Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Copper IUDs, oral contraceptives, "morning-after' pills and injectables are discussed in general in this review. Small IUDs are less effective, but better tolerated. An exception is the Dalkon shield, which is no longer manufactured because several women died from latent infections when they became pregnant. The Copper T IUD is tolerated much better than the Copper 7, and has only a 3% failure rate. Copper Ts must be replaced every 2 years, however, and are difficult to remove. A beneficial effect of IUDs is cure of uterine adhesions; a subjective side effect if discomfort reported by husbands. Strict contraindications or oral contraceptives are history of cholostatic jaundice of pregnancy, thromboembolism, essential hypertension, tension, diabetes, gynecologic cancer and pregnancy. Relative contraindications are hyperthyroidism, hyperlipidemia, and depression. Depressions occuring soon after starting pills may be due to unconscious rejection; those appearing later may be due to the progestagen itself. The subjective sequelae of pills are more likely in maternal women, women raised to feel guilty for using contraception, women susceptible to believing sensational media reports about pills, and women dominated by their husband's views. Pills are beneficial for essential dysmenorrhea, menstrual irregularity, premenstrual syndrome, depression, frigidity due to fear of pregnancy, uterine hypotrophy, ovarian cyst, certain ovarian dystrophies such as Stein Levinthan syndrome, menopausal symptoms, acne and hirsutism. The morning after pill, 5 mg ethinyl estradiol for 3 consecutive days, is indicated only in exceptional cases such as rape. Injectables are more suitable for those who desire long-term contraception and whose who want no more children. A lower cancer rate has been reported for users of depot progestagens than for women notu sing contraception.
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PMID:[Subjective and objective aspects of modern methods of contraception]. 114 75

Twenty-six patients under 20 years of age having cerebrovascular disease were studied from 1968 to 1972. Common risk factors such as hypertension, diabetes mellitus, hyperlipidemia and heart disease were not present. Angiographical study showed a variety of abnormalities. No consistent defect was present. There was a high incidence of pyrexia and convulsions in the early stages of stroke and it appears possible that some form of arteritis might have been important in the production of the cerebral infarction.
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PMID:Stoke in the young: a four-year study, 1968 to 1972. 115 68

This is a response to 2 previous articles in the Journal which confirmed the association between the risk of myocardial infarction and the taking of combined oral contraceptive pills. An alternative method of contraception should be recommended for women over age 34 years if they have predisposing risk factors, such as diabetes, obesity, hypertension, or Type 2 hyperlipidemia. The effect of the combined estrogen-progestogen pill may be synergistic. With other methods of contraception there may be a greater risk of pregnancy. However, after age 34 the fecundity is less. In case of failure, early abortion, if acceptable, should be offered. Sterilization might be best. Vasectomy for the husband offers a good alternative.
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PMID:Letter: Oral contraceptives in women over 34. 115 1

One hundred and ten patients with radiologically established peripheral atherosclerotic arterial disease were studied. None of them suffered from diabetes, endocrine disorders or renal disease. Their serum cholesterol and triglyceride values were compared with those of a reference group consisting of 548 individuals. When the 95th percentile of the reference values was used for cut-off, the frequency of hyperlipidemias in the patients with peripheral arterial atherosclerosis was about 52%. Combined hyperlipidemia was slightly more common (21%) than isolated increase of either cholesterol (17.9%) or triglycerides (12.6%). Using other cut-off limits for the definition of hyperlipidemia, a striking change in the distribution between these three types of hyperlipidemia occurred. In our patients, the frequencies of different blood groups were not significantly different from those of a comparable population. The serum lipids were at the same level in the different blood groups.
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PMID:Hyperlipidemia in peripheral atherosclerotic arterial disease. 117 25

Male and female, arteriosclerotic and nonarteriosclerotic rats were subjected to acute myocardial infarction by two, subcutaneous injections (spaced 24 hr apart) of isoproterenol. During the immediate postinfarct repair phase all of the experimental animals were made severely diabetic with alloxan. Two weeks later the animals were sacrificed and their blood and pertinent organs analyzed for biochemical and pathologic changes. Females survived the myocardial infarct with superimposed diabetes in significantly greater than males. In addition to marked loss in body weight all of the experimental animals developed marked adrenal hypertrophy and thymus gland involution, cardiac hypertrophy, and unusual increase in ovarian or testicular size and weight. The combined conditions of myocardial infarction + diabetes led to substantial increases in serum creatine phosphokinase (CPK) and glutamic oxaloacetic transaminase (SGOT) whereas the enzymes glutamic pyruvic transaminase (SGPT) and lactic dehydrogenase (LDH) were reduced. Although serum triglyceride levels were greatly elevated, total cholesterol and free fatty acids were reduced. All of the animals were severely hyperglycemic and had greatly increased B.U.N. levels. Diabetes caused hypercalcemia but diabetes + myocardial infarction was associated with a definite reduction of this hypercalcemia. Despite marked adrenal hypertrophy, circulating Cmpd. B levels were subnormal. The diabetic condition and its attendant hyperlipidemia did not alter the morphologic nature of the arterial lesions in the breeder rats but the diabetes did cause definite impairment of the usual myocardial repair process observed in these rats with a particularly high incidence of left ventricular aneurysms in males.
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PMID:Metabolic and histopathologic changes in arteriosclerotic versus nonarteriosclerotic rats following isoproterenol-induced myocardial infarction with superimposed diabetes. 119 29

