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

Diabetes mellitus and bilateral optic atrophy are the defining characteristics of the autosomal recessive Wolfram syndrome. Diabetes insipidus, neurogenic bladder, deafness, and other neurological manifestations are frequent. A review was made of the medical records of 68 Wolfram syndrome patients, aged between 8 and 43 years, identified by casefinding throughout the USA. 41 of the patients (60%) had episodes of severe depression, psychosis, or organic brain syndrome, as well as impulsive verbal and physical aggression. These symptoms were very severe in 17 patients (25%), of whom 12 required admission to a psychiatric hospital and 11 attempted suicide. We conclude that the Wolfram syndrome gene predisposes homozygotes to psychiatric illness.
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PMID:Psychiatric findings in Wolfram syndrome homozygotes. 197 60

The biological validation of islet grafts would free total pancreas resection from the onus of severe diabetes mellitus. Islet cell transplants can reverse diabetes mellitus and prevent complications in animal models. Immune rejection has foiled attempts at human transplantation despite moderate success with whole pancreas grafts. Aggressive rejection of islet grafts has been extensively studied in animal models and seems no different in substance from standard cell-mediated rejection but vastly different in tenacity. Rejection cannot be prevented by immunosuppression strategies effective for transplantation of heart, kidney, or liver. New strategies to circumvent islet rejection include encapsulation of the islets to obfuscate immune recognition, pretreatment of the islets in vitro to reduce immunogenicity, donor manipulation to provide specific tolerance, and combination strategies. In the development of these strategies, much has been learned or confirmed about the nature of immune rejection, and another round of human trials can be anticipated.
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PMID:Update on pancreatic islet cell transplantation. 210 70

The relationship between the two granulomatous diseases sarcoidosis and tuberculosis is reviewed. Data from 14 published case series are presented in the form of a figure which indicates that case series collected earlier in time and with a high proportion of non-white patients show a higher prevalence of tuberculosis. This high prevalence was also found in other chronic diseases such as diabetes and rheumatoid arthritis. The more frequent presence of mycobacteria in sarcoid than in control tissue, the parallel changes in the prevalence of sarcoidosis and tuberculosis in a community and the presence of myocbacteria on culture if pursued with sufficient aggression, are consistant with a mycobacterial aetiology. Recent developments in the immunology of the two diseases are reviewed.
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PMID:What's in a relationship? Sarcoidosis and tuberculosis. 220 99

Glucagonomas, considered among the rarest of the islet cell neoplasms, produce a well-defined clinical syndrome characterized by necrolytic migratory erythema, diabetes mellitus, glossitis, anemia, and weight loss. This report describes seven patients with glucagonoma treated at our institution. All seven had the characteristic dermatologic manifestations, present from 1 to 6 years prior to diagnosis. Five patients had extensive disease at the time of initial operation, three of whom underwent aggressive cytoreductive surgery, whereas the other two had biopsy only. The remaining two patients presented with a single nodule each, underwent distal pancreatectomy and splenectomy, and remain free of disease 2 and 6 years postoperatively. Earlier recognition of the distinctive physical findings peculiar to this syndrome should increase survival. Aggressive cytoreductive surgery results in prolonged remission.
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PMID:Glucagonoma syndrome is an underdiagnosed clinical entity. 225 25

Allograft coronary artery disease (CAD) is the major determinant of long-term survival following heart transplantation (HTx). In a group of 210 heart transplant recipients, we diagnosed CAD in 54 (27.1%) by coronary angiography, postmortem examination or examination of the transplanted heart at the time of retransplantation. Retrospective analysis of potential risk factors for the development of CAD was performed for both immunological (rejection pattern, immunosuppressive therapy, cytomegalovirus [CMV] infection), and nonimmunological (hyperlipidemia, smoking, hypertension, diabetes mellitus, obesity) risk factors. The total number of rejection episodes correlated significantly with the occurrence of CAD (P less than 0.05), showing that patients who experienced two or more rejection episodes had an incidence of CAD of 40%, as opposed to a 23% incidence in patients who experienced no rejection. A composite rejection score derived from multivariate regression analysis of the severity, frequency, and timing of acute cardiac rejection episodes was found to correlate with the development of CAD (P less than 0.05). Postoperative arterial hypertension also correlated significantly with the onset of CAD (P less than 0.01), with a 92.6% incidence of hypertension in the group with CAD versus 76.3% in the group without CAD. Smoking after transplantation correlated significantly with the occurrence of CAD (P less than 0.05). There was no significant correlation with other analyzed factors in this group of patients. In this review, the development of CAD after heart transplantation correlated with treated allograft rejection. Aggressive treatment of hypertension and cessation of smoking may contribute to alleviation of this serious complication.
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PMID:Risk factors for development of accelerated coronary artery disease in cardiac transplant recipients. 236 Oct 19

