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

Preventive-care practices among persons with diabetes can prevent or delay complications such as eye disease, kidney disease, or nerve damage that is a precursor to disabling foot disease. However, the level of diabetes-related preventive care is inadequate in the United States, and little has been reported about preventive care in Puerto Rico, where an estimated 10% of adults have diagnosed diabetes. CDC analyzed data from 2000, 2001, and 2002 Behavioral Risk Factor Surveillance System (BRFSS) surveys to assess the percentage of adults with diabetes in Puerto Rico who engaged in five selected preventive-care practices. This report summarizes the results of that analysis, which indicated that, with the exception of hemoglobin A1c testing, the percentages of adults engaging in preventive-care practices were lower than the target percentages set by U.S. national health objectives for 2010.
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PMID:Preventive-care practices among adults with diabetes--Puerto Rico, 2000-2002. 1553 21

Visual impairment and blindness affect an estimated 3.4 million U.S. adults aged >/=40 years. The leading causes of visual impairment and blindness are diabetic retinopathy and age-related eye diseases (e.g., cataracts, macular degeneration, and glaucoma). Diabetes affects approximately 18 million U.S. adults, of whom an estimated 30% have undiagnosed diabetes, and imposes an increased risk for eye disease. To characterize the prevalence of visual impairment and selected eye diseases (i.e., diabetic retinopathy, cataracts, macular degeneration, and glaucoma) among persons aged >50 years with and without diabetes, CDC analyzed data from the 2002 National Health Interview Survey (NHIS). This report summarizes the findings of that analysis, which identified a substantially higher prevalence of visual impairment and eye disease among those with diabetes compared with those without diabetes. Measures are needed to increase comprehensive eye examinations, especially among adults at high risk for blindness and visual impairment (e.g., persons aged >/=65 years and those with diabetes).
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PMID:Prevalence of visual impairment and selected eye diseases among persons aged >/=50 years with and without diabetes--United States, 2002. 1554 22

The hormone insulin, which is produced in the pancreas, is an important regulator of blood sugar levels. In people with diabetes, the pancreas does not produce sufficient insulin (type 1 diabetes) or the body does not respond appropriately to the insulin (type 2 diabetes). Alcohol consumption by diabetics can worsen blood sugar control in those patients. For example, long-term alcohol use in well-nourished diabetics can result in excessive blood sugar levels. Conversely, long-term alcohol ingestion in diabetics who are not adequately nourished can lead to dangerously low blood sugar levels. Heavy drinking, particularly in diabetics, also can cause the accumulation of certain acids in the blood that may result in severe health consequences. Finally, alcohol consumption can worsen diabetes-related medical complications, such as disturbances in fat metabolism, nerve damage, and eye disease.
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PMID:Consequences of alcohol use in diabetics. 1570 98

The most significant complication of diabetes mellitus involves the eye and which develops 85% of all diabetics eventually to retinopathy. Diabetic retinopathy is the commonest cause of blindness between 4th and 7th decades. It is essentially a microangiopathy with two distinct stages during its evolution, the preclinical and clinical stages. Diabetic maculopathy is the commonest cause of visual loss in diabetics. Progression of the diseases can be retarded by early diagnosis and using appropriate measures. Well known risk factors are diabetes age, metabolic control of hypertension, associated renal disease and pregnancy. The management plan of the secondary level is early diagnosis and laser photocoagulation or surgical intervention. Vitreoretinal surgery is certainly of benefit in patients with advanced diabetic eye disease. The PROMPT factors can be applied to decrease diabetes mellitus related blindness.
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PMID:Diabetic retinopathy for general practitioners. 1587 59

Diabetic retinopathy (DR) remains a major cause of new cases of blindness onset in adults. The prevalence of diabetic eye disease is strongly related to the duration of diabetes, blood pressure and glycemic control, although a multifactorial pathogenesis is likely to be probable. Despite the effectiveness of current prevention (by tight metabolic and blood pressure control) and treatment (with laser photocoagulation) methods, and with the help of screening programs, diabetic eye disease is still a problem. Recent advances in our understanding of the pathogenesis of microvascular complications and particularly of the role of growth factors (GFs) in retinal changes have allowed significant advances in the medical management of DR. Studies of the biochemical process underlying DR have clearly demonstrated an important role for a number of aberrantly expressed GFs or their second messengers (eg, vascular endothelial growth factor, growth hormone, insulin-like growth factor-1, protein kinase C and pigment epithelium derived factor) possibly acting together in the development of structural changes characterizing early stages of vascular DR. The critical role of GF expression has led to new experimental therapeutic intervention in DR. In fact, timely pharmacological intervention in GF synthesis and activities may arrest the development of early vascular changes. As the effects of GFs become better understood, pharmacological manipulation of GF synthesis and action will be useful in the early stages of vascular change with the potential to prevent diabetes-related visual loss.
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PMID:Treating diabetic retinopathy by tackling growth factor pathways. 1589 47

