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

This study examined the levels of ciliary neuronotrophic factor (CNTF)-like activity in the sciatic nerve of rats with short-term streptozotocin-induced diabetes or dietary supplementation with 40% galactose. CNTF-like activity, found in nerve extracts by in vitro bioassay, was reduced to 20% of control values after 1 or 2 months of galactose feeding (both P less than 0.01) and to 70% of control values after two months of streptozotocin diabetes (P less than 0.01). These data demonstrate that short-term hyperglycemia or its consequences can reduce extractable levels of Schwann cell-derived neuronotrophic factor and raise the possibility that impaired Schwann cell production of CNTF may contribute to the development of experimental diabetic neuropathy.
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PMID:Reduced ciliary neuronotrophic factor-like activity in nerves from diabetic or galactose-fed rats. 157 89

Brainstem acoustic evoked potentials (BAEPs) were studied in streptozotocin (STZ)-diabetic rats and age-matched controls at 3 and 5 months from induction of the pathology. The diabetic status of the animals was kept uncontrolled throughout the study. Body weight and glycosylated hemoglobin were markedly altered in the diabetic animals (-42%, and +120% of control values, respectively). Neurophysiological results showed an increase in the latency of the major components of BAEPs; this increase was clearly time-dependent for the peripheral component (peak I). The central component (peak IV) was also significantly delayed. However, no significant impairment of the central conduction time was demonstrated by examining the interpeak I-IV latency. In conclusion, BAEPs prove to be a useful non-invasive neurophysiological technique that may help unravel both the relative involvement of the peripheral and central nervous systems in the course of diabetes mellitus, and the evolution of diabetic neuropathy.
Diabetes Res Clin Pract 1992 Apr
PMID:Brainstem auditory evoked potentials in rats with streptozotocin-induced diabetes. 157 28

Neuropathy is the most common and perhaps the most devastating complication associated with diabetes. Although many theories regarding the pathogenesis of diabetic neuropathies have been proposed, the most popular theory focuses on the accumulation of sorbitol in the nerve cell through the "polyol pathway." Treatment for diabetic neuropathy remains inadequate. Newer agents such as the aldose reductase inhibitors show some promise in halting and perhaps reversing the pathogenesis of this complication; however, these agents remain investigational. Currently, the most reasonable approach involves the use of agents to control pain and other symptoms associated with this progressive disease.
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PMID:Drug therapy of diabetic neuropathy. 158 3

Abnormal myoinositol metabolism has been implicated as a contributor to the development of diabetic neuropathy. Furthermore, in vitro glucose inhibits animal and human myoinositol transporters. To investigate whether myoinositol transport is abnormal in diabetic subjects with and without neuropathy, we used a triple-isotope technique to measure [14C]myoinositol uptake in leucocytes from 23 insulin-dependent diabetic subjects and 13 matched nondiabetic subjects. All subjects with diabetes underwent neurophysiological studies, and subjects without neuropathy were compared with those with various degrees of neuropathy. The relationship between glycemia and flux was also studied. Diabetic subjects had similar intracellular and plasma myoinositol concentrations but had higher rates of uptake of myoinositol over the extracellular concentrations of myoinositol studied. Although the derived Km, Vmax, and passive components were not significantly different, the Vmax:Km ratio was significantly higher in diabetic subjects compared with nondiabetic subjects (0.25 [0.17-0.32] vs. 0.16 [0.13-0.19], respectively (P = 0.006). In diabetic subjects, the rate of myoinositol uptake correlated with HbA1c, particularly at 3 microM extracellular myoinositol where active uptake was a high proportion of the total influx (P less than 0.005). No difference in myoinositol uptake was found among diabetic subjects with various degrees of neuropathy. We conclude that although myoinositol transport is abnormal in diabetes, it is not specifically abnormal in diabetic neuropathy. Prolonged hyperglycemia is associated with higher myoinositol flux.
Diabetes 1992 Jun
PMID:Abnormal myoinositol influx in human leucocytes in diabetes but not specifically in diabetic neuropathy. 158 2

Macroangiopathy of the lower extremities is one of the most frequent complications of diabetes and has a very adverse impact on the quality of life of the patients. It affects approximately as much as half the diabetics with the duration of the disease for more than 15 years. It is encountered in two forms. The first type of affection--obliterating atherosclerosis--reminds of affections of the arteries of the lower extremities in the non-diabetic population, although some differences in the site of affection, morphology of sclerotic changes as well as the spectrum of risk factors were found, when compared with obliterating atherosclerosis in non-diabetics. Risk factors of this form of macroangiopathy include cholesterol, triacylglycerols, reduced values of HDL-cholesterol, hypertension, fibrinogen, smoking and apparently also albuminuria. The second form of macroangiopathy--mediocalcinosis--is not associated with the mentioned risk factors of atherosclerosis but is probably the consequence of diabetic neuropathy. Contrary to atherosclerosis, it does not lead to the development of obliteration but has also an adverse effect on the function of blood vessels. Its incidence correlates with the duration and compensation of diabetes as well as deteriorated perception of vibrations. With regard to the high incidence of gangrenes requiring amputation, it seems rational to influence in diabetics all known risk factors of macroangiopathy although convincing results of long-term intervention studies are still lacking.
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PMID:[Characteristics of diabetic macroangiopathy of the lower extremities]. 159 8

