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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of the long-acting calcium channel blocking agent, nisoldipine, on silent myocardial ischaemia due to occult atherosclerotic coronary arterial disease has been evaluated in 12 asymptomatic patients (seven diabetics and five claudicants), none of whom had any history suggestive of ischaemic chest pain or previous myocardial infarction. All patients had normal resting electrocardiograms but positive exercise testing using 16-lead electrocardiographic mapping of the chest wall. They also had silent episodes of ST-segment depression during 24-hour ambulatory (Holter) monitoring. The study was of double-blind, cross-over design with four weeks randomised nisoldipine 10 mg twice daily versus placebo twice daily. Both the exercise test and Holter monitoring were carried out before entry to the trial and at the end of each randomised active and placebo phase. Plasma fibrinogen was also estimated at entry to the trial and at the end of each randomised phase. There were significant reductions in the magnitude (P less than 0.001) and duration (P less than 0.001) of depression of the ST segment on exercise testing and in the number of episodes (P less than 0.01), magnitude (P less than 0.001) and duration (P less than 0.02) of ST-segment depression on Holter monitoring at the end of the nisoldipine phase as compared to the randomised placebo phase. A significant reduction in plasma fibrinogen was also noted at the end of the nisoldipine phase (P less than 0.001). This study demonstrates the efficacy and usefulness of nisoldipine in treating myocardial ischaemia due to occult coronary arterial disease in asymptomatic subjects presenting with diabetes mellitus or intermittent claudication. Its use was associated with reduction in plasma fibrinogen.
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PMID:Improvement of silent myocardial ischaemia and reduction of plasma fibrinogen during nisoldipine therapy in occult coronary arterial disease. 207 Dec 52

Erythrocyte aggregation is one of the principal determinants of blood viscosity at low shear rates (low flow). Anatomical and hemodynamical characteristics make retinal venous circulation particularly dependent on hemorheological factors. Erythrocyte aggregation and other laboratory parameters (haematocrit, fibrinogen, plasma proteins, clotting) were measured in 85 patients presenting with retinal vein occlusion and 64 controls matched for age, sex and vascular risk factors (hypertension, diabetes, smoking). Statistical analysis of the results demonstrated a significant difference between the retinal vein occlusion group an the control group for erythrocyte aggregation (p less than 0.001 for the aggregation index at 10 sec and for the threshold of dissociation). The fibrinogen level, haematocrit and plasma proteins (albumin, IgA, IgG, IgM, total proteins, 2-macroglobulin) were similar in the two groups. No statistically significant difference for erythrocyte aggregation was observed between occlusions of the venous branch and occlusions of the central retinal vein or between ischaemic and non-ischaemic forms. These results suggest that raised erythrocyte aggregation mainly explains the increase in blood viscosity previously demonstrated, and could play a role in the constitution of retinal vein occlusion.
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PMID:[Increase of erythrocyte aggregation in retinal vein occlusion]. 208 40

Diabetes is associated with altered blood viscosity and abnormal tissue oxygenation. Transcutaneous oxygen tension is measured in 119 diabetic and 20 normal subjects. Measurements of transcutaneous oxygen pressure (TcPO2) are made by Oxymonitor SM 361 at 45 degrees C at the dorsum of the foot. At the same time, the main microrheological parameters (plasma viscosity, albumin, fibrinogen, red cell aggregation times, disaggregation threshold and red cell aggregate structure index) are measured in diabetic patients with good and poor glycemic control, with and without angiopathy. All the diabetics have a significant reduction of TcPO2 and have rheological disturbances. TcPO2 values are related significantly with plasma viscosity and with several parameters of aggregation-disaggregation phenomenon. As for microrheological parameter abnormalities, it seems that tissue hypoxia precedes clinical signs of angiopathy and depends on the metabolic state as rheological abnormalities. TcPO2 values are the result of numerous parameters as rheological parameters. It seems that TcPO2 measurement is able to provide useful informations about microcirculation in diabetes mellitus without clinical signs of tissue hypoxia.
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PMID:Transcutaneous oxygen pressure and hemorheology in diabetes mellitus. 209 59

The incidence of myocardial infarction is higher in women that use oral contraceptives. The most important pathophysiologic mechanisms are: a) modification of coronary risk factors: the pill produces an elevation of both serum cholesterol and trygliceride levels, increase of blood pressure and decompensation of diabetes mellitus; b) blood coagulation disorders: oral contraceptives increase platelet aggregation and fibrinogen blood levels, therefore they have a considerable thrombogenic capacity. At this moment there are several update publications concerning this matter; however most of the mechanisms involved in the increase of coronary heart disease in this specific group still remain unclear.
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PMID:[Contraceptives and ischemic cardiopathy]. 210 93

