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

We determined the frequency of acute complications associated with insulin pump therapy in 161 insulin-dependent patients followed up for a total of 2,978 patient-months. Diabetes control improved substantively with pump therapy, but 42% of the patients experienced one or more acute complications while using insulin pumps. Infected infusion sites, ketoacidosis, and hypoglycemic coma occurred once in every 27, 78, and 175 patient-months, respectively. More patients experienced ketoacidosis after the onset of pump therapy than in an equivalent interval immediately before the onset of pump therapy. Ketoacidosis also occurred in more patients using pump therapy than in a comparison group of 165 patients receiving conventional insulin injections surveyed during an equivalent period. The frequency of hypoglycemic coma was not significantly changed by pump therapy.
JAMA 1984 Dec 21
PMID:Acute complications associated with insulin infusion pump therapy. Report of experience with 161 patients. 643 96

Effects of chronic cigarette smoking on cerebral blood flow were investigated by measuring gray matter blood flow (Fg) using xenon 133 inhalation among 192 volunteers without cerebrovascular symptoms. There were 108 normal, healthy volunteers; 84 had risk factors for stroke (hypertension, hyperlipidemia, diabetes mellitus, and/or heart disease). Of both risk and nonrisk groups, 75 were habitual smokers (0.5 to 3.5 packs per day for 25 years). Comparisons of mean Fg values for both hemispheres showed significant reductions related to tobacco consumption and risk factors for stroke. Multiple-regression equations using smoking, age, risk, and alcohol consumption indicated a combined R2 value of 0.22. Smoking seems to be a potent risk factor decreasing cerebral blood flow probably by enhancing cerebral arteriosclerosis. Chronic cigarette smoking in persons with other risk factors further reduced Fg values in an additive manner when compared with subjects who had corresponding risk factors who did not smoke.
JAMA 1983 Nov 25
PMID:Cigarette smoking decreases cerebral blood flow suggesting increased risk for stroke. 664 57

Risk factors for first nonfatal myocardial infarction (MI) in women younger than age 50 years were evaluated in a case-control study of 255 women with MI and 802 controls. The relative risk of MI increased with the amount smoked. The estimated risk of MI for current smokers of 35 or more cigarettes per day was ten times that of women who never smoked; an estimated 65% of MIs were attributable to cigarette smoking. The relative risk of MI increased markedly with increasing levels of total plasma cholesterol and decreasing levels of high-density lipoproteins, and the effects of the two factors appeared to be independent. Other factors significantly associated with MI were hypertension, angina pectoris, diabetes mellitus, blood group A, and a history of MI or stroke before age 60 years in a mother or sibling. Factors not significantly associated with MI were obesity, history of preeclamptic toxemia, and type A personality. Women who were postmenopausal appeared to have a lower risk of MI than premenopausal women of similar ages. Of the identified risk factors, the most prominent was cigarette smoking, a habit that is amenable to change.
JAMA 1983 Nov 25
PMID:Myocardial infarction in women under 50 years of age. 664 58

The provision of ophthalmologic care to diabetic patients was examined in a large, geographically defined population-based study in southern Wisconsin. Of the total of 2,272 patients examined, 902 were taking insulin and were diagnosed before 30 years of age (younger onset) and 1,370 were diagnosed at or after 30 years of age (older onset). Approximately 26% of the younger-onset and 36% of the older-onset diabetic population had never had an ophthalmologic examination. Characteristics of the younger-onset and older-onset population associated with never having had an ophthalmologic examination included living in a nonmetropolitan county, being older at the time of diagnosis, having a shorter duration of diabetes, having fewer years of education, receiving their diabetes care from a family or general practitioner, and having better visual acuity. Eleven percent of younger- and 7% of older-onset persons with Diabetic Retinopathy Study high-risk characteristics for severe visual loss had never been seen or were seen more than two years before the time of the study. Because severe visual loss caused by proliferative diabetic retinopathy may be reduced by timely photocoagulation treatment, this study suggests that a large number of patients who would benefit from ophthalmologic care are currently not receiving it.
JAMA 1984 May 18
PMID:Ophthalmologic care for persons with diabetes. 671 81

To determine whether immunization against pneumococcal pneumonia could be justified on the basis of a favorable benefit to cost ratio, we evaluated the projected impact of a program of pneumococcal vaccination on the population of a health maintenance organization. Retrospective data on average provider and patient costs associated with episodes of pneumococcal pneumonia were coupled with forecasts of the likely effectiveness of currently available vaccine and its impact on anticipated incidence of pneumonia. We found that when provider-centered and patient-centered costs and benefits were added, a program of immunizing those traditionally considered to be at high risk of contracting pneumococcal pneumonia (50 years of age and older; patients with chronic diseases of the heart, liver, lungs, or kidneys; and those with diabetes mellitus) was justified on a cost-benefit basis.
JAMA 1981 Feb 06
PMID:A cost-benefit analysis of immunization for pneumococcal pneumonia. 677 17

