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

The frequency of electrocardiographic evidence of coronary heart disease (CHD) and the rate of autopsy-proved myocardial infarction were determined in the Pima, a tribe of American Indians with a high prevalence of diabetes mellitus. The electrocardiograms of 701 Pimas, aged 40 years and over (85 per cent of the adult reservation population, 45 per cent of whom had diabetes) were read according to the Minnesota Code, and 120 postmortem examinations were reviewed for evidence of myocardial infarction. The frequency of CHD as evidenced by major Q-wave changes in the Pima (1.6/100) was about one-half that found in Tecumseh, Michigan (p less than 0.10). The relatively low rate of myocardial infarction at autopsy (15 per cent of males and 8 per cent of females aged 40 years and over) was consistent with the low prevalence of Q-wave changes. The subjects with diabetes had a higher rate of CHD than nondiabetics, both electrocardiographically and at postmortem examination, although the differences were not statistically significant. The low prevalence of CHD in the living Pima and the low rate of infarction at autopsy indicate that this tribe has a low frequency of CHD despite the extraordinarily high prevalence of diabetes mellitus.
Diabetes 1976 Jul
PMID:Coronary heart disease in the Pima Indians. Electrocardiographic findings and postmortem evidence of myocardial infarction in a population with a high prevalence of diabetes mellitus. 108 7

The incidence and prevalence of diabetes mellitus in residents of Rochester, Minnesota, for 25 years (1945 to 1970) were determined from available medical records. The over-all incidence rate for diabetes is 133 new cases per 100,000 population per year (age-adjusted to 1970 U.S. white population). The rate increased with age for both men and women and was higher among men over 30 years of age. The average annual incidence rates per five-year period for juvenile-onset diabetes mellitus were low and variable and showed little change. Polyuria, polydipsia, glycosuria, lean habitus, loss of weight, and high levels of fasting hyperglycemia at initial diagnosis occurred more frequently in younger than in older patients. The peak incidence in 1960 through 1964 and the decrease in the following five years may be a reflection of the introduction of the AutoAnalyzer method for blood glucose in 1958. The average annual incidence rates for 1955 through 1959 and 1965 through 1969 were essentially the same. The over-all prevalence for diabetes mellitus is 1.6 per cent, with a higher rate among men than among women over 40 years of age; among school children the rate is 0.1 per cent. Survivorship in the diabetic population is lower than that in the general population. The leading cause of death was coronary heart disease, the death rate from it being higher than for the general population.
Diabetes 1976 Jul
PMID:Diabetes mellitus: incidence, prevalence, survivorship, and causes of death in Rochester, Minnesota, 1945-1970. 108 8

TAKING INTO ACCOUNT AGE, SEX, GEOGRAPHICAL DISTRIBUTION, OBESITY, AND ASSOCIATED CAUSE OF DEATH, IT WAS CONCLUDED THAT: (1) the extent of aortic calcification was much lower in cerebral haemorrhage than in cerebral infarct. In deaths due to cerebral haemorrhage aortic calcification was at about the same level as in those due to cancer of the stomach, while in deaths due to cerebral infarct it was at the same level as in those due to coronary heart disease; (2) the prevalence of large myocardial scar was low in deaths due to cerebral haemorrhage (at about the same level as in those due to prostatic cancer), while in deaths due to cerebral infarct it was more frequent (at the same level as in deaths due to diabetes); (3) the extent of coronary calcification and prevalence of coronary stenosis and fresh myocardial infarction were low in the cerebral haemorrhage and cerebral infarct deaths, but a little lower in the former; and (4) the extent of raised lesions of the aorta and coronary arteries was similar in the cerebral haemorrhage and cerebral infarct deaths, the level of aortic lesions being high and overlapping in level with those in the coronary heart disease and hypertensive deaths, and the levels of coronary lesions being much lower and well below those in the coronary and diabetic hypertensive deaths.
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PMID:Atherosclerosis and myocardial lesions in subjects dying from fresh cerebrovascular disease. 108 1