Various parameters of coagulation and fibrinolysis were measured in 13 men (aged 54 +/- 3 yr) with non-insulin-dependent diabetes mellitus (NIDDM) before and after 12-14 wk of exercise training. Subjects exercised for 30 min 3 times/wk at 70% of maximum O2 consumption (VO2max). Training increased VO2max by 12.5% but did not alter body weight, relative body fat, blood pressure, cholesterol, triglycerides, or high-density lipoprotein cholesterol. Slight downward trends were apparent for fasting glucose and insulin, but glycosylated hemoglobin was unchanged. There were no changes in coagulation parameters of plasminogen, hematocrit, or alpha 2-antiplasmin. Plasma fibrinogen (303 +/- 24.2 vs. 256 +/- 12.3 mg/dl) and fibronectin (380 +/- 41.9 vs. 301 +/- 22.2 micrograms/ml) were significantly reduced (P less than 0.02) by exercise conditioning. Three assays of fibrinolytic activity (tissue plasminogen activator, euglobulin lysis time, and an isotopic measure of fibrinolysis) confirmed that neither basal fibrinolysis nor the fibrinolytic responses to venous occlusion and maximal exercise were significantly altered. Exercise conditioning may have antithrombotic effects in NIDDM by reducing plasma fibrinogen and fibronectin. Although the significance of the fall in fibronectin awaits further studies, the reduction in plasma fibrinogen gives a rationale for the use of exercise training in men with NIDDM.
Diabetes Care 1990 Feb
PMID:Hemostatic alterations with exercise conditioning in NIDDM. 211 52

Parameters of fibrinolysis, including plasminogen, alpha 2 plasmin-inhibitor (alpha 2 PI), tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) antigens, and fibrinogen were assayed in 53 patients (28 women and 27 men; mean age: 64 years, age range: 32-87 years) with non-insulin-dependent diabetes mellitus (NIDDM). The control group was similarly aged (mean age: 60.4 years, age range: 38-81). The levels of t-PA and t-PA/PAI-1 ratio of the diabetic group (mean +/- SD; 9.8 +/- 4.3 ng/ml, 0.94 +/- 0.47, respectively) were significantly higher than that of the control group (5.5 +/- 2.5 ng/ml, 0.51 +/- 0.23, respectively). The increased levels of t-PA antigen and t-PA/PAI-1 ratio in diabetics mean that free t-PA has been released. However, there was no significant difference in the level of PAI-1 between the diabetic group (12.9 +/- 6.4 ng/ml) and the control group (12.1 +/- 5.6 ng/ml). Levels of fibrinogen, plasminogen and alpha 2 PI in plasma were not different in the two groups. Duration of the disease, levels of glycosylated hemoglobin, differences in treatment and presense of diabetic nephropathy or retinopathy did not affect the fibrinolytic parameters. The levels of fibrinogen was higher in those with nephropathy than in the diabetics without nephropathy and retinopathy (p less than 0.05). There were no significant differences in the levels of t-PA, t-PA/PAI-1 ratio and PAI-1 between younger (less than 65 years) and older (65 years or more) subjects, in either the control or diabetic groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Tissue-type plasminogen activator and its inhibitor (PAI-1) in plasma in cases of non-insulin-dependent diabetes mellitus (NIDDM)]. 212 12

A double-blind placebo-controlled prospective trial assessed the effect of a slow release formulation of bezafibrate (Bezalip Mono) on lipids, glucose homeostasis, platelet function and plasma fibrinogen in non-insulin dependent (type II) diabetics. Twenty-four patients completed the trial. There was a significant improvement in the cholesterol and triglyceride levels and in the fasting blood glucose and glycated haemoglobin levels of those who received the active preparation but not in those who received placebo. Treatment, but not placebo, also resulted in a significant fall in plasma fibrinogen concentration and a trend towards inhibition of platelet aggregation. Bezafibrate was well tolerated and only one patient withdrew from the trial possibly because of side-effects of the drug. A larger study is needed to establish whether bezafibrate can reduce non-lipid risk factors (e.g., plasma fibrinogen concentration; glucose intolerance--hyperinsulinaemia) in normo- and hyperlipidaemic patients.
Diabetes Res 1990 Jul
PMID:The effect of a slow release formulation of bezafibrate on lipids, glucose homeostasis, platelets and fibrinogen in type II diabetics: a pilot study. 213 85