A 17-year-old boy with hemophilia A and strong inhibitors for factor VIII suffered a myocardial infarction on the sixth day of treatment with large amounts of human factor IX complex (Konyne). The patient also had had diabetes for one year, for which he was receiving insulin injections, but there was no evidence of vascular disease. Thromboembolic complications that occur after the administration of factor IX concentrates have been reported in patients with hemophilia B or liver disease, but these complications are extremely rare in patients with classic hemophilia.
JAMA 1981 Apr 10
PMID:Myocardial infarction after factor IX therapy. 678 56

One thousand one hundred eighty men in a medical outpatient clinic were screened as to the presence of impotence. Four hundred one men (34%) were impotent, and of those, 188 (47%) chose to be examined for their problem. After a comprehensive evaluation the following diagnoses were obtained: medication effect, 25%; psychogenic, 14%; neurological, 7%; urologic, 6%; primary hypogonadism, 10%; secondary hypogonadism, 9%; diabetes mellitus, 9%; hypothyroidism, 5%; hyperthyroidism, 1%; hyperprolactinemia, 4%; miscellaneous, 4%; and unknown causes, 7%. The mean age of the impotent patients was 59.4 years, and the prevalence of alcoholism was 7%. Luteinizing hormone, follicle-stimulating hormone, testosterone, thyroxine, triiodothyronine (T3), T3 resin uptake, and prolactin studies were necessary to diagnose individual cases. We conclude that erectile dysfunction is a common and often overlooked problem in middle-aged men followed in a medical clinic.
JAMA 1983 Apr 01
PMID:Impotence in medical clinic outpatients. 682 62

The clinical and radiological features of pneumococcal pneumonia were studied in 94 hospitalized patients. Fifty-seven (61%) had a bronchopneumonic pattern on roentgenogram, and 37 (39%), a lobar pattern. Eighty-two (87%) of the patients in both roentgenographic classifications had one or more underlying disease states. There was no difference in the frequency of heart disease, diabetes, chronic pulmonary disease, or malignancy between the two categories. Sputum Gram's stains were also similar in both patterns. Twenty (54%) of the 37 patients with the lobar pattern were bacteremic compared with only five (9%) of the 57 patients with the bronchopneumonic pattern; all five patients with bronchopneumonia and bacteremia had an associated malignancy. Although a lobar pattern is usually emphasized in the diagnosis of pneumococcal pneumonia, this study showed that the majority of patients hospitalized with pneumococcal pneumonia had a roentgenographic bronchopneumonic pattern rather than the classic lobar pattern. Thus, patients with the bronchopneumonic pneumococcal pneumonia pattern may be underdiagnosed. The implications are important both for treatment and for epidemiologic data used in the selection of pneumococcal types for prophylactic vaccines.
JAMA 1983 Jan 14
PMID:Pneumococcal pneumonia in hospitalized patients. Clinical and radiological presentations. 684 6

The controversial conclusions of University Group Diabetes Program (UGDP) investigators are refuted by new findings uncovered by analyses of patient data obtained from the UGDP Coordinating Center and by critical review of data previously published by UGDP investigators and the Biometric Committee. These new findings (1) document a notable discrepancy in the sex ratio of cardiovascular (CV) death rates in placebo-treated subjects, (2) show that all excess CV mortality in tolbutamide-treated subjects was restricted to a relatively small group of poorly controlled diabetics, and (3) provide evidence that insulin was efficacious in reducing CV deaths. The anomalous sex ratio of CV deaths in UGDP placebo-treated subjects dictates the conclusion that the CV death rate in placebo-treated subjects was spuriously low, giving the false impression of increased death rates in the other treatment groups, thereby accounting for all of the controversial observations reported by UGDP investigators. For this reason UGDP conclusions based on comparison with placebo-treated subjects should not be extrapolated to the general diabetic population.
JAMA 1980 Feb 01
PMID:The Achilles heel of the University Group Diabetes Program. 698 89

Between July 1971 and March 1977, steroid-induced diabetes (SD) developed postoperatively in 31 (10.8%) of 286 nondiabetic adult kidney transplant recipients who were observed for a total of 410 patient transplant years. There was a highly significant association between HLA-A28 and SD. There was no significant association between SD and BB or Bw 15. Age was also associated with SD. However, A28 was associated with SD even when corrected for age. A28 occurred more frequently in blacks than whites, 25.4% and 6.3%, respectively, and accounted for the higher incidence of SD in black adults. There were no significant associations between SD and patients' sex, donor source, number of short-term rejection treatments, or maintenance dose of corticosteroids. Steroid-induced diabetes had no adverse effects on graft or patient survival.
JAMA 1980 Feb 08
PMID:HLA-A28 and steroid-induced diabetes in renal transplant patients. 698 91


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