norske legeforening 09/2000; 120(20):2441-4.
• Article: The urinary excretion of deoxypyridinium cross-links is higher in diabetic than in nondiabetic adolescents.

  M Bjørgaas, E Haug, H J Johnsen
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  ABSTRACT: We have measured the urinary excretion of deoxypyridinium (D-Pyr) crosslinks, a sensitive and specific marker of bone resorption, in morning urine in 102 healthy, nonhospitalized, Caucasian subjects (8-18 years) and in 18 diabetic subjects (12-17 years). The free D-Pyr crosslinks were measured using the Pyrilinks D-Assay. In the diabetic subjects, plasma glucose was regulated throughout the night by a constant infusion of insulin and a variable infusion of 24% glucose. In the nondiabetic subjects, the excretion of D-Pyr increased until 12-14 years of age, and thereafter decreased, and the excretion of D-Pyr/hour was correlated with the height Z-score. The excretion of D-Pyr/hour and the D-Pyr/creatinine ratio was higher in the diabetic adolescents than in the nondiabetic adolescents. In subjects over the age of 12, the D-pyr/creatinine ratio was higher in males than in females. In conclusion, in healthy children and adolescents, the excretion of D-Pyr peaks at 12-14 years of age. The D-Pyr excretion is higher in diabetic than in nondiabetic adolescents, suggesting increased bone resorption in diabetic adolescents.
  Calcified Tissue International 09/1999; 65(2):121-4. · 2.38 Impact Factor
• Article: Vagal stimulation augments maximal (penta) gastrin-stimulated acid secretion in humans.

  G Qvigstad, M Bjørgaas, I Eide, A K Sandvik, H L Waldum
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  ABSTRACT: Since the late sixties, the pentagastrin test has been the standard method to examine maximal gastric acid secretion in humans. However, studies on rats and dogs have shown that maximal pentagastrin-stimulated acid secretion can be augmented by concomitant cholinergic stimulation. The aim of this study was to examine whether the combined stimulation of the vagal nerves and pentagastrin infusion could increase maximal gastric acid secretion compared with pentagastrin alone. Eight healthy medical students (seven males) were included in the study. Gastric acid secretion was determined thrice in each subject. On day one, pentagastrin (6 microg kg(-1) h(-1)) was infused. On day two, insulin-induced hypoglycaemia (plasma glucose approximately 2.3 mM during 30 min) was obtained by applying the glucose clamp technique. On day three, pentagastrin infusion and insulin induced-hypoglycaemia were combined. The combination of insulin-induced hypoglycaemia and pentagastrin infusion increased peak acid output about 20% (P = 0.018) compared with pentagastrin alone. The hypoglycaemia did not cause significant release of gastrin. It is concluded that vagal stimulation of gastric acid secretion may be safely obtained by insulin-induced hypoglycaemia when applying the glucose clamp technique. In addition, maximal pentagastrin-stimulated acid secretion does not represent the maximal acid secretory capacity in humans.
  Acta Physiologica Scandinavica 04/1999; 165(3):277-81. · 2.55 Impact Factor
• Article: Urinary excretion of catecholamines in hospitalized and non-hospitalized healthy children and adolescents.

  M Bjørgaas, E Sagen, H Johnsen, T Vik, G Sager
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  ABSTRACT: Non-conjugated catecholamines were measured in morning urine samples from 111 healthy, non-hospitalized subjects aged 8-18 y and in 16 hospitalized, healthy subjects aged 12 16 y. The catecholamines were extracted by cation exchange columns and alumina adsorption and quantitated with HPLC with electrochemical detection. The concentration of catecholamines was related both to the urinary creatinine concentration and to the collecting period and body surface area. Linear regression analysis was used to estimate continuous age-related reference centiles based upon the measurements from the 111 non-hospitalized subjects. The upper limits for the adrenaline/creatinine and noradrenaline/creatinine ratios were lower than in previous studies. The excretion of adrenaline and noradrenaline per hour and m2 body surface area was higher in the 16 hospitalized than in the 74 age-matched non-hospitalized subjects. The excretion of the catecholamines expressed per hour and m2 body surface area and expressed relative to creatinine excretion, decreased with increasing age, and the excretion of adrenaline and noradrenaline per hour and m2 body surface area was higher in boys than in girls. In conclusion, standardization of urine sampling leads to more narrow ranges for urinary adrenaline and noradrenaline excretion in healthy children and adolescents.
  Scandinavian Journal of Clinical and Laboratory Investigation 08/1998; 58(4):339-46. · 1.38 Impact Factor
• Article: Quantitative EEG during controlled hypoglycaemia in diabetic and non-diabetic children.

