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

In a questionnaire-based survey of 285 randomly selected diabetic patients, diarrhea was found to occur in 8%; this was found to be similar to that in 150 nondiabetic control patients attending other medical clinics (8%). When the diabetic patients were divided into separate therapeutic groups, metformin-treated (with or without sulfonylureas) patients had a markedly greater prevalence of diarrhea (20%) than those not on this drug (6%). A majority of patients with metformin-associated diarrhea had soiling of clothes as a problem, while at least two complained of frank loss of control over their anal sphincter. These patients did not have autonomic neuropathy, and in all who stopped this drug, diarrhea settled within 2-5 days. Only 6% of insulin-dependent diabetic individuals (IDD) had diarrhea, one of whom had explosive nocturnal stools with incontinence and features diagnostic of autonomic neuropathy. Metformin is by far the commonest cause of diarrhea and incontinence in our diabetic clinic, where it is used routinely. In contrast, diarrhea due to autonomic neuropathy is rare.
Diabetes Care
PMID:Diarrhea and metformin in a diabetic clinic. 633 43

Urine incontinence in elderly patients can be observed in about 7% of men and 12% of women. Short review of the anatomy of the urinary bladder, continence mechanism, micturation and bladder innervation. Description of urodynamic examination and the various forms of incontinence with differentiation between extrasphincteric urinary leakage (ectopic ureter, fistula) and incontinence due to weakness of the sphincter or detrusor dysfunction. Discussion of the detrusor function in "neurogenic bladder" as cause of incontinence in many diseases of elderly people (apoplexia, M. Parkinson, diabetes etc.). Briefing of the therapeutic possibilities.
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PMID:[Urinary incontinence in the aged]. 648 83

Motility disturbances of the colon can give significant symptoms in patients with diabetes mellitus. Constipation is a common complaint in these patients. Diarrhea associated with a generalized autonomic neuropathy can be very troublesome. There is a disturbance in the gastrocolonic response to eating in patients with diabetes mellitus who have constipation. These patients have no postprandial increase in colonic motility. However, their colonic smooth muscle contracts normally to the exogenous administration of neostigmine or metoclopramide. Stool softeners used in combination with the smooth muscle stimulants (neostigmine or metoclopramide) are helpful in treating constipation in patients with diabetes mellitus. Diarrhea can be treated with loperamide or diphenoxylate. Biofeedback may be useful in treating incontinence associated with diarrhea in these patients.
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PMID:Disorders of colonic motility in patients with diabetes mellitus. 667 Feb 91

Diabetes mellitus, which is a common metabolic disorder, classically presents with urological symptoms. In the assessment of patients referred to a urological service, complaining of urological symptoms including incontinence, diabetes may be overlooked in the search for other causes or contributory factors. Conversely, the diabetic patient presenting with such symptoms requires careful investigation if therapy is to have a rational basis.
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PMID:Urological aspects of diabetes. 709 88

We studied 16 patients with diabetes and fecal incontinence. The onset of incontinence coincided with the onset of chronic diarrhea in most patients. Episodes of incontinence occurred when stools were frequent and loose; however, 24-hour stool weights were usually within normal limits. All patients had evidence of autonomic neuropathy, and one third had steatorrhea. Incontinent diabetics had a lower mean basal anal-sphincter pressure than 35 normal subjects (63 +/- 4 vs. 37 +/- 4 mm Hg; P less than 0.001), reflecting abnormal internal-anal-sphincter function. The increment in sphincter pressure with voluntary contraction (external-sphincter function) was not significantly different from normal. Incontinent diabetics also had impaired continence for a solid sphere and for rectally infused saline. In contrast, 14 diabetics without diarrhea or incontinence had normal sphincter pressures and normal results on tests of continence, even though 79 per cent had evidence of autonomic neuropathy and nearly half had steatorrhea. We conclude that incontinence in diabetic patients is related to abnormal internal-anal-sphincter function, and that as a group, diabetics without diarrhea do not have latent defects in continence.
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PMID:Pathogenesis of fecal incontinence in diabetes mellitus: evidence for internal-anal-sphincter dysfunction. 714 65

