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

Left ventricular function was assessed by measuring sytolic time intervals in insulin-requiring diabetics with and without significant microangiopathy. The results were compared with those in normal controls. Significant microangiopathy was defined as proteinuria over 3 g/24 h or proliferative retinopathy. Left ventricular function was also assessed one and a half years later by echocardiography in four patients with microangiopathy. Patients with angina, previous myocardial infarction, hypertension, and alcoholism were excluded. All had normal electrocardiograms and chest radiographs. Diabetics with microangiopathy had impaired left ventricular function, whereas those with uncomplicated diabetes had normal function. This finding supports the existence of a specific diabetic cardiomyopathy due to microangiopathy rather than the metabolic defect. The association of microangiopathy and impaired left ventricular function may explain the high immediate mortality and the high incidence of cardiogenic shock and congestive heart failure after myocardial infarction in diabetics.
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PMID:Diabetic cardiomyopathy: the preclinical phase. 86 81

His bundle recordings were obtained in 121 patients with chronic bundle branch block and the patients were followed for a mean period of 18 months. Seventy-nine patients had an infranodal conduction time (H-Q) less than 70 msec while 42 had H-Q greater than or equal to 70 msec. There was no significant difference in mean age, smoking history, diabetes, syncope, dizziness, blood pressure, and serum cholesterol or triglyceride levels between the two groups. There was a significantly greater incidence of progresssion to second degree or third degree atrioventricular block (9/42, 21%), and of severe congestive heart failure (16/42, 38%) in patients with H-Q greater than or equal to 70 compared with those with H-Q less than 70 (1/79, 1.3%; and 13/79, 16%, respectively). The risk of sudden death was significantly greater only in the group with H-Q greater than or equal to 70 and severe congestive heart failure. There was no correlation between the presence of first degree atrioventricular block and/or any particular type of bundle branch block pattern with sudden death and/or progression to second degree or third degree atrioventricular block. Analysis of the surface electrocardiogram is only of limited value in predicting high risk patients with chronic bundle branch block. Electrophysiologic studies are of greatest value in patients with bundle branch block with transient neurologic symptoms in whom no cause for the symptoms is evident.
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PMID:Prognostic value of infranodal conduction time in patients with chronic bundle branch block. 87 16

The antihypertensive effect and side-effects during 12 months' treatment with bendroflumethiazide and propranolol have been compared in two randomly selected, equally large groups (n= 53) of previously untreated male hypertensives. Systolic BP above 170 or diastolic BP above 105 mmHg on two occasions were defined as hypertension. The same BP reduction was achieved in both groups. During the 12 months' treatment one subject on bendroflumethiazide developed diabetes mellitus and one on propranolol developed cardiac decompensation. None developed gout. Contrary to what had been presumed, glucose tolerance improved during 12 months' treatment with both agents, while there were no changes in fasting blood sugar, insulin or triglyceride concentrations. No changes were found in serum potassium or total body potassium during 12 months' bendroflumethiazide treatment, while serum potassium increased during treatment with propranolol. Uric acid increased slightly during treatment with both agents. Prolongation of the follow-up to 24 months did not change any of the findings regarding metabolic changes during treatment. The frequency of subjective side-effects decreased to the same extent during treatment with both drugs. It is concluded that bendroflumethiazide and propranolol are equally useful as antihypertensive agents and that the risk of impariment of glucose metabolism and potassium balance seems to be very slight during treatment with bendroflumethiazide in mild hypertension.
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PMID:Antihypertensive effect and side-effects of bendroflumethiazide and propranolol. 93 76

Three newborn infants with congestive heart failure had hemodynamic, angiographic, and echocardiographic features of hypertrophic subaortic stenosis (hypertrophic obstructive cardiomyopathy). Treatment with digitalis and diuretic drugs was ineffective, but improvement occurred when these agents were withheld in one patient, and when treatment with propranolol was begun in two patients. Echocardiography was helpful in establishing the diagnosis in two patients and showed resolution of the condition during the first six months of life. Serial cardiac catheterizations confirmed resolution of the outflow obstruction in the third patient. Family studies revealed no evidence of familial cardiomyopathy, but the mothers of two infants had insulin-dependent diabetes mellitus and the mother of the third was presumed to be prediabetic.
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PMID:Transient hypertrophic subaortic stenosis in infants of diabetic mothers. 94 37

Forty-six practicing physicians and 357 patients with diabetes mellitus or congestive heart failure were the subjects for this study, which focuses on the impact of medication regimen and doctor-patient communication in affecting patient medication-taking behavior and physician awareness of these behaviors. Four types of medication errors were defined: omissions, commissions, scheduling misconceptions and scheduling non-compliance. The average error rates were 19 per cent, 19 per cent, 17 per cent and 3 per cent, respectively. The combined average error was 58 per cent; scheduline non-compliance on the part of the patient was a minor component. Specific aspects of the medication regimen were associated with increased errors: (1) the more drugs involved between the doctor-patient pair, the greater the errors of omission and commission; and (2) the greater the complexity of the scheduling, the greater the errors of commission and scheduling misconceptions. If the patient did not know the function of all his drugs, errors of commission and scheduling misconception increased. Neither characteristics of patients nor the severity of disease were influential in determining the extent of medication errors. For patients with congestive heart failure, good communication of instructions and information from physician to patient was associated with low levels of all types of errors.
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PMID:Communication, compliance, and concordance between physicians and patients with prescribed medications. 96 52