  M Bjørgaas, T Sand, T Vik, R Jorde
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  ABSTRACT: We investigated quantitative EEG in 19 diabetic children (mean age 14.2 (SD 1.4) years, mean HbA1c 9.8 (SD 1.2)% and 17 non-diabetic children (14.3 (1.1) years) during and after a gradual reduction in plasma glucose with the glucose clamp technique. The amplitudes of the EEG frequency bands at each glucose level were compared to the registration prior to hypoglycaemia. At plasma glucose approximately 4 mmol l(-1), a small increase in delta (p < 0.05) and theta (p < 0.01) amplitude appeared in the combined diabetic and control group. At approximately 3 mmol l(-1), and at glucose nadir, a further and widespread increase in low-frequency EEG activity was observed. In diabetic and non-diabetic subgroups with similar glucose nadirs, the diabetic children had more delta (p < 0.01) and theta (p < 0.01) activity, and more epileptiform activity (p < 0.05), than the non-diabetic children. In the non-diabetic subjects, but not in the diabetic subjects, the increase in delta and theta activity correlated with a hypoglycaemic symptom score (r = 0.75, p = 0.001 and r = 0.77, p < 0.0005, respectively). In conclusion, EEG changes are detectable already at plasma glucose approximately 4 mmol l(-1) in children. EEG deterioration during hypoglycaemia is more pronounced in diabetic than in non-diabetic children. The increase in cerebral disturbances is not accompanied by an increment in hypoglycaemic symptoms in diabetic children.
  Diabetic Medicine 01/1998; 15(1):30-7. · 2.90 Impact Factor
• Article: Urinary excretion of adrenaline and noradrenaline during hypoglycaemic clamp in diabetic and non-diabetic adolescents.

  M Bjørgaas, T Vik, G Sager, E Sagen, R Jorde
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  ABSTRACT: The urinary excretion of non-conjugated adrenaline and noradrenaline during hypoglycaemic clamp was investigated in 16 diabetic and 15 non-diabetic adolescents. In the diabetic adolescents, the mean excretion of adrenaline was approximately nine times higher in clamp urine than in morning urine (p < 0.0001). In the non-diabetic adolescents, the mean excretion of adrenaline was 20-30 times higher in clamp urine than in morning urine (p < 0.0001). Plasma catecholamines were measured, and the area under the plasma concentration-time curve (AUC) and renal clearance of catecholamines were calculated. There was a linear correlation between the AUC and the urinary excretion of adrenaline (r = 0.57, p = 0.001) and noradrenaline (r = 0.49, p = 0.006) during the hypoglycaemic clamp. The renal clearance of adrenaline and noradrenaline did not differ between the diabetic and non-diabetic subjects. In the diabetic group, there was a positive correlation between HbA1c and the adrenaline excretion in clamp urine (r = 0.60, p = 0.015). The eight diabetic subjects with HbA1c < 10% had lower adrenaline excretion in clamp urine than the subjects with HbA1c > 10% and the non-diabetic subjects (all p values < 0.05). We conclude that there is a marked increase in urinary adrenaline excretion during hypoglycaemia in diabetic and non-diabetic adolescents. The increase in adrenaline excretion during hypoglycaemia was attenuated in the better-controlled diabetic adolescents in our study.
  Scandinavian Journal of Clinical and Laboratory Investigation 12/1997; 57(8):711-8. · 1.38 Impact Factor
• Article: Counterregulatory hormone and symptom responses to hypoglycaemia in diabetic children.

  M Bjørgaas, T Vik, T Sand, K Birkeland, G Sager, H Vea, R Jorde
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  ABSTRACT: The hormonal responses to, and symptoms of, hypoglycaemia were investigated in 19 diabetic children (mean age 14.2 (SD 1.4) years, mean HbA1c 9.8 (SD 1.2)%) and 16 non-diabetic children (14.4(1.0) years) during a gradual reduction in plasma glucose with the glucose clamp technique. Plasma glucose was reduced from approximately 5.7 to approximately 2.6 mmol l(-1) in the diabetic children and from approximately 5.7 to approximately 2.9 mmol l(-1) in the non-diabetic children over 200 min. The mean glycaemic thresholds for adrenaline, and for autonomic and total symptom score, were similar in the diabetic and non-diabetic groups, and were found at plasma glucose levels between 3.4 and 3.7 mmol l(-1). The mean glucose levels which elicited increase of cortisol, growth hormone, and glucagon were lower (p < 0.01), and the mean incremental responses of adrenaline, cortisol, and glucagon were smaller in the diabetic than in the non-diabetic children. In the diabetic children, a correlation was found between Body Mass Index (BMI) and the hypoglycaemic thresholds for autonomic and total symptom scores (r = 0.64, p < 0.01 and r = 0.72, p = 0.001, respectively). We conclude that counterregulatory hormone responses are attenuated in diabetic as compared to non-diabetic children, whereas recognition of autonomic symptoms is similar in the two groups. Diabetic children with a higher BMI seem to have increased awareness of a declining plasma glucose level.
  Diabetic Medicine 07/1997; 14(6):433-41. · 2.90 Impact Factor
• Article: Cognitive function in type 1 diabetic children with and without episodes of severe hypoglycaemia.

