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

The long-term prognosis and quality of life of 201 patients admitted to hospital with reversible ischemic attacks (RIA) were estimated in a prospective study. The median follow-up time was 58 months. Further RIAs were reported by 91 patients (45%) and 48 (24%) suffered a stroke. The risk of stroke was markedly higher in the first 6 months after RIA, after which the annual stroke rate was rather constant with an average of 4.8%, about 8 times higher than expected. The average annual mortality rate for the RIA patients was 5.9%, which is significantly higher than expected. Cardiovascular deaths accounted for more than half of all deaths, stroke for one fourth. Life-table analysis of subgroups disclosed a much more favorable prognosis for women under 60 years. High systolic blood pressure, diabetes, and previous myocardial infarction were identified as risk factors. The occurrence of RIA had significantly influenced the quality of life and occupational status for the majority of the patients, even for those who did not suffer a subsequent stroke. Decreased working capacity, general asthenia and fatigue and impaired memory were the most common complaints. We conclude that RIA may be a more serious vascular event than generally believed. Apart from carrying a substantial risk of stroke and death, even a single RIA can cause permanent psychological dysfunction influencing the quality of life.
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PMID:Long-term prognosis and quality of life after reversible cerebral ischemic attacks. 271 39

The associations between generalized obesity measured as body mass index (BMI), or adipose tissue distribution, measured as the waist/hip circumference ratio (WHR), on one hand, and a number of socioeconomic, somatic as well as psychologic and mental health variables on the other, were analysed in a population study of women (1462 participants, aged 38-60 years, participation rate 90.1%). The anthropometric measurements were adjusted for their influence on each other. BMI, but not WHR, was negatively associated with socioeconomic status and education. Increased WHR correlated to a number of somatic diseases from different organ systems, including diabetes mellitus, infectious respiratory and abdominal diseases. Even more striking were strong correlations to a number of variables indicating accident proneness as well as mental disorder, and increased use of antidepressants and tranquilizers. BMI and WHR were also associated to different personality profiles. Furthermore, the use of alcohol and smoking were positively correlated to the WHR. In contrast, most of these associations were not seen with the BMI--sometimes even negative correlations were found. Exceptions were, however, varicose veins, joint problems and surgery for gall bladder disease, which were positively correlated to BMI only. Blood pressure, plasma triglycerides and uric acid were positively correlated to both BMI and the WHR, plasma cholesterol, however, only to the WHR. Obesity (high BMI) and abdominal adipose tissue distribution (high WHR) clearly show differences in their associations to various health variables. It is hypothesized that an arousal syndrome might be a contributing factor to cause symptoms of psychological maladjustment, including psychosomatic disease. Hypothetically, in parallel, an accumulation of depot fat in the abdominal depot, might follow as a consequence of neuroendocrine dysregulation of endocrine secretions.
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PMID:Obesity, adipose tissue distribution and health in women--results from a population study in Gothenburg, Sweden. 278 94

The results of a small scale retrospective study are presented. The study was initiated to determine the incidence of diabetes in long-stay patients in two psychiatric hospitals in Northern Ireland and to attempt to define whether there was a relationship between the two disease states, schizophrenia and diabetes mellitus. There was a higher percentage of diabetics in the two institutions than was expected. It was concluded that drug therapy of the mental illness may have had a contributory effect on the subsequent development of diabetes mellitus.
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PMID:Diabetes and schizophrenia--a preliminary study. 287 11

The authors studied data on psychiatric disorders and eight chronic medical conditions in a community sample of 2,554 persons. The sex- and age-adjusted prevalence of any psychiatric disorder in the preceding 6 months was 24.7% and of lifetime psychiatric disorder was 42.2% among persons with one or more medical conditions, compared to 17.5% and 33.0%, respectively, for persons with no medical condition. Persons with chronic medical conditions were more likely to have lifetime substance use disorders and recent affective and anxiety disorders. Arthritis, cancer, lung disease, neurological disorder, heart disease, and physical handicap were strongly associated with psychiatric disorders, but hypertension and diabetes were not.
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PMID:Psychiatric disorder in a sample of the general population with and without chronic medical conditions. 296 99

Anxiety disorders are common among patients with diabetes and appear to recur in a substantial proportion of cases. The presence of generalized anxiety disorder is associated with both poorer glucose control and the increased report of clinical symptoms of diabetes. A complex interactive model best accommodates observations from psychiatric-diabetic research, one wherein diabetes may affect psychiatric status or vice versa in an independent or reciprocal fashion. No information from systematic studies is available currently to determine if treatment of the psychiatric disorder will have a beneficial impact on glucose regulation, despite the direct clinical relevance of such information to management of diabetes.
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PMID:Anxiety disorders in adults with diabetes mellitus. 304 9