Empathy, emotional responsiveness, depression, aggression, and self-concept in 80 chronically ill and 40 well school-age children (9-11 years) were examined in a quasi-experimental study. The ill children had either diabetes or asthma. Results suggested a similarity of emotional functioning for empathy, emotional responsiveness, and depression in the ill children. The ill children had significantly higher levels of these behaviors than the well children. The groups of ill children did not significantly differ from each other in these areas. The diabetic and asthmatic children significantly differed in aggression and self-concept. The diabetic children, however, did not differ from the well children in self-concept. The asthmatic children had the lowest self-reported aggression while the diabetic children had the highest. Neither ill group differed from the well children in aggression.
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PMID:Emotional behaviors in chronically ill children. 260 57

Hypertension is more common in persons with both insulin-dependent and noninsulin-dependent diabetes. Pathophysiologic mechanisms that result in an increased prevalence of essential hypertension in noninsulin-dependent diabetes, premature diastolic hypertension in insulin-dependent diabetes, and systolic hypertension in both forms of diabetes are described. Aggressive treatment of the hypertension associated with diabetic nephropathy will result in a deceleration of renal decompensation. The commonly used antihypertensives that successfully treat hypertension in the non-diabetic population often have unacceptable side effects in the diabetic population. Rational approaches to the treatment of diabetic hypertension in general and in circumstances unique to the hypertensive diabetic individual are described.
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PMID:Hypertension in the person with diabetes. 265 May 43

Experimental results and therapeutic strategies. Insulin-dependent diabetes mellitus (IDDM) results from an autoimmune aggression toward beta cells in genetically predisposed individuals. Examination of the frequency of the different antigens coded by the major histocompatibility complex reveals an increased proportion of DR3-DQ2 and DR4-DQ8 haplotypes in IDDM subjects. Sequencing DQ-beta chains in such patients indicates the absence of aspartate in position 57 when compared to control individuals. Islet cell cytoplasmic autoantibodies are early markers of ongoing autoimmunity in addition to insulin autoantibodies before administration of exogenous insulin. Experimental models of autoimmune diabetes like the NOD (NonObese Diabetes) mouse underline the predominant role of T lymphocytes in the constitution of both insulitis and beta cell destruction. In humans, an increased proportion of activated T lymphocytes can be observed but is not specific of the disease. This underlines the need for new cellular markers of the autoimmune process. Transgenic mice allow studies on the consequences of abnormal expression of new molecules on beta cell surface like cytokines or MHC class II molecules which represent a new field of investigation on the pathogenesis of IDDM. Prospective studies in first degree relatives of type I diabetic patients indicate the existence of an asymptomatic phase of beta cell destruction where specific autoimmune markers can be individualized. In some individuals abnormal insulin response to glucose--loss of first phase insulin release during intravenous glucose tolerance test--precedes insulin deficiency. The identification of an autoimmune process leading to beta cell destruction allows new therapeutic approaches with immunointervention at early stages of the disease.
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PMID:[Autoimmunity and insulin-dependent diabetes mellitus. Experimental data and therapeutic prospects]. 267 68

The metabolic-endocrine state of diabetes mellitus affects the brain and behavior of diabetic animals. Feeding, paradoxical sleep, analgesia, submissive behavior, and avoidance behavior, are generally increased in diabetic compared with nondiabetic rodents. In contrast, sexual behavior, aggressive behavior and sensitivity to the behavioral effects of amphetamine are decreased in diabetic rodents. This review examines behavioral changes in diabetes mellitus within the context of known disease-linked alterations in hypothalamo-pituitary relationships and brain monoamine metabolism.
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PMID:The psychoneuroendocrinology of diabetes mellitus in rodents. 268 24

The following types of carbohydrate intolerance are discussed as a risk in infusion therapy: Hereditary fructose intolerance, fructose-1,6-biphosphatase deficiency, impairment of glucose utilization during the post-aggression syndrome and/or in latent or overt diabetes mellitus. Asking about symptoms of fructose intolerance has to be part of every routine anamnesis. Application of any kind of carbohydrate requires differential therapeutic considerations. Undiscovered fructose intolerance is more likely the younger the patient is, whereas the frequency of glucose intolerance increases with age. In unconscious patients without anamnesis, fructose or sorbitol should not be applied. Never should an attempt be made to compensate falling blood glucose levels under infusion therapy by application of fructose or sorbitol. As carbohydrate addition to routine fluid and electrolyte substitution xylitol in the specified low dosage is without risk in a diabetes-like metabolic condition as well as in fructose intolerance.
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PMID:[Carbohydrate intolerance as a danger in infusion therapy]. 311 5


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