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

The urinary excretion of albumin (a marker of glomerular damage) and retinol binding protein (a low molecular weight protein marker of tubular dysfunction) was determined by sensitive immunochemical methods in 110 insulin-dependent (Type I) diabetic patients. We observed a statistically significant correlation between the urinary excretion levels of both proteins, in particular albumin, and the degree of retinopathy. The incidence of macroalbuminuria and tubular proteinuria was significantly higher in patients with manifest background retinopathy and proliferative retinopathy as compared to patients with no or slight retinopathy. The duration of diabetes was significantly correlated to the degree of retinopathy, but not to the urinary excretion of albumin and retinol binding protein.
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PMID:Diabetic retinopathy related to degree of albuminuria and tubular (low molecular weight) proteinuria in insulin-dependent (type I) diabetes mellitus. 239 1

The life expectancy and quality of life of diabetic patients are largely determined by the long-term complications. Convincing evidence exists to show that the complications are secondary to the altered internal milieu caused by inappropriate insulin action--insulin deficiency in type 1 diabetes and insulin resistance in type 2 diabetes. Genetic factors play only a minor role in the process with the exception of diabetic nephropathy. Of the many metabolic disturbances present in diabetes hyperglycaemia seems to be the most important in this respect. Long-term it has a cumulative effect on the development of background retinopathy in the whole diabetic population and a similar effect on diabetic nephropathy in a genetically predisposed subset. The role of hyperglycaemia in the pathogenesis of macroangiopathy is less clear. Since diabetic microangiopathy is not related to diabetes itself but is secondary to its metabolic consequences, it is--at least in principle--preventable. That this is true has been shown in animal experiments but it has not been proved in human diabetes. There is, however, much evidence suggesting that the incidence of diabetic complications may be diminished when diabetes is well controlled. When the known facts about the rise and fall of the diabetic complications are taken into account the treatment of hyperglycaemia remains as one of the most essential aspects of managing diabetic patients.
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PMID:Why should we treat hyperglycaemia? 239 56

To examine the associations between cigarette smoking, connective tissue changes, and diabetic retinopathy, a detailed smoking history was elicited from 150 normotensive non-diabetic subjects, and from 266 randomly selected adult patients with Type 1 diabetes, after examination for limited joint mobility, Dupuytren's contracture, and diabetic retinopathy. Mean insulin dose and current glycosylated haemoglobin concentrations were comparable in diabetic smokers and non-smokers. The historical duration of smoking correlated with the duration of diabetes (r = 0.72, p less than 0.001). In diabetic patients limited joint mobility was positively associated with retinopathy, being found in 73/147 (50%) patients with retinopathy compared with 20/114 (18%) without retinopathy (chi 2 = 28.9, p less than 0.001), and also with Dupuytren's contracture, 19/34 (56%) of patients with limited joint mobility having Dupuytren's contracture, compared with 76/232 (33%) of patients without Dupuytren's contracture (chi 2 = 7.05, p less than 0.01). Limited joint mobility was observed in 50% of diabetic smokers compared with 25% of non-smokers (odds ratio = 2.87 (corrected for diabetes duration), 95% confidence interval 1.64-5.01). Diabetic retinopathy was weakly associated with smoking (odds ratio 1.09; 95% confidence interval 0.60-1.96). There was however an increased prevalence of background retinopathy among male smokers (50% vs 29%; chi 2 = 6.88, p less than 0.01). In non-diabetic males limited joint mobility was observed in 37% of smokers but only in 11% of non-smokers (NS), while 33% of smokers and 8% of non-smokers had Dupuytren's contracture (p = 0.012). These results suggest that cigarette smoking contributes to the development of extra-articular connective tissue changes in both diabetic patients and non-diabetic subjects, and possibly to the development of diabetic retinopathy.
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PMID:Limited joint mobility, Dupuytren's contracture and retinopathy in type 1 diabetes: association with cigarette smoking. 252 59

All diabetic children (n = 113) under 19 years old and with more than 2 years of diabetes attending the Steno Memorial Hospital in 1987 were studied. Normal urinary albumin excretion (less than 30 mg 24 h-1) was found in 96 patients (85%), 15 had microalbuminuria (30-300 mg 24 h-1) (13%), and 2 patients were proteinuric (greater than 300 mg 24 h-1) (2%). Retinal morphology was evaluated by colour fundus photography. Background retinopathy was more frequent in the group with elevated albumin excretion (71%) than in a matched normoalbuminuric group (20%, 2p less than 0.001). Long-term blood glucose control was assessed from all previous HbA1c measurements in the hospital records, an average of nine per patient. The mean observation period was 48 (3-76) months. Children with elevated albumin excretion had a higher mean HbA1c than children with normal urinary albumin excretion (10.3 +/- 1.9 vs 9.2 +/- 1.3% (+/- SD), 2p less than 0.05). Children with retinopathy had an HbA1c of 9.9 +/- 1.7 vs 9.0 +/- 1.2% in patients without retinopathy (2p less than 0.01).
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PMID:Elevated albumin excretion and retinal changes in children with type 1 diabetes are related to long-term poor blood glucose control. 252 37

216 patients with insulin-dependent diabetes mellitus were studied by retinal photography, and the absence or presence of retinopathy was related to the mean of serial glycosylated haemoglobin measurements (mean HbA1) carried out every 3 months during the previous 6 years. 122 patients had no diabetic retinopathy, 86 had background retinopathy, and 8 proliferative retinopathy. Mean HbA1 levels showed a strong correlation with increasingly severe grades of retinopathy, even when differences in duration of diabetes were taken into account. Proliferative retinopathy was seen only in patients with mean HbA1 above 10%. These results support the view that the development of diabetic retinopathy is related to long-term glycaemic control and emphasise the desirability, and possible benefit, of achieving control as close to normal as is possible for each individual patient.
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PMID:Long-term glycaemic control and diabetic retinopathy. 196 84