To determine the factors related to discontinuation of continuous subcutaneous insulin-infusion (CSII) therapy in patients with insulin-dependent diabetes mellitus, we analyzed clinical data from a group of 177 patients followed for up to 5 yr. Fifty-one (29%) of the patients made a decision to terminate CSII during the study. Of the clinical characteristics present before the onset of treatment with an insulin pump, the most important variable to predict a future decision to terminate CSII was pregnancy, followed by female gender. In addition, there was a greater percentage of smokers, single or divorced patients, and patients with a history of treatment for mental illness in the dropout group, although none of these differences was statistically significant. There was no correlation between discontinuation of CSII and age, duration of diabetes, or prepump concentrations of HbA1c. Events occurring during CSII were also analyzed for predictive value. Patients who discontinued CSII had a higher incidence of ketoacidosis and a lower incidence of hypoglycemic coma while using a pump. The most common reason reported by patients for terminating CSII therapy, cited by 24 (47%) of the 51, was discomfort, irritation, or infection at the infusion site.
Diabetes Care 1988 Jan
PMID:Factors related to discontinuation of continuous subcutaneous insulin-infusion therapy. 312 87

The 28-item General Health Questionnaire (GHQ) has been validated against the criterion of the Clinical Interview Schedule (CIS) in Spanish patients in hospital with several types of endocrinological illnesses. The screening instrument correctly identified 91 of 100 respondents as exhibiting psychiatric disorder. The questionnaire's efficacy was similar at the time of medical discharge, when the rate of disorder was significantly lower. Significant correlations were found between GHQ total scores and endocrine blood measures in Addison's disease, and in Type I diabetes. The four subscales of the GHQ sum to provide additional information concerning somatic symptoms and anxiety.
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PMID:Emotional disturbances in endocrine patients. Validity of the scaled version of the General Health Questionnaire (GHQ-28). 316 67

To examine the prevalence of psychiatric disorders in patients with long-standing type I diabetes mellitus, we assessed a series of candidates for pancreas transplantation. Using the Diagnostic Interview Schedule, six-month and lifetime prevalences of psychiatric disorders were established for the candidates and their potential donors (first-degree relatives). Excluding tobacco use disorder and psychosexual dysfunction, 38 diabetic subjects (51%) received one or more psychiatric diagnoses. The lifetime prevalence of major depression was comparable for female (11 of 48 [22.9%]) and male (seven of 27 [25.9%]) diabetics; both rates were significantly higher than rates in first-degree relatives and the general population. Among female diabetics, the six-month and lifetime prevalences of simple phobia were increased vs donors and the general population; among male diabetics, the lifetime prevalence of antisocial personality disorder was greater than that in the general population. None of these disorders was found to be related to the duration of diabetes or the presence of various complications. The data suggest that increased rates of psychiatric disorder in type I diabetics have both gender-independent and gender-related components.
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PMID:Prevalence of major depression, simple phobia, and other psychiatric disorders in patients with long-standing type I diabetes mellitus. 325 79

Two-stage screening for psychiatric disorder was carried out with a sample of 99 male and 95 female outpatients with insulin-dependent diabetes mellitus, using the General Health Questionnaire and the Clinical Interview Schedule. The estimated prevalence of psychiatric disorder in this sample was 18%: only 28% of the psychiatric morbidity so identified was detected by physicians. In contrast, physicians rated 10% of the sample as psychiatric 'cases' using a simple 6-point scale.
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PMID:Psychiatric disorder in patients with insulin-dependent diabetes mellitus attending a general hospital clinic: (i) two-stage screening and (ii) detection by physicians. 360 42

This study examined sexual dysfunction in diabetic women. Eighty-one insulin-treated diabetic women were interviewed and administered standardized questionnaires. Using criteria derived from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) (DSM-III; American Psychiatric Association, Washington, D.C., 1980), 38 (47%) of the women were diagnosed with sexual dysfunction and 43 (53%) did not report sexual problems. The more frequently reported sexual problems were inhibited sexual excitement, inhibited sexual desire, and dyspareunia. Diabetic women with sexual dysfunction were more depressed, more stereotyped in their sex-role definitions, and less satisfied in their sexual relationships than those without sexual dysfunction. The two groups did not differ in metabolic control, insulin dose, duration of diabetes, or frequency of diabetic complications (e.g., neuropathy, etc.). Results suggest that diabetes may be associated with inhibited sexual excitement and dyspareunia in women. Both psychological and physiological concomitants of sexual dysfunction in diabetic women should be considered in diagnostic and treatment programs.
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PMID:Sexual dysfunction in diabetic women. 374 98


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