The burden of Type II diabetes is growing rapidly worldwide, across high-, middle- and low-income countries. This burden is associated primarily with increased risks of macrovascular and microvascular diseases, and it is agreed that multifactorial treatment regimens are required to reduce it. ADVANCE (Action in Diabetes and Vascular disease: Preterax and Diamicron-MR Controlled Evaluation) is a large-scale, 2 x 2 factorial, randomised clinical trial. It will investigate the potential benefits of blood pressure lowering, using a fixed low-dose combination of perindopril and indapamide vs placebo, and of tighter glucose control, using an intensive gliclazide-MR-based glucose control regimen vs a standard guidelines-based regimen, separately and together. The two primary outcomes are a composite macrovascular end point of nonfatal stroke, nonfatal myocardial infarction and cardiovascular death; and a composite microvascular end point of new or worsening nephropathy or microvascular eye disease. Following successful recruitment and randomisation of 11,140 participants by March 2003, the study is currently half way through its planned follow-up of 4.5 years. Adherence to randomised study treatment is good; and loss to follow-up is minimal. It is hoped that the study will answer a number of unresolved issues. The blood pressure lowering arm will investigate the possible reduction in major vascular disease in patients with Type II diabetes whether or not they have hypertension, and the possible benefits of blood pressure lowering in such patients already receiving background therapy with the ACE inhibitor perindopril. The glucose control arm will investigate the possible reduction in both macrovascular and microvascular disease achieved with tighter glucose control, targeting an HbA1c of 6.5% and a fasting blood glucose of 6.0 mmol/l. Finally, the factorial design will enable investigation of the combined effects of more intensive glucose control and tighter control of blood pressure.
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PMID:ADVANCE: action in diabetes and vascular disease. 1607 30

Previous studies identified serine, cysteine and metalloproteases in normal aqueous humours (AH) and suggested that a balance between proteases and their inhibitors may play a role in the modulation of the AH outflow. We aimed to determine whether secretory leukocyte protease inhibitor (SLPI), a serine protease inhibitor, is present in AH of patients with cataract and other eye pathologies. AH was collected from 117 cataract patients of which 55 were diagnosed with more when one eye disease: cataract only (n=62), pseudoexfoliation (PEX) (n=26), glaucoma (n=6), diabetes retinopathy (n=4), iritis-uveitis (n=4) and macular degeneration (n=28). The total protein in AH was determined by a Bradford assay and SLPI was analyzed by Western blot and ELISA methods. The average concentration of total protein and SLPI in AH samples was 160+/-15 microg/ml (n=117, +/-SEM) and 500+/-94 pg/ml (n=105), respectively. The cataract patients with additional eye disease(s) showed higher protein levels (201+/-35 microg/ml) than cataract (controls) (128+/-31 microg/ml), P<0.01. It is noteworthy that no correlation was found between SLPI and the total protein concentrations in AH, but SLPI was positively correlated with age (r=0.2, P<0.05). No statistical difference in SLPI levels was found between controls (cataract) and other pathologies, while patients with iritis/uveitis had higher SLPI levels compared to those with diabetes (P<0.05). We show here for the first time that SLPI is present in AH and may play a role as well as serve as a marker in pathological states.
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PMID:Secreted leukocyte protease inhibitor is present in aqueous humours from cataracts and other eye pathologies. 1620 5

Western Australia has a large landmass and low population density. Dating back to the 1970s and even today, specialist medical services are often lacking or non-existent outside of Perth, the capital city. Diabetes has always been a major health problem, particularly in the Australian Aboriginal community. In conjunction with the Lions Save Sight Foundation and Diabetes Foundation of Western Australia a diabetic screening programme was initiated in 1978 for rural and remote diabetics. The programme aimed to screen for diabetic retinopathy, educate diabetics, medical and paramedical personnel and to arrange treatment for sight threatening eye disease. Eye screening continues to date although the role of the Lions Eye Institute has changed from programme initiator to reading centre and teaching unit, and continues to evolve with changing technologies.
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PMID:Diabetic screening in Western Australia: a photographer's perspective. 1692 89

With the highest prevalence of diabetes in the United States, American Indians and Alaska Natives are at greatest risk for diabetic eye disease (DED), a leading cause of blindness. The National Eye institute (NEI) conducted formative research to understand DED-related knowledge, identify approaches to managing this disease, and design a communication plan to increase awareness and reduce DED among these populations. The NEI conducted qualitative research at five locations in indian country with representatives from national organizations, tribal members, and healthcare providers. While diabetes ranked high on their list of primary community health issues in need of attention, study participants had only a basic level of diabetes-related knowledge, acknowledged the need for DED education, and underscored the importance of the use of interpersonal and culturally appropriate communication strategies. This is the first exploratory qualitative research study to examine the status of diabetic eye disease among American indians and Alaska Natives whose primary purpose was to inform the design of a national DED communication campaign.
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PMID:The National Eye Health Education Program: increasing awareness of diabetic eye disease among American Indians and Alaska Natives. 1706 47

Thyroid-associated ophthalmopathy (TAO) is an inflammatory process associated with autoimmune thyroid diseases (AITD), most commonly Graves disease. It is clinically present in up to one half of patients suffering with AITD and 3-5 % of patients suffer from intense pain and inflammation with double vision or even loss of vision. Because diabetes mellitus type 1 and AITD have similar pathogenesis and shared genetic background it is not surprising that up to 30% of patients with type 1 diabetes develop AITD during long term follow-up. It is important to consider the activity and severity ofTAO separately. Treatment is effective at the beginning of disease in the high activity phase. Glucocorticoids represent a milestone in the treatment of TAO and are necessary in diabetic patients as well. According to the latest experience the most effective and best tolerated regimen is iv glucocorticoid administration of methylprednisolone at weekly intervals up to a cumulative dose of 4.5 g. Orbital radiotherapy is considered to be contraindicated in patients with diabetes for fear of worsening retinopathy. Surgical orbital decompression is indicated in severe proptosis and progressive neuropathy in the acute stage. Rehabilitative (extraocular muscle or eyelid) surgery is often needed after treatment and inactivation of eye disease.
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PMID:[Thyroid orbitopathy and diabetes]. 1764 37


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