The relative extent of raised and calcified coronary aortic lesions, prevalence of coronary stenosis and of fresh and old myocardial infarction, and mean heart weight were expressed on a continuous scale for 4 disease groups (coronary heart disease, cerebral infarction/haemorrhage, hypertension/diabetes, cancer). Within these groups the relative position for each of the lesions was calculated by subgroups of disease in order to show the elevating or depressing effect of hypertension, diabetes, obesity, and combinations of disease. The strength of association between 33 factors (town 5, disease 24, obesity, heart weight, age, and sex) and the lesions was calculated. An analysis of variance was carried out and the proportion of the variance of the different lesions accounted for by town, disease, etc., is shown. The extent of raised aortic lesions is strongly associated with age and hypertension. It is positively associated with coronary heart disease and inversely associated with cancer. Town factors have a small positive association which is larger than that due to obesity. 33 factors taken together account for 50% of the variance. Age alone accounts for 37% and sex for only 0.3%. The extent of calcified aortic lesion is strongly associated with age, town, hypertension, coronary heart disease and diabetes mellitus. It is inversely associated with cancer, more strongly in cancer of the bronchus and the liver than in other cancers. It is inversely associated with obesity. 33 factors together account for 30% of the variance and age alone accounts for about 13%. The extent of raised coronary lesions is strongly associated with age, coronary heart disease, sex, diabetes mellitus, hypertension and obesity. It is inversely associated with cancer, more strongly in cancer of the prostate and the liver than in other cancers. Town factors have a small association. 33 factors taken together account for about 43% of the variance. Age alone accounts for 25%. The extent of calcified coronary lesions is associated with coronary heart disease and age. There is a low association with hypertension and diabetes, an inverse association with cancer, and a low inverse association with obesity. 33 factors together account for 20% of the variance. Coronary heart disease alone accounts for 12% and age alone accounts for 8%. The prevalence of coronary stenosis is strongly associated with coronary heart disease, age, and sex. There is a small association with town factors, obesity, and hypertension, and an inverse association with cancer. All the factors together account for about 30% of the variance. Coronary heart disease alone accounts for 23% and age 10%.
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PMID:Aortic, coronary, and myocardial lesions in relation to various factors. 108 2

Among a group of 286 patients with atherosclerotic arterial disease 35.3% had normal carbohydrate tolerance, 28% asymptomatic (biochemical or latent), and 36.7% overt diabetes mellitus. There was a tendency towards peripheral artery involvement and a greater incidence of coronary heart disease (myocardial infarction, changes in ST-T segment) among patients with asymptomatic or overt diabetes, figures being comparable for men and women. Most of the patients with atherosclerotic arterial disease without diabetes mellitus were in stage II, while in diabetics there was a shift towards stages I and IV. There was no significant correlation between incidence, symptoms, and location of atherosclerotic arterial disease, on the one hand, and duration of overt diabetes, on the other.
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PMID:[Peripheral arterial disease and diabetes mellitus(author's transl)]. 115 92

Clinical coronary heart disease (CHD) occurred in 257 subjects during eight to nine years of follow-up (average, 8 1/2 years) in a prospective study of 39- to 59-year-old employed men. Incidence of CHD was significantly associated with parental CHD history, reported diabetes, schooling, smoking habits, overt behavior pattern, blood pressure, and serum levels of cholesterol, triglyceride, and beta-lipoproteins. The type A behavior pattern was strongly related to the CHD incidence, and this association could not be explained by association of behavior pattern with any single predictive risk factor or with any combination of them.
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PMID:Coronary heart disease in Western Collaborative Group Study. Final follow-up experience of 8 1/2 years. 117 96

Factors in the prevention of coronary heart disease (CHD) are review ed. In regards to oral contraceptives (OCs), there is some evidence that OCs significantly increase the risk of CHD in women over 40 years of age who are already at increased risk. There have also been reports that the risk of developing myocardial infarction or coronary death is 5-6 times higher in women aged 40-44 years using OCs than in nonusers. OCs can induce hypertension, though this condition is generally reversible after discontinuation of use. There also appears to be a relationship between OC use and carotid or cerebrovascular thromboses. It is recommended that caution be exercised in prescribing OCs to women over 40 years of age, those with a family history of premature CHD, and those who are heavy cigarette smokers or have other risk factors. It is also recommended that prospective OC users have their blood pressure tak en, and those with a family history of CHD or diabetes mellitus should be tested for plasma lipid levels.
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PMID:Prevention of coronary heart disease. Report of a Joint Working Party of the Royal College of Physicians of London and the British Cardiac Society. 126 63