A familial syndrome of partial lipodystrophy inherited as a dominant trait is reported. Subcutaneous fat loss was confined to the extremities and trunk. Diabetes mellitus, hyperlipidemia, hepatomegaly and renal disease were very prevalent in this family. Metabolic studies were performed on 3 members. In vivo tests suggested that the remaining fat tissue responded normally to stimulators and inhibitors of lipolysis. In vitro incubation of the dystrophic fat tissue of one patient suggested that the intracellular pathways of lipid and glucose metabolism were normal. The pattern of subcutaneous loss of adipose tissue observed in this family may be due to sympathetic nervous system overactivity of certain non-contiguous dermatomes.
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PMID:Metabolic studies in familial partial lipodystrophy of the lower trunk and extremities. 120 25

The two cases described exhibited elastopathy associated with arterial stenosis (case 1) or aneurysms (case 2). The first was clearly a case of elastic pseudo-xanthoma with characteristic cutaneous lesions associated with retinal angioid streaks and severe arterial lesions, notably stenosis of the vertebral arteries (especially the left) causing disorders in the mechanism of balance. There were, in addition, mild diabetes, hyperlipidaemia and abnormal cutaneous pigmentation. The second patient, an African, had been hospitalised for an optochiasmatic syndrome which further investigation, notably by arteriography, indicated was caused by compression of the visual pathways due to massive bilateral carotid aneurysms. The patient had molluscoid pseudo-tumours of the axillae and she reported that her father was in the same condition. Although in the first case, cutaneous biopsy enabled diagnosis of systematized elastorrhexis to be confirmed, histological investigation in the second case revealed mainly hyaline sclerosis of the deep dermal layer. The diagnosis of Ehlers-Danlos disease, suggested for this second patient, could not be confirmed. These two cases emphasize the possibility of various neurological disorders occurring in the course of dystrophy of the connectivo elastic tissue.
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PMID:[Cutaneous elastopathy and vascular anomalies associated with neurological disorders. Apropos of 2 cases]. 120 57

The various contraceptive methods available and their suitability and contraindications in the case of diabetic patients are reviewed. After briefly discussing tubal sterilization, condoms, diaphragms and spermicides, and IUDs, and their respective safety and effectiveness, the risks and advantages of contraceptive steroids are analyzed in detail. It is concluded that the metabolic effects of estrogen-progestin combinations are more serious in many diabetics, and their use often increases the need for exogenous insulin, as well as the tendency to hyperlipemia, excessive weight gain, and hypertension, which are all factors that aggravate diabetes. The contraindications apply to cases of subclinical diabetes, because the administration of these drugs to genetically predisposed subjects may precipitate the appearance of clinical diabetes. Oral contraceptives should then be used only if IUDs are contraindicated in a specific case and the desire for future pregnancies precludes sterilization. Patients should then be carefully monitored, and the oral contraceptive used contain the smallest possible effective dose of estrogen (preferably ethinyl estradiol) and progestin (preferably other than the nortestosterone type of a 19-nortestosterone derivative in a very low dose).
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PMID:[Choice of a contraceptive method in the diabetic patient]. 121 58

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 initial management of non-insulin-dependent diabetes mellitus (NIDDM) should include patient education, dietary counselling and, when feasible, individualised physical activity. It is only when such measures fail that drug therapy should be considered. Dietary management of NIDDM includes a restriction in calories, and these should be appropriately distributed as carbohydrates, lipids and proteins. Supplementation of the diet with soluble fibre and supplementation with magnesium salts if hypomagnesaemia is demonstrated, is recommended. However, supplementation with fish oils or with fish oil-derived omega-3 fatty acids is not currently recommended. Oral drug therapies used in NIDDM include sulphonylurea derivatives, which are a first-line treatment in patients who are not grossly obese, metformin, which is the treatment of choice for obese patients, and alpha-glucosidase inhibitors such as acarbose, which are used mainly to reduce postprandial blood glucose peaks. These types of drugs can be used alone or in combination. Insulin therapy may be required to achieve adequate control of blood glucose levels in some patients. In several instances, it is suggested that insulin therapy be combined with sulphonylureas (essentially when residual insulin secretion is present), with metformin, or with alpha-glucosidase inhibitors. The treatment of disorders associated with NIDDM, such as obesity, hypertension or hyperlipidaemia, requires particular attention in diabetic patients, since some drugs can adversely affect glycaemic control. Oral drugs for the treatment of NIDDM include sulphonylurea derivatives used in first-line treatment in patients who are not grossly obese, metformin, which is often the treatment of choice for obese patients and, more recently, the alpha-glucosidase inhibitors, such as acarbose, which are effective in reducing the postprandial rise in blood glucose.
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PMID:Management of non-insulin-dependent diabetes mellitus. 128 May 75


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