Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Corneal epithelial lesions can be found in approximately one-half of asymptomatic patients with diabetes mellitus. These lesions are transient and clinically resemble the keratopathy seen in staphylococcal keratoconjunctivitis. Staphylococcal organisms, however, can be isolated in equal percentages from diabetic patients without keratopathy. Diabetic peripheral neuropathy was found to be related to the presence of diabetic keratopathy after adjusting for age with analysis of covariance. The strongest predictor of both keratopathy and corneal fluorescein staining was vibration perception threshold in the toes (P less than 0.01); and the severity of keratopathy was directly related to the degree of diminution of peripheral sensation. Other predictors of keratopathy were: reduced tear breakup time (P less than 0.03), type of diabetes (P less than 0.01), and metabolic status as indicated by c-peptide fasting (P less than 0.01). No significant relationships were found between the presence of keratopathy and tear glucose levels, endothelial cell densities, corneal thickness measurements, the presence of S epidermidis, or with duration of disease. It is our conclusion that asymptomatic epithelial lesions in the nontraumatized diabetic cornea can occur as a manifestation of generalized polyneuropathy and probably represent a specific form of corneal neuropathy.
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PMID:Diabetic corneal neuropathy. 667 64

Ocular complications of diabetes in humans are reviewed briefly, and experimental models available for study of the complications are described. Potentially suitable models include not only diabetic animals, but also nondiabetic animals in which analogous lesions have been demonstrated. Many abnormalities of the lens, cornea, iris, and retina comparable to those of diabetes in humans may be observed in diabetic animals, although all abnormalities are not necessarily observed in every species. Retinal changes, in particular, may occur in diabetic animals of several species, but only in large animals (dogs, primates) have saccular capillary aneurysms been reproduced consistently, together with other retinal changes typical of diabetes in humans. A few examples of the uses of animal models are offered, and attention is called to a lack of animal models of proliferative diabetic retinopathy and of rubeosis iridis.
Diabetes 1982
PMID:Ocular complications. 681 71

Fluorophotometry using the Metricon Model 120 slit-lamp fluorophotometer showed, at an anterior focus, two peaks which corresponded to the cornea and ciliary region--the latter predominantly due to the ciliary body but contributed to by the lens--and following this, at a posterior focus, a mid-vitreous minimum and a chorioretinal peak. Tracings made both before and after fluorescein injection were similar but the levels were higher post-injection, with increasing age and with non-pigmented irides. The change in fluorescein distribution with time after injection is described. Abnormally high fluorescein levels were found in the normal fellow eye in retinal vein occlusion, in diabetes, in senile macular degeneration with neovascular membrane, in active central serious retinopathy and in acute optic neuritis. It is of use in the differentiation of primary choroidal melanoma from naevus and metastases. There was no correlation between isolated measurements of the haemoglobin A1C level and leakage; plasma and ultrafiltrate fluorescein levels in diabetics did not differ from normal.
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PMID:Experiences with fluorophotometry. 710 62

Endothelial cell density and thickness of the cornea do not appear to be affected by long-standing diabetes mellitus. Standard intra- or extracapsular cataract surgery results in a statistically significant reduction of endothelial cell density, but not in a long-term change of corneal thickness. Endothelial cell loss after trans pars plana surgery averages 8.5%. Differences in endothelial cell loss between phakic eyes of diabetics and phakic and aphakic eyes of nondiabetics subjected to lens removal and/or vitrectomy are not statistically significant. Corneal thickness is increased to a statistically significant degree in all eyes after trans pars plana surgery. Although the cornea in diabetics requires more time to recover after trans pars plana surgery, we found no evidence that it suffers significantly more damage than the cornea in nondiabetics.
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PMID:Effect of trans pars plana surgery on the corneal endothelium. 726 10