A female patient with acanthosis nigricans, insulin resistant diabetes, and generalized lipoatrophy is reported. The patient developed skin pigmentation and acanthosis nigricans around the age of 34. Arthralgia, muscle weakness, and peripheral neuropathy were also present when she first visited us at 36 years of age. Dermatomyositis, systemic sclerosis, and internal malignancy were ruled out, and the diagnosis of acanthosis nigricans and insulin resistant diabetes was made. Her diabetes gradually worsened and, since the age of 39, she has been treated with an oral anti-diabetic drug. Around the age of 47, generalized lipoatrophy became prominent. Insulin receptor studies ruled out insulin resistant diabetes type A and B. At this point, we diagnosed this patient as having lipoatrophic diabetes, which is a syndrome characterized by insulin resistant diabetes, acanthosis nigricans, generalized lipoatrophy, and other metabolic disturbances. The control of her diabetes has been poor, and diabetic neuropathy and lipoatrophy-induced painful skin lesions such as clavus and tylosis have been persistent. The present case indicates the importance of careful skin examinations in the diagnosis of this syndrome.
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PMID:Lipoatrophic diabetes. 160 89

The potential of the aldose reductase inhibitor ponalrestat (600 mg daily) to ameliorate diabetic neuropathy was evaluated in 259 diabetes mellitus patients with peripheral neuropathy (defined by abnormal vibration perception threshold and abnormal peroneal motor conduction velocity) in a double-blind placebo-controlled clinical trial running for 18 months. Overall, no beneficial effect of ponalrestat on vibration perception thresholds, nerve conduction velocities, and nerve action potential amplitudes was detected. Because vibration perception thresholds and conduction velocities in median, peroneal, and sural nerves did not deteriorate in the placebo group, the potential of ponalrestat to prevent the expected deterioration in peripheral nerve function that occurs with an increased duration of diabetes was not tested. Patients with an abnormal heart rate reaction to standing (abnormal 30:15 ratio; n = 84) on ponalrestat did not deteriorate in this autonomic nerve function test as shown in those on placebo. In conclusion, ponalrestat did not improve peripheral nerve function in diabetes mellitus patients with signs of peripheral neuropathy, although it did ameliorate a deterioration in autonomic nerve function in diabetic patients with signs of autonomic neuropathy.
J Diabetes Complications
PMID:Peripheral and autonomic nerve function in 259 diabetic patients with peripheral neuropathy treated with ponalrestat (an aldose reductase inhibitor) or placebo for 18 months. United Kingdom/Scandinavian Ponalrestat Trial. 161 Nov 36

An oral prostaglandin E1 (PGE1) analogue, OP-1206.alpha-CD, was given to rats with streptozocin (STZ)-induced diabetes to examine the therapeutic effects of OP-1206 on short-term and long-term diabetic neuropathy and its action mechanism with special reference to nerve Na(+)-K(+)-ATPase activity. In the short-term experiment, OP-1206 was administered daily to diabetic rats in 3- and 30-mg/kg doses for 4 wk from the day of STZ injection. In the long-term study, 10 micrograms/kg OP-1206 was also given daily for 8 wk from 7 mo after induction of diabetes. The compound improved decreased sciatic motor nerve conduction velocity in both short-term and long-term diabetic rats. The nerve Na(+)-K(+)-ATPase activity of diabetic rats, reduced by 40% compared with controls, was reversed to the level of controls in both experiments, whereas weight loss and hyperglycemia were unchanged, and neither nerve sorbitol accumulation nor myo-inositol depletion was corrected. In a morphometric analysis of myelinated nerve fibers (MNFs) in long-term diabetes, the mean diameter of the largest 10% of MNFs was significantly reduced in untreated diabetic compared with control rats, but OP-1206 completely reversed this reduction. The results suggest that OP-1206 ameliorates a decrease in nerve Na(+)-K(+)-ATPase activity without any effect on nerve myo-inositol level and that the compound may be not only a potent therapeutic agent for the treatment of diabetic neuropathy but also a useful research tool to investigate the mechanism of nerve Na(+)-K(+)-ATPase activity regulation.
Diabetes 1991 Jun
PMID:Amelioration of nerve Na(+)-K(+)-ATPase activity independently of myo-inositol level by PGE1 analogue OP-1206.alpha-CD in streptozocin-induced diabetic rats. 164 81

As many as 84 patients suffering from diabetes mellitus with and without clinical manifestations of diabetic neuropathy (DN) underwent clinical and electromyographic examinations. The patients with clinical manifestations of DN showed a decrease of the rate of wave spreading in the distal and proximal parts of lower limb nerves, an increase of the proximal distal gradient, a decline of the amplitude of the maximal M-response, an increase of the latent period or the lack of H-reflex. The data point to generalized impairment of the peripheral neuromotor apparatus with primary involvement into the process of the distal parts of limb nerves. In the majority of the patients without clinical manifestations of DN, electromyography also demonstrated injury to the peripheral nerves, evidence of a possibility of electromyographic diagnosis of the subclinical stage of DN.
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PMID:[Evaluation of the functional state of the peripheral motor neuron apparatus in patients with diabetes mellitus]. 165 85

As many as 43 patients suffering from diabetes mellitus associated with the clinical manifestations of diabetic neuropathy underwent ++clinico-electromyographic and immunologic examinations. The control group comprised 30 practically healthy persons of the same age. The electromyographic++ examination included measurements of the rate of wave spreading in motor fibers of the limb nerves in the distal and proximal parts (in accordance with the F-wave), a study of H-reflex from the musculus soleus of the leg together with M-response of hand and foot muscles. The immunologic examination consisted in measurements of different class immunoglobulins in the blood serum. Based on the electromyographic findings, 3 groups of patients were distinguished: group I included patients with primary injury to the myelin membrane of the nerves; group II was made up of patients with primary injury to the axon, and group III of patients with concomitant injury to the nervous membranes and axons. There was a significant elevation of the concentration of anti-myelin activity possessing IgM in the blood serum of patients belonging to groups I and III, which attests to the involvement of the immunopathological mechanism into myelopathy development.
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PMID:[Informative value of complex electromyographic and immunologic examinations of patients with diabetic neuropathies]. 165 86


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