Multiple Sclerosis (MS) cases found at autopsy in patients who had died from other diseases and in whom no sign or symptom could be related to MS are called "asymptomatic". Three cases are reported. The first patient was a 62 year old man who presented with a slowly progressive disturbance of gait, incontinence and deterioration of intellectual function. A falx meningioma was surgically removed. The patient died 3 years later with an acute respiratory illness. Examination of the brain disclosed evidence of the operation and numerous old plaques disseminated through the cerebral hemispheres (centrum semi-ovale, periventricular regions, internal thalamus and junction between cortex and white matter) and in the brain stem. The second case, a 77 year old woman with diabetes mellitus and hypertension, presented with cortical blindness and disturbances of memory of acute onset. She died one year later. Examination of the brain showed multiple infarcts involving the territories of both posterior cerebral arteries and the left middle cerebral artery. Numerous old plaques were seen in the periventricular regions, in the corpus callosum and in the left middle cerebellar peduncle. The third case, a 60 year old woman with mitral and aortic stenosis, presented with cortical deafness and transient right hemiparesis. She died 5 years later. Brain examination showed infarcts involving both middle cerebral artery territories. There was also many old plaques in the periventricular areas, thalamus, internal capsule, centrum semi-ovale, brain stem and right nucleus dentatus. In the 3 cases, the optic tracts were normal. The spinal cord, examined only in the first case, was also normal. The asymptomatic character of these MS cases can be explained first by the location of the plaques and the lack of spinal cord and optic tract involvement. It could also be due to the small size of the plaques and to axonal preservation. Such features are rare since our 3 observations have been selected from a pathological collection of 125 MS cases and 9,300 general neuropathological records. Six other cases have been previously reported by other authors.
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PMID:[Asymptomatic multiple sclerosis - 3 cases (author's transl)]. 733 73

Diarrhoea in patients with diabetes mellitus may be due to anorectal or rectal dysfunction that results in incontinence, intestinal secretion or rapid intestinal transit, or may be associated with disorders that typically cause malabsorption. The latter include small bowel bacterial overgrowth, coeliac sprue and pancreatic insufficiency. A practical algorithm for diagnosis and advances in therapy is discussed.
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PMID:Diarrhoea in patients with diabetes mellitus. 749 59

Bionursing is a series of 12 articles looking at how biological theories should integrate with practice. In the fourth article, the authors describe the case study of an elderly, bereaved woman suffering from incontinence and lack of motivation. They argue that with a physical assessment, the woman's underlying problem of diabetes mellitus would have been diagnosed earlier.
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PMID:Bionursing: diabetes in elderly patients. 757 17

Although diabetes is a common health problem of the elderly, the impact of diabetes on health and functioning in older persons is not well established. The purpose of this analysis was to identify health conditions accompanying diabetes in four samples of community dwelling elderly people. The study samples consisted of 13,601 persons ages 65 or older who participated in the Established Populations for Epidemiologic Studies in the Elderly (EPESE). Extensive interviews were conducted in respondents' homes to obtain information on diabetes and other health conditions, health behaviors, use of health services, and demographic characteristics. A lifetime history of diabetes was reported by 14 percent of respondents. The prevalence of the disease was higher in blacks than whites, especially among women. Persons with diabetes were more likely to report myocardial infarction, stroke, vision problems, physical disability, incontinence, and nursing home stays than persons without diabetes, but the diabetics were less likely to consume alcohol or tobacco. Those with diabetes were only slightly heavier than those without diabetes at the time of the interview. However, body mass at age 50 was substantially greater among persons with diabetes. Associations between diabetes and other health conditions and behaviors were similar for whites and blacks. These results show that aged persons with diabetes experience substantial comorbidity, which has important ramifications for functioning and survival.
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PMID:The health burden of diabetes for the elderly in four communities. 780 Jul 88

Urinary bladder dysfunction was investigated in spontaneously diabetic Chinese hamsters of the Asahikawa colony (CHAD). The wet weight of the urinary bladder was significantly increased in CHAD when compared with non-diabetic controls. In response to continuous infusion of physiological saline into the bladder under anesthesia, regular micturition was observed in controls. However, the threshold volume (i.e. the minimum volume at which rhythmic contraction appeared) was significantly increased and the amplitude of bladder contractions during micturition was decreased in CHAD aged 3-5 months (duration of diabetes, 0.6-2.2 months), leading to incomplete micturition. The frequency of micturition was also increased. Overflow incontinence was observed in all CHAD aged 13-15 months (duration of diabetes, 10-14 months). Acetylcholinesterase staining and activity in the urinary bladder walls were both significantly decreased in CHAD compared with controls. The in vitro increment of urinary bladder pressure caused by stimulation with bethanechol was not different between CHAD and controls. These findings suggest that CHAD have urinary bladder dysfunction which is caused by autonomic neuropathy and not by detrusor myopathy.
Diabetes Res Clin Pract 1994 Jan
PMID:Urinary bladder dysfunction in spontaneously diabetic Chinese hamsters. 791 Oct 80


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