Diabetes mellitus is associated with a number of changes in the cornea. These include increased corneal autofluorescence, thickening and enhanced endothelial cell permeability. In this study we have investigated the biochemical changes of corneal collagen due to advanced Maillard reaction and lysyl oxidase mediated crosslinking in diabetes. Advanced Maillard reaction was estimated by collagen-bound fluorescence and pentosidine. Hydroxypyridinium (a trifunctional fluorescent crosslink) was estimated as an index of lysyl oxidase mediated crosslinking. Both fluorescence (p < 0.05) and pentosidine were present at higher levels in diabetic corneas when compared with age-matched control corneas. Hydroxypyridinium levels were only marginally increased in diabetes. These results suggest that corneal collagen is modified in diabetes by advanced Maillard reaction and that such modifications may have effect on corneal thickening, endothelial cell permeability and other abnormalities of the cornea in diabetes.
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PMID:Advanced Maillard reaction and crosslinking of corneal collagen in diabetes. 757 46

Thick, 0.34 mm, 38% water hydrogel lenses were fitted, under a pressure patch, to one eye of 18 type I diabetic patients (aged 18-40 years) to assess the acute response to hypoxia and hypercapnia; the response was compared with that in 18 healthy, aged-matched non-diabetic subjects; the closed-eye lens wear was started mid-morning. Pre-lens wear assessments were made of acuity, intraocular pressure (IOP), central corneal thickness (CCT) and corneal appearance by biomicroscopy. The mean duration of the diabetes was 13 +/- 7 years and the average fasting blood glucose was 8.7 +/- 3.3 mMl-1. Baseline CCT values were marginally greater in diabetic patients (600 +/- 33 microns) compared with a group of non-diabetic control subjects (584 +/- 26 microns; P > 0.5). A 7.7 +/- 2.1% increase in CCT was measured after 3 h lens wear in the diabetic patients while an average 10.6 +/- 2.4% increase in CCT was measured in the control subjects (P < 0.05). The recovery of corneal thickness to baseline values in diabetic patients was slower (at 44.8 +/- 2.0% per hour) than the control subjects (53.9 +/- 2.1 per hour; P < 0.05) although recovery of corneal thickness occurred in both groups within 2.5-3h. IOP values (non-contact tonometry) were higher in the diabetic patients than in the controls (14.5 +/- 2.9 vs 12.4 +/- 1.7 mmHg; P < 0.01). Overall, those corneas with greater baseline CCT values tended to swell less than those with lower baseline CCT values (r = 0.582). Positive correlations were also found between corneal thickness and IOP and blood glucose. The diabetic patients thus tended to have slightly thicker corneas (but this could be related to blood glucose or IOP rather than true corneal disease) and also had corneas that tended to swell less with a contact lens stress test (but this could be constitutively due to the slight oedema already present). The different corneal response in diabetic patients may thus be the result of physical determinants such as initial oedema and IOP and not the result of a disease of the cornea itself.
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PMID:Corneal swelling and recovery following wear of thick hydrogel contact lenses in insulin-dependent diabetics. 766 21

Animal studies have shown that insulin eyedrops containing an absorption-enhancing agent can have a significant effect on blood glucose levels. When formulated as a topical solution, insulin might potentially be used to treat or augment the treatment of diabetes mellitus in humans. We sought to investigate the feasibility of using insulin eyedrops in humans by studying the local toxicity and efficacy of insulin administered without surfactant to the eyes of healthy volunteers. A prospective, randomized, placebo-controlled, single-masked study was conducted in which 8 subjects were given 50 microliters of sterile normal saline containing varying insulin concentrations randomized to one eye, and 50 microliters of placebo (sterile normal saline) to the fellow eye. Subjective ocular irritation was evaluated, and the eyelids, conjunctiva, cornea, and anterior chamber were examined objectively with slit lamp biomicroscopy. Subjects were evaluated for 2 hours following administration of a single dose of insulin. There was no statistically significant difference (P > 0.05) in toxicity observed by any parameter evaluated between eyes receiving insulin and placebo. No systemic absorption of insulin was observed; blood glucose levels and serum immunoreactive insulin levels were unchanged. The results of this study suggest that single-dose insulin in concentrations up to 100 U/ml formulated in saline has no detectable clinical toxicity to the anterior structures of the human eye.
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PMID:Insulin administration to the eyes of normoglycemic human volunteers. 771 12