Diabetic cardiomyopathy appears to be due to "premature ageing" of the myocardium which loses some of its compliance and becomes less sensitive to catecholamines. The condition seems to be severe mainly in those frequent cases where it is associated with hypertensive and/or ischaemic cardiomyopathy. Neuropathic denervation of the heart, usually partial and predominantly affecting the parasympathetic system, might play a part in the myocardial dysfunction. It has been held responsible for sudden death, but its real consequences in diabetic patients remain to be assessed. Coronary artery disease is the most common cardiac complication of diabetes mellitus: it accounts for 50 per cent of deaths among noninsulin-dependent, and 25 per cent among insulin-dependent diabetic subjects. Its incidence does not seem to decline and its severity, notably in women, is demonstrated by a mortality rate that is twice as high as that observed in the non-diabetic population; hence the importance of primary prevention and treatment of risk factors. However, the specificity to abnormal lipid metabolism, notably hypertriglyceridaemia, the potentiation by chronic hyperglycaemia of the harmful effects of arterial hypertension, and the possible responsibility of coagulation disorders and hyperinsulinism are points that have not yet been elucidated. We still do not know whether the objectives to be attained in terms of plasma cholesterol, triglycerides and fibrinogen levels, as well as of blood pressure values, should be different in diabetic and non-diabetic subjects. In any case, the treatment of risk factors should be accompanied by a systematic search for silent ischaemia which is 2 to 3 times more frequent among diabetic patients. Detection of silent ischaemia by electrocardiography during exercise and/or Holter recordings, and by echocardiography and/or thallium scintigraphy should be performed not only in diabetic patients with coronary artery disease but also to those with other risk factors or albuminuria.
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PMID:[Heart involvement in diabetic patients]. 213 51

Adult male Sprague-Dawley rats with streptozotocin-induced diabetes (6 to 8 wk duration), treated or untreated with insulin, were studied with two aims: (a) to ascertain whether protracted diabetes in the rat is associated with changes in circulating plasma protein levels analogous to those reported in human diabetic patients with clinical evidence of complications; (b) to evaluate the effects of experimental diabetes on the net cumulative biosynthesis of 10 specific plasma proteins by the isolated liver, perfused for 24 hr. Samples of liver donor plasma and samples of perfusate were analyzed by single radial immunodiffusion or by rocket immunoelectrophoresis for albumin, alpha 1-macroglobulin and the acute phase glycoproteins: fibrinogen, alpha 1-acid glycoprotein (Darcy), alpha 1-acid glycoprotein (Kawasaki), haptoglobin, alpha 2-(acute phase) globulin, hemopexin, C3-complement and ceruloplasmin. Diabetes (6 to 8 wk), untreated with insulin, resulted in significantly increased liver donor plasma levels of alpha 1-acid glycoprotein (Darcy) and alpha 1-acid glycoprotein (Kawasaki); plasma levels of hemopexin and of C3 decreased to 75% and 30% of normal, respectively. Insulin treatment of diabetic liver donors for 6 to 8 wk prevented the increase in alpha 1-acid glycoprotein (Darcy) and alpha 1-acid glycoprotein (Kawasaki) and minimized the decrease in C3 to 75% of normal. Perfused livers from untreated diabetic rats (6 to 8 wk) showed slightly decreased cumulative synthesis and secretion of alpha 1-acid glycoprotein (Darcy); however, synthesis of albumin was reduced to 35% of normal and that of eight glycoproteins ranged from 25% of normal (fibrinogen) to 12% of normal (C3). The striking in vitro induction of increased synthesis of acute-phase proteins by cortisol plus insulin in the isolated perfused normal liver was in contrast to the severely attenuated induction in perfused livers of untreated diabetic rats, which ranges from 50% of normal for alpha 1-acid glycoprotein (Darcy) to 5% of normal (C3). Severely negative perfusate nitrogen balance and impaired glucose utilization by perfused untreated diabetic livers contrasted with positive nitrogen balance and good glucose utilization of normal livers in response to insulin plus cortisol. The plasma protein synthetic capacity and the in vitro response to insulin plus cortisol of perfused livers from insulin-treated diabetic rats were normal for seven of the proteins but moderately decreased for albumin, haptoglobin and C3.
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PMID:Effects of streptozotocin diabetes in the rat on blood levels of ten specific plasma proteins and on their net biosynthesis by the isolated perfused liver. 213 29

The major cause of disability and early mortality in Type 2 diabetes is cardiovascular disease. An enhanced urinary albumin excretion is strongly predictive of increased mortality, but the causal relationship behind this association is unclear. Abnormalities in the haemostatic system may be involved in the vascular pathology. We therefore studied the level of von Willebrand factor (vWf:Ag), factor VIII (VIII:Ag), fibrinogen, and fibronectin in male diabetic patients 50-70 years of age, with normal albumin excretion (n = 14), microalbuminuria (n = 14), and frank albuminuria (n = 7). Fourteen healthy age-matched males served as a reference group. There were no significant differences between normo- and micro-albuminuric patients but vWf:Ag (p less than 0.01), VIII:Ag (p less than 0.01), and fibrinogen (p less than 0.05) were increased in those with frank albuminuria. Urinary albumin excretion rate was significantly correlated to vWf:Ag (r = 0.46, p = 0.005), VIII:Ag (r = 0.45, p = 0.007), and fibrinogen (r = 0.49, p = 0.003). The known duration of diabetes was correlated to vWf and F VIII. The increased level of vWf:Ag in Type 2 diabetes and the significant association to the urinary albumin excretion rate may suggest a linkage between albuminuria and cardiovascular disease. However, the present study demonstrated no increase in haemostatic variables in patients with microalbuminuria as compared with those with normal albumin excretion.
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PMID:Haemostatic measures in type 2 diabetic patients with microalbuminuria. 214 55


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