Seventy patients with cutaneous erythema of the feet with or without necrosis were the subjects of this investigation. Sixty-five of them had open diabetes. The glucose tolerance of the remaining five patients was altered in a diabetic direction. Twenty-seven of the 70 patients had roentgenologically demonstrable destruction in the bones of the feet. These 70 patients were compared with 61 diabetic control patients of corresponding age and duration of diabetes but without these skin lesions of the feet. Only four of the 61 control patients had destruction in the bones of the feet and all these destructions were small. Precipitating factors were identified in general for the skin lesions, the most common being cardiac decompensation. A higher frequency of precipitating factors was seen in patients with skeletal destructions than in those without. The skeletal destructions and cutaneous necrosis are supposed to be equivalent lesions, localized to different tissues in the feet. When patients presenting skin lesions of the feet in the form of distal gangrene were compared with those who had cutaneous erythema and necrosis of the feet, but no distal gangrene, no differences were found with respect to age, duration of diabetes, occurrence of precipitating factors and the occurrence of skeletal destruction. Cutaneous erythema without necrosis is understood to be incipient diabetic gangrene.
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PMID:Skeletal lesions of the feet in diabetics and their relationship to cutaneous erythema with or without necrosis on the feet. 97 Feb 23

The one year mortality of patients from the Perth Acute Myocardial Infarction Register surviving the acute episode (first 28 days) is presented. Of 1138 patients suffering definite or possible acute myocardial infarction in one year, 705 (62%) survived 28 days. There were 89 deaths (11-5%) in the subsequent 11 months. One year mortality was related to age but not sex, previous symptoms of coronary heart disease, but not hypertension or diabetes, to tachycardia and congestive cardiac failure at first examination, but not arrhythmias in the acute episode. These observations highlight the importance of protecting the myocardium in the acute phase of myocardial infarction.
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PMID:Acute myocardial infarction: one year follow-up of 1138 cases from the Perth Community Coronary Register. 107 74

The series reported includes 85 patients who underwent arterial embolectomy for 101 embolic events. The over-all hospital mortality rate following embolectomy was 41 percent. The etiological factors for this high mortality rate are analyzed. The group includes 58 patients who had arteriosclerotic heart disease and 27 patients with rheumatic valvular disease. The mortality rate encountered in the arteriosclerotic group of patients was 52.9 percent, whereas that in the rheumatic group of patients was 18 percent. The major cause of death was cardiorespiratory failure (51 percent). Factors which weighed heavily on the final outcome were previous myocardial infarction, hypertension, diabetes, cardiac decompensation, and rhythm disturbances. Limb salvage was accomplished in 51 patients (60 percent). Amputation was performed in 17 patients (20 percent).
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PMID:Mortality rate following lower limb arterial embolectomy: causative factors. 112 92

A case of lactic acidosis associated with phenformin therapy for diabetes mellitus is reported, and 34 previously reported cases of lactic acidosis associated with phenformin therapy are reviewed to determine if any predisposing factors to lactic acidosis were apparent. Observations of sex, age, duration of diabetes, pathologic conditions, dosage, duration of phenformin therapy and the onset of symptoms preceding lactic acidosis were made. Renal impairment, urinary tract infections, hepatic impairment, ethanol ingestion and poorly controlled congestive heart failure were found to be predisposing factors to lactic acidosis. The appearance of a syndrome of impending lactic acidosis consisted of anorexia, nausea, vomiting with abdominal pain or lethargy.
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PMID:Phenformin-associated lactic acidosis; a review. 114 21

An earlier report described cutaneous lesions, consisting of erythema with or without necrosis, on the legs and/or feet of elderly diabetics and the cause was suggested to be an altered reaction to precipitating factors such as cardiac decompensation. The present investigation concerns the cutaneous reactions to traumatization with local heat or cold to the skin of legs and forearms of 35 diabetics and 25 controls. Petechiae within the area of traumatization with either heat or cold were observed more often in diabetics than in controls. They occurred more frequently on the legs than on the forearms. Among the controls, petechiae were observed only in those over 50 years of age and only on the legs. In the diabetics under 50, petechiae were almost always observed when the duration of diabetes was 10 years or more but seldom in young patients with diabetes of short duration. The duration of diabetes was not significantly related to the occurrence of petechiae in diabetics over 50. In these diabetics, moreover, petechiae developed after traumatization with heat of a lower temperature than that which caused petechiae to appear in corresponding controls. The initial skin lesions in dermopathia diabetica (Melin) have a reddened border. The skin of the legs of some of the diabetics developed an intensely reddened border round the area of experimental heat or cold traumatization. These patients were either elderly diabetics or younger patients with diabetes of long duration. Each of them had dermopathia diabetica and each developed atrophic circumscribed skin lesions on the site of traumatization. Nineteen diabetics had dermopathia diabetica and 16 of them developed atrophic circumscribed skin lesions on the site of traumatization, lesions which were never seen in the controls. Thus, diabetics differ from controls in their reaction to a certain thermal trauma. The possible reasons for this altered reaction are discussed.
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PMID:Cutaneous reactions of the extremities of diabetics to local thermal trauma. 118 89


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