We measured the corneal autofluorescence in groups with different levels of diabetic retinopathy severity (72 eyes of 46 patients) and in age-matched non-diabetic controls (34 eyes of 24 controls). We also estimated the corneal endothelium cell count and pachymetry with a contact specular microscope. For the controls, mean corneal autofluorescence was 8.8 ng equivalents fluorescein/ml (SD 0.3). Results showed increased autofluorescence of the cornea in diabetic patients (mean 17.9 ng equivalents fluorescein/ml, SD 4.2), related to the duration of diabetes (P < 0.05) and to the severity of diabetic retinopathy (P < 0.0001). Corneal endothelial cell count results showed no statistically significant relation to corneal autofluorescence (P < 0.6), indicating that the increased autofluorescence cannot be attributed to a change in corneal cell density.
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PMID:The relation between corneal autofluorescence, endothelial cell count and severity of the diabetic retinopathy. 779 83

In an open label, two period cross-over study we compared the ocular tolerability of NODS vs. Isopto-NaturaleR eye drops. Thirty healthy volunteers were asked to rate the application system they were using for ocular discomfort, utilizing a visual analog scale in which 100 = no ocular discomfort and 0 = severe ocular discomfort. In addition each subject had to answer a questionnaire and underwent a full ophthalmic control before, at day 7, at day 14 and at day 21 of the study. Each application form had to be applied to one eye only once a day for 7 days, followed by a washout period of 1 week. The type of application form was then changed and again had to be applied to one eye only for 7 consecutive days, followed by a final ophthalmic examination. The mean irritation score was recorded at day 7 and at day 21 of the study. Volunteers had no history of eye disease, no acute pathology of the eye, no contact lenses, no conditional foreign body of the cornea within the last four weeks prior to the study or within the study, no local therapy, no systemic therapy, no diabetes, no pregnancy. Informed consent was obtained. At day 1 one of the two application forms was given to each volunteer in a randomized order. 29 volunteers finished the protocol (16 male, 13 female); mean age: 26 years (range 20-32 years). The mean irritation score of NODS: 35 (2-81); the mean irritation score of Isopto-NaturaleR: 80.4 (45.5-99).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The ocular tolerability of a new ophthalmic drug delivery system (NODS). 796 Apr 9

Diabetic patients seem to have problems with dry eye symptoms. Therefore, 92 patients with diabetes types I and II and aged from 7 to 69 years were compared with a group of normal healthy controls comparable in number, age and sex. A general ophthalmological check-up was performed. The main points of comparison were subjective complaints, objective findings on conjunctiva and cornea, break-up time (BUT), basal secretion test, impression cytology of the conjunctiva, and grade of diabetic retinopathy. The results show that 52.8% of all diabetic subjects complained of dry eye symptoms, as against 9.3% of the controls. A BUT value lower than 10 s was found in 94.2% of the diabetics and in only 5.8% of the controls. Basal secretion test lower than 5 mm was observed in 26% of the diabetics and in 16% of the normal controls. Pathologic conjunctival epithelium (grade III-V after Tseng) was found in 86% of the diabetic patients and in 6.7% of the healthy subjects. Among the type II diabetic patients, 70% had proven dry eye syndrome, while 57% with type I diabetes suffered from this. A correlation was found between the HBA1c values and the presence of dry eye syndrome. The higher the HBA1c values, the higher the rate of dry eye syndrome. The study thus supports the impression that diabetic patients have an elevated incidence of dry eye syndrome. Impression cytology was found to give the most distinctive and discriminating results. Close monitoring of diabetic patients and good blood sugar regulation is important for the prevention of dry eye syndrome and retinopathy.
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PMID:[The dry eye and diabetes mellitus]. 801 43


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