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

The production of insulin autoantibodies (IAA) was studied after common viral infections in 12 children with type 1 diabetes mellitus and in their 18 healthy siblings. In addition, the production of IAA was measured after influenza vaccination with booster in 39 patients with type 1 diabetes mellitus and in 39 healthy controls. In 7 of the 12 diabetic children 13 viral infections were serologically confirmed. Among the siblings 14 periods of infection were noted in 9 individuals. A significant rise in IAA antibody titre was demonstrated in patients twice (IgG both times) and in siblings 11 times (IgM 5x, IgG 6x, difference significant P less than 0.05). In only three cases the rise in antibody titres occurred 6-12 wk after documented infection. There was a significant inverse correlation with age in both patients (r = 0.89, P less than 0.0001) and siblings (r = 0.67, P less than 0.001) for IgM IAA. After influenza vaccination a significant increase in IAA was noted twice: IgM IAA in a patient with diabetes and IgG IAA in a healthy volunteer. A four-fold decrease in IgG IAA was demonstrated in one diabetic patient. From these results it is concluded that IAA formation is not a direct sequela of viral infection or vaccination.
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PMID:No evidence for the enhanced production of insulin autoantibodies after confrontation with common viral antigens in insulin dependent diabetes mellitus. 207 15

Insulin-dependent diabetes mellitus results from the autoimmune destruction of the insulin-producing beta cells of the pancreatic islets. The target antigen(s) involved in this immunopathological process has not been identified. Our strategy was to determine whether expression of a novel surface antigen by murine pancreatic beta cells would result in insulin-dependent diabetes mellitus. We have generated lines of transgenic mice (RIP-HA) that express the hemagglutinin of the A/Japan/305/57 strain of influenza virus on their insulin-producing beta cells. Hyperglycemia developed in mice derived from all three founders at a frequency varying from 13% to 27%, and was associated with lymphocytic infiltration of the islets and a humoral response against beta cell antigens, including hemagglutinin. These results suggest that the RIP-HA mice should provide a useful system in which to study the cellular interactions involved in the induction of self-tolerance and autoimmunity.
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PMID:The expression of influenza virus hemagglutinin in the pancreatic beta cells of transgenic mice results in autoimmune diabetes. 218 89

Herein, epidemiological data on influenza pneumonia and mortality, results of clinical studies, and the outcome of influenza vaccination trials are reviewed. All excess mortality studies that specify for underlying disease list diabetes as one of the major risk factors. During influenza epidemics, death rates among patients with diabetes mellitus may increase by 5-15%. Diabetes mellitus is also mentioned as a risk factor in most clinical studies, making up 3-14% of the patients studied. Even in recent studies, diabetes mellitus is only preceded as a risk factor by cardiovascular disease and chronic pulmonary disorders. To what extent cardiovascular disease and old age contribute to the increased influenza mortality and morbidity in diabetic patients remains unclear. The influence of epidemic influenza on the incidence of diabetic acidosis in combination with an impaired immune response to both Staphylococcus aureus and the influenza virus suggests that diabetes mellitus itself is the main risk factor. It is concluded that all patients with diabetes mellitus should receive annual vaccinations and that, in official recommendations, patients with diabetes mellitus should be mentioned as a separate risk group. Whole-virus vaccines are preferred over subunit vaccines.
Diabetes Care 1990 Aug
PMID:Influenza infection and diabetes mellitus. Case for annual vaccination. 220 23

Occupants of 482 long-stay and 33 short-stay beds in 11 Leicester City Council homes for the elderly were studied during a 30-week period from September 1988 to March 1989 to determine the incidence, aetiology, morbidity, and mortality of acute upper respiratory tract viral infections and the use of influenza vaccine. Influenza immunization rates by home ranged from 15.4 to 90% (mean 45%). There were no differences in the distribution of medical conditions by home. The highest immunization rates were seen in people with chest disease (77%), heart disease (60%), diabetes (56%), and those with three medical conditions (75%). There was an average of 0.7 upper respiratory episodes per bed per annum with a mortality of 3.4% (6/179). Half of all episodes were seen by a general medical practitioner and 81 of 90 (90%) referrals were prescribed antibiotics costing approximately 7.50 pounds per patient. Lower respiratory tract complications developed during 45 (25%) of 179 episodes including 3 of 12 coronavirus infections, 3 of 9 respiratory syncytial virus infections, 2 of 4 adenovirus infections, 1 of 11 rhinovirus infections, but none of 5 influenza infections. Respiratory infections were caused mostly by pathogens other than influenza virus during the influenza period documented nationally. This highlights the role of coronaviruses, respiratory syncytial virus, and unidentified agents in the elderly, and questions the assumptions made in American estimates on the impact of influenza and the value of influenza vaccines.
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PMID:Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly. 224 24

The present study describes the results achieved 6 months after the establishment of a health examination, with different features depending on age and sex groups, which was progressively applied to the population of the C.A.P. "Virgen de la Fuensanta" (Valencia). The preventive activities included: vaccination (rubella, tetanus and influenza), tuberculin skin testing, determination of body weight and mass (BMI), measurement of blood pressure and heart rate, cervical cytology, breast examination and search for occult blood in feces. Among the 388 evaluated individuals (69.4% females and 30.6% males), 10 cases of hypertension, 2 of diabetes, 65 of obesity, 20 of hypercholesterolemia, 23 women with benign breast abnormalities and 8 instances of occult blood in feces were detected. In the age group of 15-26 years, 7 positive tuberculin reactions were detected. In 175 cytological studies no case of malignant disease was discovered. The degree of acceptance of the program by the users was satisfactory, as assessed by the compliance with both the appointments (85%) and the individual interventions (88-100%).
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PMID:[Results of health examination by age and sex groups]. 251 28

We have evaluated the fulfillment of the aims of an integrated influenza vaccination program for a basic urban health area. We have focused the analysis on the vaccine coverage for age and sex groups, groups of risk modifiers and risk gradient. We have evaluated the most adequate method of call. