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

Since hypothermia is commonly used to lower local and general metabolism during cardiopulmonary bypass, we attempted to identify its specific effects on glucose-insulin interactions. A group of nondiabetic patients undergoing hypothermic (28 degrees C) cardiopulmonary bypass with ischemic (cold) cardiac arrest was compared to a similar group operated on under normothermic conditions with potassium cardioplegia. In the absence of exogenous dextrose administration, hypothermia blocked insulin secretion for the duration of the operation. It also inhibited insulin secretion in response to an exogenous dextrose load (e.g., the priming fluid of the cardiopulmonary bypass circuit) or a glucagon injection, but this inhibition was lifted by rewarming. Blood glucose levels, which during normothermia were mildly elevated even in the absence of dextrose administration, remained normal during the hypothermic phase of cardiopulmonary bypass. By the end of the rewarming period, however, blood glucose levels had reached the same level as observed under normothermic bypass, a fact suggesting that the cold inhibition of hepatic glucose production had been only temporary. Cold inhibition of hepatic glucose production also explains why glucose clearance after a sudden dextrose load was initially faster at low body temperature than at normal temperature. Glucose-clamp studies indicated that insulin resistance was initiated by anesthesia and surgical trauma, and further accentuated by cardiopulmonary bypass, in association with elevated levels of hormones indicative of surgical stress. Regardless of body temperature changes, the assimilation of glucose by nondiabetic subjects during and immediately after bypass called for the infusion of large doses of insulin. A comparison with diabetic subjects showed that insulin-dependent patients (type I diabetes) required no more insulin during cardiopulmonary bypass than normal subjects, whereas patients with type II diabetes exhibited a marked insulin resistance during the operation and in the immediate postoperative period.
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PMID:Glucose-insulin interactions during cardiopulmonary bypass. Hypothermia versus normothermia. 351 20

In the present study, we used streptozocin (STZ) to induce diabetes in rats and observed alterations in several physiologic functions and in monoamine content of different brain regions. Rats with STZ diabetes displayed a thermoregulatory deficit in the cold. Both the body temperature and metabolic rate of the diabetic animals were reduced at ambient temperatures below 22 degrees C. These diabetic animals had a higher level of the spontaneous pain threshold, but displayed a reduced sensitivity of analgesic responses to morphine injection. In addition, these diabetic animals had a lower level of spontaneous motor activity, but displayed an increased sensitivity of locomotor stimulant responses to amphetamine administration. Biochemical examination revealed that the diabetic animals had a lower serotonin level in both the hypothalamus and the brainstem without changes in the serotonin levels of the corpus striatum. These diabetic animals also had a lower catecholamine level in the hypothalamus, but a higher catecholamine level in the corpus striatum. The alterations in brain monoamine content and in the above-mentioned physiologic parameters were reversed after insulin replacement therapy. The data suggest that alterations in various autonomic, somatosensory, and motor neural functions of untreated STZ-diabetic rats correlated with a reproducible pattern of monoamine content in various brain regions (a pattern that differed from that observed in healthy control rats), and that both the altered neural function and the altered brain monoamine pattern were reversed after insulin therapy.
Diabetes 1986 Apr
PMID:Alterations in physiologic functions and in brain monoamine content in streptozocin-diabetic rats. 351 26

The regulation of nonshivering thermogenesis by insulin was studied in cold-acclimated rats (2 weeks at 5 degrees C) made diabetic after injection with streptozotocin (75 mg/kg, i.p.) and maintained in the warm (25 degrees C) for 2-7 days. To investigate whether thermogenesis was activated in brown adipose tissue (BAT) of diabetic rats under physiological conditions, conscious rats were briefly exposed to cold (2 h at 5 degrees C) and the temperature of interscapular BAT (Tbat) was compared with the colonic temperature (Tcol). It was found that Tbat, Tcol, and Tbat-Tcol (an index of thermogenesis activation in BAT) were significantly reduced in 7-day diabetic rats (P less than 0.01) but not in 2-day diabetic animals, suggesting that diabetes progressively decreases BAT thermogenic capacity. To further assess whether the maximal capacity of BAT for nonshivering thermogenesis was affected by the lack of insulin, the calorigenic response to noradrenaline (0.4 mg/kg, i.m.) was determined at 25 degrees C in anesthetized animals using an open circuit respirometer. The results showed that the calorigenic response to noradrenaline was inhibited by 50 and 70% in 2- and 7-day diabetic rats, respectively. Significantly, tissue weight, protein content, and cytochrome oxidase activity of interscapular BAT were also decreased by 30-40% and 50-70% in the same animals. Insulin treatment of 3-day diabetic rats for 4 days (6.5 U/day per rat) restored their calorigenic response to noradrenaline to control levels.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of insulin in nonshivering thermogenesis. 355 63

Thirty-nine initially normotensive children (25 girls) with a large increase in systolic blood pressure (SBP) over a period of 7 years were compared with 78 children with a small increase, matched for age and gender. They were selected from a random sample of 596 Dutch children who were examined at an initial examination and 4 weeks later, and at yearly intervals thereafter. Body weight, height and Quetelet index at baseline were similar in children with a large rise in SBP and those with a small rise. Children with a large increase had a larger weight gain during follow-up than those with a small rise. Parental blood pressure (BP) and parental history of diabetes mellitus and cardiovascular diseases did not differ between the study groups. Cardiovascular reactivity as assessed by a cold-pressor test at baseline did not differ between the study groups, nor did urinary sodium excretion during follow-up. Total tobacco consumption was larger in those with a small increase. Children with a large rise in SBP experienced a larger fall in SBP from the initial to the 4-week examination. The individual variability of BP over the whole observation period did not differ between the study groups. These observations suggest that a fall in BP after a short follow-up period may be indicative of high BP in the years to come.
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PMID:Determinants of rise in blood pressure in normotensive children. 361 84

A quantitative fluid-phase radioassay for autoantibodies reacting with insulin (competitive insulin autoantibody assay, CIAA) was developed. The assay's features include 1) use of a physiologic amount of 125I-labeled insulin, 2) parallel incubations with supraphysiologic cold insulin (competitive), and 3) an incubation time of 7 days and a single-step multiple-wash polyethylene glycol separation. Mean +/- SE CIAA levels in 50 controls were 8 +/- 1.4 nU/ml (range -16-33.3). In 36 cytoplasmic islet cell antibody (ICA)-positive nondiabetic first-degree relatives of type I (insulin-dependent) patients less than 30 yr of age, CIAA levels exceeded the normal range in 20 (55.6%) of 36 (mean 86.8 +/- 17.1 nU/ml). In 26 ICA-positive relatives greater than 30 yr of age, only 5 (19.2%) of 26 exceeded the normal range (mean 26.1 +/- 9.4 nU/ml); P less than .001 compared with younger ICA-positive relatives). Six ICA-negative HLA-identical siblings of type I diabetic patients had normal CIAA levels (mean 3.6 +/- 5.8 nU/ml), and only 2 of 13 ICA-negative identical twins discordant for diabetes (mean 15.4 +/- 6.6 nU/ml) exceeded the normal range. Nine (50%) of 18 ICA-positive schoolchildren exceeded the normal range (mean 105.3 +/- 36.7 nU/ml). Genetically susceptible subjects negative for CIAA (with only 3 exceptions) remained negative for CIAA on multiple determinations (3 conversions observed), and CIAA levels of positive subjects were relatively stable. Linear regression of the first CIAA level versus last (interval between sampling 1 mo to 10 yr) in genetically susceptible individuals showed a highly significant correlation (r = .95, P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes 1987 Nov
PMID:Competitive insulin autoantibody assay. Prospective evaluation of subjects at high risk for development of type I diabetes mellitus. 366 19

The goal of measuring the conduction velocity of a peripheral nerve is to describe the distribution of conduction velocities (DCV) of each nerve fiber in a nerve bundle examined. The author devised a fully automatized method to describe the DCV of a nerve bundle with a signal processor. The principle of the method is nerve impulse collision method which was devised by Hopf in 1963. DCV of the ulnar nerve innervating the first dorsal interosseous muscle from the elbow to the wrist was examined in sixty five normal subjects without any evidence of peripheral nerve problems, in ninety seven patients with diabetes mellitus (DM) and in five normal subjects whose forearm was cooled. Maximum conduction velocity at the same region was measured by using conventional method and compared to the DCV. In control group, there was very mild influence of aging on the peak velocity of DCV but there was no statistically significant deference of mean DCV pattern between any decade of age. In this group a bimodal distribution of velocities was demonstrated. It is assumed that the distribution represents populations of motor fibers innervating the fast and the slow twitch muscle fibers in this muscle. Those results in patients with DM and those normal subjects with their forearm was cooled were controversial. In patients with DM the peak velocity of DCV and its density has positive correlation, in contrast those cold injury group has negative correlation. It might be represents that the pathological condition of large fiber loss in the former group and small fiber damage in the latter group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Distribution of motor nerve conduction velocities in the ulnar nerve--a control study, its clinical application and limitations]. 368 3

Five members in three generations of a family were affected by an illness that had many clinical features of the hypokalemic form of periodic paralysis (HPP). The serum potassium was either moderately reduced or normal during attacks, and there was no evidence of myotonia or cold-intolerance. All of the patients improved to a variable degree with oral potassium supplements, and 3 responded favorably to triamterene. The usually beneficial drug acetazolamide, however, invariably caused weakness in these patients, an effect previously described in only one other family with HPP. In addition, amphetamine-like sympathomimetic drugs effectively aborted or prevented paralysis in several members. Muscle biopsy in two patients revealed some unusual features, and electromyography showed myopathic potentials. There was no evidence of diabetes. The urine electrolyte concentrations during glucose tolerance tests, however, were different from those previously reported in HPP. This family may represent a variant form of HPP.
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PMID:Hypokalemic periodic paralysis with unusual responses to acetazolamide and sympathomimetics. 369 25

Conditions were developed to permit the extraction of branched-chain 2-oxoacid dehydrogenase from brain tissue in the state of phosphorylation in which it occurred in vivo. Tissue was cold clamped to prevent interconversion of the enzyme forms without rupturing mitochondrial membranes. Extraction was carried out in the presence of NaF to prevent dephosphorylation of the enzyme complex and in the presence of ADP to prevent phosphorylation. In adult male control rats, approximately 35% of the total enzyme from brain was present in the active form. In brains of diabetic rats, the active fraction was increased to 56%. Total activities did not differ in the two groups of rats.
Diabetes 1986 Sep
PMID:Diabetes increases active fraction of branched-chain 2-oxoacid dehydrogenase in rat brain. 374 6

The clinical course of angina pectoris was studied in a follow-up study of 427 patients with angina from a general population sample. The subjects were men aged 56-65 years at the time of follow-up. After a mean follow-up time of 5.8 years, 55% were still suffering from angina pectoris, 15% had died and a further 19% were either free from chest pain or had chest pain considered to be of different origin. In the group with definite angina pectoris at follow-up (n = 236), 29% had sustained a myocardial infarction, 23% had symptoms of intermittent claudication, 36% were treated for hypertension and 15% had diabetes. Many of the angina patients suffered from other chest conditions in addition to anginal symptoms. Most of the patients (56%) had infrequent attacks (a few times per month or less often) and were not severely incapacitated by their symptoms. Only one fifth worked full time compared with more than half of those in the same age groups in the general population. Only 16 of those interviewed had undergone bypass surgery and a further 16 had disabling angina but, for various reasons, they had not been operated on. The implications are that most angina patients do well on pharmacological treatment alone even though they are limited socially as well as physically. Precipitating factors other than physical activity were also investigated and associations were found between susceptibility to cold, early morning angina, angina at rest and attacks of long duration, possibly indicating a mechanism of vasospasm superimposed on a fixed stenosis.
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PMID:Clinical course and symptomatology of angina pectoris in a population study. 377 87

Eleven type-I (insulin-dependent) diabetic patients with abnormal changes in left ventricular function in response to cold stress (CS) were investigated to try and determine the cause of these abnormal responses. Resting M-mode echocardiography demonstrated that all 11 patients had normal left ventricular dimensions and wall motion, thereby excluding overt cardiomyopathy. Thallium-201 scintigraphy was used to assess myocardial perfusion during CS and eight patients were found to have perfusion defects during stress which persisted in four. It is possible that CS unmasks evidence of myocardial ischemia but it is also possible that the abnormal responses to CS reflect altered vasomotor reactivity in the diabetic patient, producing coronary spasm. Left ventricular function may be influenced by many factors in diabetes and an abnormal CS test may not necessarily indicate structural disease. Such tests, however, may help in the further understanding of the pathophysiology of heart disease in diabetes.
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PMID:Assessment of myocardial perfusion during cold stress using thallium-201 scintigraphy in diabetic patients with abnormal changes in left ventricular function during cold stress. 378 4


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