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

The pain of diabetic peripheral neuropathy responds poorly to current modes of treatment. We treated eight patients with this disorder whose pain was refractory to standard regimens but who experienced remarkable pain relief within two to five days after treatment with fluphenazine hydrochloride, amitriptyline hydrochloride, or a combination of the two. In four patients whose regimens were discontinued, pain recurred within two days and again remitted on reinstitution of the drug regimens. These findings suggest that fluphenazine alone or in combination with amitriptyline may be of benefit in treating the painful peripheral neuropathy associated with diabetes.
JAMA 1977 Nov 21
PMID:Peripheral diabetic neuropathy treated with amitriptyline and fluphenazine. 19 54

Ketotic, insulin-requiring diabetes mellitus and a severe peripheral neuropathy developed in a previously healthy 25-year-old man several days after he attempted suicide with rat poison containing N-3-pyridylmethyl N'-p-nitrophenyl urea. Study of islet-cell function ten months after ingestion showed a reduced disappearance rate of intravenous glucose and depressed C-peptide response to intravenous glucose when compared with a normal control but no impairment of glucagon release after intravenous arginine stimulation. Nerve conduction studies demonstrated severe sensory and mild motor neuropathy. Quadriceps capillary basement membrane thickness was in the diabetic range. Because at least 15 similar occurrences have been reported to the manufacturer, this agent appears to be diabetogenic in man, probably causing beta-cell destruction. Niacinamide, which can prevent glucose intolerance in both streptozocin- and alloxan-treated animals and prevents death in rats given this rodenticide, may be a useful antidote.
JAMA 1978 Mar 20
PMID:Diabetes mellitus following rodenticide ingestion in man. 20 29

Forty patients (including 37 juvenile diabetic patients) with insulin-dependent diabetes mellitus and end-stage renal failure received 42 renal allografts during the interval from June 1970 to December 1975. Of the 30 patients who are alive (between six and 72 months after transplantation; average, 29 months), 19 have been fully rehabilitated. Gangrene of peripheral extremities occurred in 30% of the survivors. The use of "pretreated" cadaveric kidneys in the diabetic patient may become an attractive alternative to grafts from living related donors. Renal transplantation with living related and pretreated cadaveric donor kidneys is the treatment of choice and is superior to dialysis in the insulin-dependent diabetic patient with end-stage renal disease.
JAMA 1977 Mar 14
PMID:Renal transplantation in patients with insulin-dependent diabetes mellitus. 32 Mar 53

The prevalence of urinary tract infection was determined in 333 patients attending a diabetes mellitus outpatient clinic during a one-year period. A total of 19% of the women and 2% of the men were found to have urinary tract infections. Antibody-coated bacteria, indicating parenchymal infection, were initially present in 43% of patients and rose to 79% within a mean pretreatment period of seven weeks. In those with recurrent infection following treatment, there were more reinfections than relapses, both in those with kidney infections (67%) and those with bladder infections (57%). The high prevalence of urinary tract infection among diabetic women and the evidence of rapid parenchymal involvement emphasizes the need for clinical awareness of the problem and clarification of its consequences.
JAMA 1977 Oct 31
PMID:Urinary tract infections in patients with diabetes mellitus. Studies on antibody coating of bacteria. 33 37

The University Group Diabetes Program is a long-term prospective clinical trial designed to evaluate the effects of various hypoglycemic agents on vascular complications in patients with asymptomatic adult-onset diabetes. Mortality and blood glucose levels were determined as well as certain nonfatal events for patients assigned to diet alone or to either of two insulin treatment regimens. Lower levels of blood glucose with mean values close to normoglycemia were achieved in the treatment group in which the insulin dosage was adjusted to achieve normoglycemia compared with the levels achieved in patients treated with diet alone or with a fixed dose of insulin. In spite of differences in blood glucose levels among the treatment groups, there were only minor differences in the occurrence of fatal or nonfatal events.
JAMA 1978 Jul 07
PMID:Effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes. VII. Mortality and selected nonfatal events with insulin treatment. 35 Dec 18

Based on 20 years of surveillance of the Framingham cohort relating subsequent cardiovascular events to prior evidence of diabetes, a twofold to threefold increased risk of clinical atherosclerotic disease was reported. The relative impact was greatest for intermittent claudication (IC) and congestive heart failure (CHF) and least for coronary heart disease (CHD), which was, nevertheless, on an absolute scale the chief sequela. The relative impact was substantially greater for women than for men. For each of the cardiovascular diseases (CVD), morbidity and mortality were higher for diabetic women than for nondiabetic men. After adjustment for other associated risk factors, the relative impact of diabetes on CHD, IC, or stroke incidence was the same for women as for men; for CVD death and CHF, it was greater for women. Cardiovascular mortality was actually about as great for diabetic women as for diabetic men.
JAMA 1979 May 11
PMID:Diabetes and cardiovascular disease. The Framingham study. 43 Jul 98