The spectrum of diabetic retinopathy, the need for fundus screening and the evaluation of two presumptive screening methods, was investigated in a population based study among patients with type II diabetes. Retinal evaluation was performed in 86.9% of the known diabetic population. Background diabetic retinopathy was detected in 37.8%, pre-proliferative in 1.1% and proliferative retinopathy in 3.8%. Diabetic maculopathy was found in 24.3% of the patients. Laser therapy was considered in 11.4% of the patients due to diabetic retinopathy, and in 14.6% when venous occlusive diseases were included. Two methods, a slit-lamp observation enhanced by a 60D lens and reading from two non-stereo photographs of the posterior pole, were evaluated among 154 patients willing and mentally capable of being examined by either method. The sensitivity of the photographic method was 87/97% (right eye/left eye) when detecting background retinopathy and 81/80% for maculopathy versus 69/61% and 79/63%, respectively, with the slit-lamp method. The photographic method could be applied in 93% of the patients mentally capable of cooperation. Only 5 or 6 patients could be examined per hour with the 60D slit-lamp compared with 30-35 examined by reading retinal photographs. The photographic method is recommended as an easy and reliable screening device for diabetic retinopathy among patients with type II diabetes.
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PMID:Non-stereo fundus photography as a screening procedure for diabetic retinopathy among patients with type II diabetes. Compared with 60D enhanced slit-lamp examination. 258 54

The relationship between insulin-like growth factor I (IGF I) and diabetic retinopathy was investigated. This somatomedin circulates bound to at least two large carrier proteins with molecular weights of approximately 150,000 and 35,000. Total and protein binding profiles of insulin-like growth factor I were determined in the serum of 18 patients who had had Type 1 (insulin-dependent) diabetes for 15-20 years, but had no signs of nephropathy and a similar degree of mild subclinical neuropathy. Nine had preproliferative or proliferative retinopathy and 9 had little or no background retinopathy but there was no difference in diabetes duration, insulin doses or glycaemic control between the two groups. In the latter group, the amounts of the somatomedin I and the serum profiles were similar to those in 9 healthy control subjects. In patients with advanced retinopathy, however, binding of insulin-like growth factor I to the carrier proteins was significantly altered. Binding to the low molecular weight protein increased to 140% whereas binding to the large molecular weight protein decreased to 70% of the normal level. In the latter Type 1 diabetic patients total serum insulin-like growth factor I was decreased to 60% of the normal level (p less than 0.02). When the alteration in serum profile was adjusted for, the level of somatomedin associated with the small carrier complex was normal whereas that associated with the large carrier complex was reduced by almost 60% in Type 1 diabetic patients with retinopathy. It is proposed that the total circulating somatomedin level is low in advanced diabetic retinopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Circulating insulin-like growth factor I in type 1 (insulin-dependent) diabetic patients with retinopathy. 259 43

The prevalence of diabetic retinopathy was assessed by direct and indirect ophthalmoscopy in a group of patients with insulin dependent diabetes mellitus (IDDM). Fourteen percent of patients had retinopathy. Proliferative retinopathy and severe background retinopathy including maculopathy were both seen in four percent of patients. It is possible that the lower prevalence rates for these complications is due to the shorter duration of diabetes in our patients.
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PMID:Retinopathy in insulin dependent diabetes mellitus (IDDM) in south India. 259 27

Aqueous flare intensity was measured with the laser flare-cell meter in 231 eyes of diabetic patients and 31 eyes of normal age-matched controls. Diabetic patients were divided into four groups based on the degree of retinopathy: (1) non-retinopathy, 42 eyes; (2) background retinopathy, 72; (3) preproliferative retinopathy, 23; and (4) proliferative retinopathy, 94. There was no significant difference between the normal controls and the non-retinopathy group, whereas the rest of the diabetic groups showed significantly higher flare values than did normal controls (P less than 0.001). Flare intensity increased with the progression of retinopathy. Our results demonstrate that clinical use of the flare-cell meter enables the quantitative assessment of blood-aqueous barrier function in diabetics and suggest that diabetic iridopathy, as one of the manifestations of diabetes in the anterior part of the eye, exists even in the early stages of this disease and progresses in parallel with retinopathy.
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PMID:Quantitative assessment of aqueous flare intensity in diabetes. 262 7

The presence or absence of retinal detachment, especially detachment of the macula, was the most critical parameter predicting visual outcome, and long duration of detachment worsened the prognosis (P = 0.0084). In contrast, the time interval from vitreous haemorrhage to surgery did not associate with the long-term visual outcome. Pre-operative visual acuity of counting fingers 1 m or better was associated with favourable visual outcome (P = 0.0032). Other pre- or per-operative parameters (e.g. aphakia, iris rubeosis, extent of photocoagulation, retinal breaks) did not associate with visual prognosis significantly. Significant association between general parameters and visual outcome was found only in the group of traction retinal detachment where loss of vision was related to shorter duration of diabetes (P = 0.0213), and shorter duration of background retinopathy (P = 0.0300), and proliferative retinopathy (P = 0.0072).
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PMID:Significance of various systemic and ocular parameters in the long-term prognosis after diabetic vitrectomy. 262 79


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