Atherosclerosis and insufficiency of the coronary arteries and their sequelae are summarized in the term "coronary heart disease". For the evaluation of the coronary arteries the knowledge of malformations, variants and supply areas is of importance. Extension and severity of atherosclerosis of the coronary arteries and their insufficiency is being influenced by hyperlipidemia, hypertension and diabetes mellitus. The process of atherosclerosis as a cause of the proliferation of vascular smooth muscle cells in complicated by ulceration, parietal and obliterative thrombosis as well by intramural hemorrhages. Relative ischemia leeds to disseminated cell necrosis; total ischemia causes large myocardial tissue necrosis, called infarction. Localization and extension of infarction and the later scars correspond to the caliber of the obliterated coronary artery and to the significance of the collaterals. Postmortem coronary angiography can detect cause and extension of the damaged cardiac area. Functional significance of chronic coronary heart disease is related to the "critical connective tissue content" of the heart. After surgical treatment qualitative and quantitative morphology may help to explain postoperative cardiac failure.
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PMID:[Morphology of coronary heart disease (author's transl)]. 126 48

The association of cigarette smoking and atherosclerorosis was investigated in 1320 autopsied men, 25--64 years of age. Aortic and coronary lesions were evaluated visually in coded specimens and objectively by analysis of radiographs. Using schedules that had been tested on pairs of living persons, interviewers obtained estimates of cigarette smoking habits of the deceased men from surviving relatives. Data were analysed for black and white men in the total sample of cases and also in groups according to the presence (selected disease group) or absence (basal group) of diseases thought to be associated with smoking (emphysema, lung cancer, etc.) or with coronary heart disease (myocardial infarction, hypertension, diabetes, stroke, etc.). Atherosclerotic involvement of aorta and coronary arteries was greatest in heavy smokers and least in nonsmokers for both races in the total sample of cases, the basal group and the selected disease group.
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PMID:Cigarette smoking and atherosclerosis in autopsied men. 126 63

Treatment with thiazide diuretics causes impaired glucose tolerance, biochemical diabetes, and insulin resistance. The effect of diuretics on glucose tolerance is clearly dose-related. Spironolactone does not impair glucose tolerance, even at high dosage, but differences among other diuretics could be due to comparisons at doses that are not equal. Diuretic-induced changes in glucose metabolism are not conclusively related to altered potassium homeostasis, and impaired glucose tolerance occurs even when relatively low doses of thiazide are combined with potassium-sparing agents. The effects of diuretics on glucose homeostasis are in large part and probably entirely reversible. These disturbances of glucose metabolism have been detected only by detailed biochemical testing, and their clinical relevance is uncertain. In established diabetes, diuretics have a rapid and substantial adverse effect on metabolic control. In nondiabetic subjects, diuretics rarely cause or trigger a serious hyperosmolar nonketotic diabetic syndrome. Otherwise, it is not known whether the metabolic changes cause clinical diabetes or lead to microvascular complications in the long term. Evidence from large outcome trials suggests that biochemical diabetes, glucose intolerance, and insulin resistance do not increase the risk of coronary heart disease in treated hypertensive patients. Diuretics should be avoided in patients with diabetes unless their use is essential. Otherwise, a low dose of thiazide remains as excellent choice for first-line antihypertensive therapy. Dihydropyridine calcium antagonists, diltiazem, and verapamil appear to have no important effects on glucose homeostasis. There is very limited evidence that selective alpha-antagonists increase insulin sensitivity. The importance of metabolic differences between drug classes will be established only by comparative outcome trials with coronary events as the end point.
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PMID:Influence of diuretics, calcium antagonists, and alpha-blockers on insulin sensitivity and glucose tolerance in hypertensive patients. 128 44


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