  M Bjørgaas, R Gimse, T Vik, T Sand
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  ABSTRACT: We assessed the effect of diabetes and of episodes of severe hypoglycaemia on cognitive function in 28 diabetic children. Fifteen diabetic children (age 12.9 (SD 2.0) years) had experienced 1-4 episodes of severe hypoglycaemia. Five of these children diseased before the age of 5 years (SH-eod subgroup), and ten diseased after this age (SH-lod subgroup). Thirteen diabetic children (age 13.1 (SD 2.0) years) had not experienced episodes of severe hypoglycaemia (non-SH group). Each diabetic child was compared with a healthy control child of the same age and gender and with a similar social background. Neuropsychological assessment was blinded. The neuropsychological tests were grouped into one of seven cognitive domains. We found no effect on cognitive performance from diabetes per se or from severe hypoglycaemia in children with late-onset diabetes. However, early-onset diabetes was associated with low scores in two cognitive domains: psychomotor efficiency and attention. The SH-eod subgroup had lower scores than the SH-lod subgroup in psychomotor efficiency (p < 0.05) and also had lower scores than the SH-lod subgroup and the non-SH group in measures of attention (p < 0.05). Our results may indicate a slight cognitive dysfunction in children with early-onset diabetes who have experienced episodes of severe hypoglycaemia early in childhood.
  Acta Paediatrica 02/1997; 86(2):148-53. · 2.07 Impact Factor
• Article: Quantitative EEG in type 1 diabetic children with and without episodes of severe hypoglycemia: a controlled, blind study.

  M Bjørgaas, T Sand, R Gimse
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  ABSTRACT: We investigated the EEG frequency distribution by quantitative EEG (QEEG) in 28 children with type 1 diabetes and 28 age- and sex-matched control children. Among the diabetic children, 15 had experienced episodes of severe hypoglycemia (SH group) and 13 had not experienced such episodes (non-SH group). The EEG analysis was blind. Frequency analysis of 15 EEG epochs, each of 4 s duration, was performed. QEEG showed increased theta activity in the SH group bilaterally in the frontocentral region and a slight trend toward more delta activity in diabetic children than control children bilaterally in the occipital electrodes. The relative alpha amplitude was decreased in the SH group at several locations. Abnormal standard EEG (diffuse theta activity) was observed in two SH patients and one non-SH patient. All control children had normal standard EEG. We conclude that episodes of severe hypoglycemia may affect frontocentral function slightly in some diabetic children.
  Acta Neurologica Scandinavica 07/1996; 93(6):398-402. · 2.47 Impact Factor
• Article: [Diabetes mellitus in children. Therapeutic control, social conditions and self care].

  M Bjørgaas, S Haugen, G Stene, P E Haereid, T Vik
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  ABSTRACT: We present a descriptive study of children with diabetes mellitus in Sør-Trøndelag county. The study included 66 children. Eight of these children had at least one other chronic disease in addition to diabetes. 31 children used more than two insulin injections daily. The median value of HbA1c was 8.6%. HbA1c was positively correlated with duration of diabetes. However, for the children who were out of remission, HbA1c was positively correlated with age and negatively with number of meals per day. Children whose parents were divorced or single had higher HbA1c than children whose parents were married or lived together. HbA1c was also higher among children who received special lessons at school than among children who did not receive such lessons. Thus, age, duration of diabetes and psychosocial factors were the most important determinants for metabolic control in our study.
  Tidsskrift for Den norske legeforening 07/1994; 114(17):1930-2.
• Article: [The incidence of acute complications in children with diabetes mellitus].

  M Bjørgaas, G Stene, S Haugen, P E Haereid, T Vik
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  ABSTRACT: The incidence of acute complications in children with diabetes mellitus was investigated from April 1992 to April 1993. During this period 27 of 66 children (40%) had experienced at least one episode of serious hypoglycemia, and six (9%) had been hospitalized because of hyperglycemia or ketoacidosis. Children whose parents were divorced or single, experienced more episodes of serious hypoglycemia than children of married or cohabitant parents. The children who had experienced serious hyperglycemia or ketoacidosis had higher HbA1c, used a relatively higher daily dose of insulin and were older than the other children.
  Tidsskrift for Den norske legeforening 07/1994; 114(17):1933-5.