[Hospital in-patients with diabetes]

As the diabetic population is becoming older, hospitalization is more frequent and of longer duration with increased costs. Hospital stay could be a good opportunity to improve diabetes care. All observational studies demonstrate that improving metabolic control reduces mortality, morbidity and hospitalisation costs. For critically ill patients and those referred for myocardial infarction or submitted to cardiac surgery, randomised controlled studies have proven the efficacy of strict metabolic control and defined the targets to be reached. Unfortunately, for many reasons, it is difficult to treat the patients to the targets and in non specialized departments, diabetes control may even be worse during hospitalisation. We urgently need to find innovating solutions to mitigate the consequences of the reduced number of competent nurses and doctors in the field of diabetes.

Synthesis and inverse emulsion polymerization of aminated acrylamidodextran

A chemically modified form of dextran was prepared, having a polymerizable moiety (acrylamide) and a reactive functional group (primary amine). Dextran was activated with 4-nitrophenyl-chloroformate (24 mol per polysaccharide, 9.8 mol per 100 glucose residues); 9.8% glucose residues were converted to aliphatic carbonates and 5.2% were converted to cyclic carbonates. The activated dextran was coupled with trityldiaminoethane (8 mol per 100 glucose residues), reactivated with 4-nitrophenylchloroformate, then coupled with acryloamidodiaminohexane (6.8 mol per 100 glucose residues). The trityl group was removed by hydrolysis with trifluoroacetic acid to yield the required aminated acryloamidodextran. The modified dextran was shown to be polymerizable by inverse emulsion polymerization. Submicron particles were successfully prepared, containing functional amine groups suitable for preparing drug conjugates or for modifying the surface properties of this biomaterial.