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

Recently new radioimmunoassay methods have been established to measure plasma concentrations of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4), platelet release products which are set free when platelets aggregate. Plasma concentrations of beta-TG and PF4 were investigated in disorders with increased thromboembolic risk. Extremely high concentrations of these platelet proteins were found in patients with venous thrombosis, pulmonary embolism, polycythemia vera, and chronic renal failure. Moderately increased beta-TG and PF4 levels were observed in patients with peripheral vascular disease, coronary artery disease, chronic rheumatoid arthritis, multiple myeloma, and diabetes mellitus. These data indicate, that plasma concentrations of beta-TG and PF4 are useful parameters for the evaluation of the "in vivo" platelet activity. By using these new methods for clinical applications special blood sampling conditions have been taken into account; moreover one has to consider that the plasma levels of the platelet "release products" are dependent from renal function.
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PMID:[Clinical significance of the radioimmunological determination of beta-thromboglobulin and platelet factor 4]. 9 43

A retrospective study of adult congestive cardiomyopathy was carried out; the admission criteria being heart failure with cardiomegaly after the exclusion of known causes of heart failure. Coronary artery disease was excluded by forming two sub groups, one with proven normal coronary arteries at angiography or autopsy and the other with only assumedly normal coronary arteries. The results concern the study of the incidence of this disease which has been regularly seen over the last 10 years in departments with a large number of referrals of cardiomyopathy. --Professional factors are analysed to see if there is a higher incidence amongst the working classes. --Other factors are analysed by comparison with three control groups: normal, coronary and valvular disease, and diabetes which may be a predisposing factor, but not the serum cholesterol which is decreased in these patients. There is a significant association with smoking and alcoholism and the main biological sign of the latter condition, macrocytosis. This is also found in both coronary sub groups. The isolation of this alcohol factor in the genesis of congestive cardiomyopathy implies the possibility of reversing or stabilising the myocardial damage after its withdrawal, so changing the severe diagnosis associated with this disease.
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PMID:[Multicenter epidemiological survey of primary myocardiopathies. Apropos of 380 cases]. 12 Jan 46

Between January, 1965, and December, 1975, 204 patients (138 men and 66 women) underwent aortoiliac reconstruction for atherosclerotic occlusive disease. Eighteen patients (9%) had a hypoplastic aortoiliac segment and an analysis of these 18 patients constitutes the basis of this report. There were 17 women and one man, and their ages ranged from 28 to 60 years, with an average of 43 years. Hyperlipidema was present in nine of 13 patients tested. All patients were heavy cigarrete smokers and had lower extremity claudication with weak or absent pulses. Carotid or subclavian artery disease was found in 50%. Angiography demonstrated hypoplasia of the aorta distal to the renal arteries with either occlusion, diffuse narrowing, or, most often, an "hourglass" stenosis. The iliac and femoral arteries also were narrowed. Reconstruction was achieved primarily by aortobilateral-iliac or femoral bypass. There were no operative deaths and all patients were improved initially. It appears that normally occurring atherosclerosis in this portion of the aorta, along with congenital narrowing, accounts for symptoms at an early age. The predominence in women is a puzzle. The prognosis does not appear to be too grim. This may be due to absence of diabetes mellitus and the infrequency of coronary artery disease. All patients are still alive; there has been one major amputation following graft infection 1 1/2 years after operation. When progression of atherosclerosis occurs, it seems to involve the superficial femoral, carotid, and subclavian arteries.
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PMID:Atherosclerosis and the hypoplastic aortoiliac system. 14 60

We have studied 32 kindreds identified by propositi with primary type V hyperlipoproteinemia. The clinical presentation, metabolic associations, and natural history confirm the distinctiveness of primary type V hyperlipoproteinemia from other lipoprotein abnormalities. Although the underlying defect(s) remains unknown, several factors such as obesity, alcohol, drugs, and diet are able to modify the glyceridemia, the major manifestation of this disorder. Abnormalities of postheparin lipolytic activity or its subfractions do not appear to be involved in the pathogenesis of primary type V. The prevalence of hyperuricemia, diabetes, pancreatitis, and xanthomatosis appears high among the 32 propositi; the last two entities are much less prevalent in the relatives, even among those relatives classified as hyperglyceridemic. There is no evidence in these families of excessive coronary artery disease prevalence. Triglyceride levels are positively associated with age in this population, especially among women. Average triglyceride levels were lower for women than for men before age 50.
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PMID:Primary type V hyperlipoproteinemia. A descriptive study in 32 families. 20 Jan 62

An analysis was made of correlative factors which might be related to the angiographically measured extent of coronary artery disease in 140 patients. All patients presented with clinically important chest pain. Thirty-three had a normal coronary arteriogram. The extent of the atheromatous process was measured precisely at angiography by three different techniques. A coronary score, based on the percentage of luminal narrowing, was found to be best suited for the analysis. The most important contributory factors to the severity of atherosclerosis was duration of clinical history, number of previous myocardial infarctions, and male sex, but more specifically elevation of serum cholesterol and diabetes mellitus. Cigarette smoking, obesity, hypertension, a family history of atherosclerosis, and elevated serum triglycerides had a positive influence but this was not statistically significant.
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PMID:Relationship between extent of coronary artery disease and correlative risk factors. 22 61

A case can be made that life expectancy has been prolonged in the diabetic, and some disabling symptoms have been ameliorated by the more recent procedures employed in the management of coronary artery disease and nephropathy. At the same time, the procedures described admittedly present problems and may not be generally available to the vast majority of diabetics. The definitive answer lies in attempting to control diabetes to prevent the development of these and other complications. A number of laboratories are attempting to develop an artificial pancreas or islet transplantation to substitute for the insulin secretory capacity that has been lost or impaired. This is an area of research that demands the highest priority. One cannot be confident that present therapeutic programs can be altered to provide the type of diabetic control necessary for the prevention of complications.
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PMID:Potentially lethal complications of diabetes mellitus. 35 5

