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

Diabetes is a chronic disease requiring a compelling and permanent treatment which has repercussions on the patient's daily activities, tempo of life, feeding habits and physical exercises. This treatment also carries a risk of acute metabolic complications dreaded by the patient, the main one being hypoglycaemia. These constraints and fears have important effects on the patient's state of mind and must be taken into consideration by all those who look after him. For a strict and global handling of the diabetics' medical problems, it has been found necessary to institute an educational approach aimed at informing the patient, teaching him practical actions, facilitating his autonomy and reducing his anxiety and isolation. This approach is called diabetes education. It requires special training, as well as time and means, and must be subjected to evaluation. It is now well established that diabetes education is able to reduce the constraints of the disease, the frequency of metabolic accidents and the cost of diabetes. It is usually developed in hospital structures, but it also concerns private diabetologists and other medical helpers. This should convince the State authorities to recognize this teaching activity as a genuine therapeutic activity.
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PMID:[Diabetes education]. 149 40

The relationship of stature with the prevalence of 18 chronic diseases or groups of diseases was analysed using data from the 1983 Italian National Health Survey, based on a sample of 63,859 individuals aged 20 or over randomly selected within strata of geographical area, size of the place of residence and of the household in order to be representative of the Italian population. Rate ratios (RR) were computed using multiple logistic regression, including terms for sex, age, geographical area, education and smoking. For 15 out of 18 diseases or groups of diseases the RR was below unity in the highest quartiles of height, and the inverse trends with stature were significant for 11 (diabetes, RR 0.90 for highest vs lowest quartile; heart disease, RR 0.92; chronic bronchitis and emphysema, RR 0.84; bronchial asthma, RR 0.70; anaemias, RR 0.70; liver cirrhosis, RR 0.62; urolithiasis, RR 0.76; renal insufficiency, RR 0.71; arthritis, RR 0.89; psychiatric and neurological disorders, RR 0.82). None of the diseases considered showed significant direct trends with height, but hypertension (RR 1.09 for the highest vs lowest quartile), haemorrhoids or varices (RR 1.09) and cancers (RR 1.22) tended to be elevated in the highest quartile of height. The generalised inverse relationship between height and prevalence of chronic disease suggests that poorer nutrition in childhood and adolescence is an unfavourable indicator for the subsequent occurrence of several diseases. Major exceptions were hypertension and varices, two conditions highly dependent on the pattern of health care utilization, and cancer.
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PMID:Height and the prevalence of chronic disease. 160 29

This study examined age differences in the quality of self-report data in patients with chronic disease conditions (hypertension, diabetes, heart disease, depression). Data are from 2,304 patients in three health care systems in Los Angeles, Chicago, and Boston. Results support the idea that self-report health data can be gathered from older and younger patients without significant decrements in data quality. Specifically, results showed: (1) small decreases in the reliability of multi-item measures with age, primarily occurring in balanced scales; (2) little evidence of differences among age groups in response set or the tendency to respond "don't know" or "uncertain," although older patients had a greater tendency to respond in a socially desirable manner; (3) higher item nonresponse in older patients; (4) little variation in item nonresponse by type of question or question placement; (5) generally high panel retention in all age groups, supporting the value of repeated follow-up; and (6) similar known-groups validity across age groups.
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PMID:Quality of self-report data: a comparison of older and younger chronically ill patients. 162 16

Investigated age and gender differences in adjustment to chronic disease in children suffering from one of five conditions: diabetes, asthma, cardiac disease, epilepsy, and leukemia. Ratings of adjustment and disease-related restrictions were obtained separately from mothers and fathers. Factor analysis of the adjustment scale yielded 6 subscales which differentiated between children in terms of age and disease type, and to a lesser extent, gender. Mothers' and fathers' ratings of adjustment and restrictions were comparable, though fathers made less differentiation on the basis of disease or age. For both parents, perceived restrictions of the disease were associated with poorer adjustment in the child, and this was particularly reflected on indices of peer relations and work.
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PMID:Adjustment to chronic disease in relation to age and gender: mothers' and fathers' reports of their childrens' behavior. 164 Mar 13

Laboratory Initiative For The Year 2000 (LIFT), the laboratory response to the Healthy People 2000 program, includes the following in its definition of chronic disease: cancer, diabetes, hypertension, end-stage renal disease, stroke, and cardiovascular disease. All are priority health targets for which the laboratory must play an active support role if we are to achieve the goal of controlling these diseases by the year 2000. What are the laboratory procedures needed to assist in the prevention and detection of chronic disease? In this review I consider the traditional tests now used in these efforts, emphasize how and where screening for diabetes, cardiovascular disease, and cancer is now done, and describe the current status of the clinical laboratory in supporting these activities, including new and promising procedures that may be useful in identifying individuals at high risk for disease. It is important to initiate good clinical laboratory practice for these new tests as they are transferred from the research laboratory to the clinical laboratory. The laboratory will be required to provide for this need rapidly and at the same time comply with federal and state controls and regulations.
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PMID:The role of the laboratory in the prevention and detection of chronic disease. 164 36