1496 women age 55 to 74 were studied in an effort to determine heart disease risk factor differences attributed to postmenopausal estrogen (PME) use. 39% of the females reported using estrogen at the time of the study, with peak hormone use in the 55 to 59 year age group. Analysis of the following possible confounding variables, social class, current cigarette smoking, family history of heart attack or diabetes and obesity found that only obesity was statistically significant ( P .001) and thus further analysis of PME use was adjusted for obesity. Results showed average cholesterol level was 9.4 to 20.4 mg/dL lower among PME users compared to nonusers. Although triglyceride level was higher in PME users at all ages it was only statistically significant for women aged 60-69 years. Mean systolic and diastolic blood pressures were 2 to 4 mm Hg lower in PME users and the average fasting plasma glucose level was significantly lower in young PME users only. Multivariate Hotellings T statistic was used to test for independence. While the study examined the net cumulative effect of PME use of putative heart disease, it did not examine specific estrogens, dosage or duration of use differences. The authors concluded that further studies are needed before final conclusions can be made regarding the use of PME as a risk factor reducer in heart disease.
JAMA 1979 May 18
PMID:Heart disease risk factors and hormone use in postmenopausal women. 43 Aug 17

A new polyvalent pneumococcal vaccine (Pneumovax) was released in February 1978. In an effort to chronicle the dissemination of the vaccine to high-risk patients, we prospectively followed up a single clinic population and conducted a telephone survey of three neighborhood health centers, two private practices, and a university hematology clinic. Three months after notification of the vaccine arrival, physicians in the prospectively chronicled clinic had immunized six of 12 patients with sickle cell disease, five of 80 patients with chronic obstructive pulmonary disease, three of 225 patients with diabetes, and three of 45 patients older than 80 years. Immunization policy in the other clinics surveyed varied greatly. As an attempt to curb low-prevalence, high-severity illness in a small target population, the pneumococcal vaccine presents a new set of problems in the systematic implementation of an immunization.
JAMA 1979 May 25
PMID:The pneumococcal vaccine. Immunization at a crossroad. 43 96

We analyzed the relationship between the pharmacogenetics of tolbutamide metabolism and the controversial University Group Diabetes Program (UGDP) study. Before the institution of that study, the extent of genetic control over the variation in the rate of tolbutamide metabolism was unknown, and all subjects included in the tolbutamide treatment group were given 1,500 mg/day of tolbutamide in a fixed dosage. We addressed the hypothesis that high accrued blood levels of tolbutamide in genetically predisposed slow inactivators might have contributed to the toxic effects reported by the UGDP study. This proposal is based on recent findings from population, twin, and family studies that tolbutamide metabolism is under monogenic control, with nearly one fourth of the population classified as slow inactivators.
JAMA 1979 Jul 06
PMID:Tolbutamide pharmacogenetics and the UGDP controversy. 44 64

Although human need for various nutrients is well-established, the exact requirements for the different nutrients are not well-known. Nutrient requirements are affected by genetics; environment; nature of the diet; and hemeostatic demands under changing physiological conditions expressed as growth, reproduction and response to the stress of injury or disease. Pregnant and lactating women should be properly nourished if well-nourished infants are desired. Nutrient and energy needs are considerably increased during pregnancy and lactation. The most rapid growth of infants occurs during the 1st 4 to 6 months of life. Because of the many advantages of breast milk over artificial milk, full-term newborn infants should be breastfed, unless there are specific contraindications or breastfeeding is unsuccessful. The American Medical Association (AMA) urges that better efforts be made to educate the public and the medical profession as to the advantages of breastfeeding. The 4th to the 6th months of life constitute the transitional period in infant feeding. The baby should be introduced to single-ingredient foods in small quantities, one at a time, to isolate food sensitivities. Good eating habits can be formed early in life through the proper and gradual introduction of varied and nutritional meal patterns. Energy balance is a nutritional problem in late childhood and once maturity is achieved, while calorically and nutritionally inadequate diets are a growing concern for the elderly. Immoderate eating habits (e.g., overeating) may aggravate or contribute to the development of degenerative diseases and should be discouraged. The AMA recommends that the American public focus on the achievement and maintenance of the most desirable body weight through a proper combination of dietary control and exercise. Specific dietary modifications (sodium restriction, weight control) are necessary in the management of hypertension, diabetes, coronary heart diseases and other medical problems. The medical profession should assume a more active role in teaching people how to achieve and maintain good health habits through behavioral modification.
JAMA 1979 Nov 23
PMID:American Medical Association concepts of nutrition and health. Council on Scientific Affairs. 49 Aug 37


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