Twenty-one insulin-dependent diabetics with azotemic nephropathy were evaluated for renal transplantation by selective coronary angiography and cine left ventriculography. All had hypertension, retinopathy, neuropathy, and required salt restriction plus diuretics for volume overload. There was no clinical or electrocardiographic evidence of ischemic coronary artery disease in twenty. Ten patients (five males, five females, mean age 29.3 years; mean duration of diabetes 21.9 years; mean serum cholesterol 239 mg%) had significant coronary artery disease, seven demonstrating focal abnormalities in left ventricular wall motion. Two patients (one male, one female; mean age 36.5 years; mean duration of diabetes 28.5 years; mean serum cholesterol 250 mg%) had no significant coronary artery disease, but demonstrated diffusely abnormal left ventricular wall motion with diminished ejection fraction. Thirty-eight percent had significant coronary artery disease unpredictable by electrocardiographic or clinical data. The finding of no significant coronary artery disease in 52% of a group with severe renal-hypertensive complications of diabetes is surprising. Two patients may have a demonstrated cardiomyopathy.
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PMID:Asymptomatic coronary artery disease: angiographic assessment of diabetics evaluated for renal transplantation. 36 Dec 77

An optimal diet cannot yet be defined. If we knew what an optimal diet was, additional research in nutrition would not be necessary. There is abundant evidence, however, that the usual American diet is not optimal and adequate reason to recommend modification. Current dietary recommendations were developed to prevent the occurrence of nutritional deficiency disease in the 1930's and 1940's. They have been largely successful. They were made, however, before any knowledge was available about the effects of diet upon chronic disease which now represent the primary health problems of the United States. Large amounts of data are available indicating the kids of recommendations which should be made to control hypercholesterolemia--a primary risk factor of coronary artery disease. These kinds of data together with less information upon diet and cancer, hypertension, obesity, diabetes, etc. lead to sensible and consistent dietary recommendations to moderate the dietary practices of most Americans.
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PMID:Optimal nutrition. 44 85

Each day, for one year, the medical records of adult patients who died in hospital were reviewed before seeing the necropsy findings. For those patients who had had chronic left or left and right heart failure, a presumptive cause was assigned on the basis of antemortem clinical data. Of 740 consecutive patients who were studied at necropsy, 90 had had chronic heart failure. In 15 patients the cause of heart failure was not apparent by clinical criteria; of these, 7 were found at necropsy to have cardiomyopathic syndrome caused by coronary artery disease. In retrospect, the presence of overt diabetes mellitus was a clue that cardiomyopathy caused by coronary artery disease was the cause of clinically unexplained heart failure; 5 of 7 patients with unexplained heart failure who were found to have this at necropsy were diabetic, whereas only 1 of the other 8 patients with clinically unexplained heart failure was diabetic (P less than 0.05). Patients in whom clinically unexplained heart failure was found to be the result of cardiomyopathy caused by coronary artery disease had multiple myocardial infarctions on pathological examination, which, with one exception, were nontransmural. By contrast, myocardial infarctions were transmural on pathological examination in each of 7 matched 'controls' with heart failure, in whom the diagnosis of coronary artery disease had been clinically apparent (P less than 0.01).
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PMID:Cardiomyopathic syndrome caused by coronary artery disease. III: Prospective clinicopathological study of its prevalence among patients with clinically unexplained chronic heart failure. 46 32

Worldwide diabetes epidemiology studies have shown quite marked differences in diabetes prevalence rates between ethnic groups. This pattern holds true in the Pacific region and provides unique opportunities for comparative studies. Diabetes is rare in Melanesians, and also in Polynesians, Micronesians, and Australian Aboriginals who retain their traditional life-style. High prevalence rates of insulin-independent diabetes have been demonstrated in Polynesians, Micronesians, and Australian aboriginals who have adopted a Western life-style. Along with the Pima Indians, the Micronesian population of Nauru have the highest diabetes prevalence yet reported--40% of people aged 20 yr and over. As diabetes is rare in traditional living Polynesians and Micronesians, yet high in westernized populations of these ethnic groups, it appears these people may have a "diabetic genotype" that is unmasked by the change in life-style. Obesity, a high caloric Western diet, and reduced physical activity may be the major precipitating factors. Bimodality of glucose tolerance distributions has been demonstrated in both westernized Polynesians and Micronesians. The frequency distributions of both fasting and 2-h postload glucose levels allow separation of these populations into normal and hyperglycemic groups. The optimal cut-off levels between the two groups were a fasting plasma glucose congruent to 140 mg/dl and a 2-h level of congruent 20 mg/dl. These findings provide a valid basis for the diagnosis of diabetes mellitus to be based on the above levels. Only sparse information exists on the prevalence of microvascular and macrovascular complications of diabetes in these populations. However, there is clear evidence that they are occurring and they are similar in nature to the complications seen in Caucasian diabetic patients. Coronary artery disease is not yet a major problem in Pacific Islanders although most of the major risk factors are not present in urbanized communities. However, with increasing westernization, and given more time for the pathologic process of atheroma to develop, it can be expected that coronary artery disease will become a major cause of morbidity and mortality in Polynesians, Micronesians, and the Australian aboriginal.
Diabetes Care
PMID:Epidemiology of diabetes and its macrovascular manifestations in Pacific populations: the medical effects of social progress. 52 Jan 18


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