Rapid socioeconomic development has led to great changes in health and disease patterns in Bahrain. Specifically, chronic diseases are replacing infectious diseases as the leading causes of morbidity and mortality. Diabetes mellitus is 1 chronic disease which causes considerable problems in Bahrain. It has a higher death rate than that of hypertension, but a lower death rate than that of cardiovascular diseases. Type 2 (noninsulin-dependent) diabetes is the most prevalent form of diabetes in Bahrain. Changes in dietary habits and lifestyle occur with rapid development in Bahrain, often resulting in obesity and decreased physical activity, particularly in women. Obesity and lack of physical exercise are risk factors of Type 2 diabetes. A community- based nutrition survey among 18-to-48 year-old mothers in Bahrain reports that 8.5% suffer from diabetes. The prevalence of diabetes among elderly Bahrainis is 13.4% (15% in females and 10.2% in males). Physicians in Bahrain tend not to list diabetes mellitus as the main cause of death; thus there is underreporting of diabetes-related mortality. Nevertheless, diabetes is responsible for 3.4% of all deaths in Bahrain. Yet, Bahrain does not have programs to detect or control diabetes. Health workers in health centers can and do provide advice on health care and dietary management, but they are not properly trained. Physicians manage diabetes through dietary restrictions, tablets, or insulin injections. Mass media promote prevention of diabetes. Their effectiveness is low, however, because educational programs are poorly designed and unattractive. The government should accord diabetes prevention and control high priority. It should support and implement training of physicians in diabetes management, public education, epidemiological surveys, and nutritional assessment of local foods.
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PMID:Diabetes mellitus in Bahrain: an overview. 164 9

When Australian Aborigines make the transition from their traditional hunter-gatherer life-style to a westernized life-style, they develop high prevalence rates of obesity (with an android pattern of fat distribution), non-insulin-dependent diabetes, impaired glucose tolerance, hypertriglyceridemia, hypertension, and hyperinsulinemia. Insulin resistance may be the common pathogenetic characteristic of this cluster of conditions associated with increased risk of cardiovascular disease. The traditional hunter-gatherer life-style, characterized by high physical activity and a diet of low energy density (low, fat, high fiber), promoted the maintenance of a very lean body weight and minimized insulin resistance. In contrast, for most Aborigines, western life-style is characterized by reduced physical activity and an energy-dense diet (high in refined carbohydrate and fat) that promotes obesity and maximizes insulin resistance. Intervention strategies aimed at prevention of insulin-resistance-related chronic disease should be directed at life-style modification. To be effective, such programs will have to be developed and controlled by Aboriginal communities.
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PMID:Westernization and non-insulin-dependent diabetes in Australian Aborigines. 166 99

Ischaemic fingers, a rare, generally chronic disease, may sometimes be acute, requiring emergency surgical treatment. Five cases are reported: 3 acute and 2 chronic. The 3 cases of acute ischaemia occurred in the context of cardiac arrhythmias in 2 cases and an aneurysm of the ulnar artery in 1 case. Treatment consisted of 2 thrombectomies with microsurgical digital sympathectomy thrombectomies with microsurgical digital sympathectomy and resection of the aneurysm. Complete clinical and functional recovery was obtained in these three cases. The 2 cases of chronic ischaemia were due to diabetes and Buerger's disease. In both cases, medical treatment was followed by thoracic sympathectomy with secondary resection of necrotic tissue as required. In conclusion, the prognosis in the acute cases depends on the rapidity of correction of the arterial obstruction associated with digital sympathectomy. In the case of chronic ischaemia, the clinical course depends on the efficacy of medico-surgical treatment and the severity of the underlying disease.
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PMID:[Management of digital ischemia. 5 cases]. 172 Sep 76

Vigorous physical activity can improve the health of both adults and children. Among adults, regular physical activity can reduce risk for chronic diseases such as coronary heart disease, hypertension, noninsulin-dependent diabetes mellitus, colon cancer, and depression, as well as lower all-cause death rates (1,2). Among children, regular physical activity can reduce chronic disease risk factors such as obesity, elevated cholesterol, and hypertension (3). Physical activity patterns established during childhood may extend into adulthood (4). This report examines the prevalence of vigorous physical activity among U.S. students in grades 9-12.
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PMID:Vigorous physical activity among high school students--United States, 1990. 173 Nov 78

The article proposes that the clinical case definition for Acquired Immunodeficiency Syndrome in Africa is an unworkable concept, with the wrong definition, incorrect validation, improper use, and consequently is a poor surveillance tool. The definition was proposed by the World Health Organization in 1986 to satisfy the use in countries with limited diagnostic resources, and resources for serological testing. Critical review until now of this procedure was lacking. Currently serological testing is available and of high quality. It does not seem justifiable to continue using a provisional surveillance definition. Abandoning this classification procedure may also lead to the focus on problems other than opportunistic infections and AIDs. Clinical surveillance is important, but as well morbidity and mortality need monitoring. It is argued that the definition is an unworkable concept because patients with underlying immunosuppression disorders such as AIDs can not be easily distinguished from chronic disease patients; i.e., pulmonary tuberculosis, renal failure, uncontrolled diabetes, or diarrhea with weight loss. Clinical accuracy is insufficient. It is the wrong definition because pulmonary tuberculosis with a persistent cough cannot be distinguished for those HIV positive and those not. There is inconsistency in the WHO clinical definition and the Centers for Disease Control definitions of AIDs. The incidence of tuberculosis in countries with unmodified clinical case definitions may contribute to an inflated number of AIDs cases. The wrong standards were used to validate the WHO definition in evaluative studies. The reference sensitivity ranges indicate that the definition is insensitive to identifying seropositive patients. Also, the HIV status of patients does not equate with AIDs. Although designed for surveillance, the clinical case definition is used by doctors for individual patient management. Labeling a patient as having AIDs, when he is HIV negative, leads to negative consequences. Researchers compare African AIDs data with North American data with imprecise and noncomparable definitions. As a surveillance tool in countries with a fragmentary or without a vital registration system, it is an inaccurate tool. Alternatives to obtaining data about the spread and impact of HIV are cluster sampling, hospital surveillance of selected populations, anonymous testing of pregnant women or patients in sexually transmitted disease clinics. In Nairobi, a necropsy survey found that 16% had AIDs but 38% were HIV positive.
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PMID:What use is a clinical case definition for AIDS in Africa? 173 1


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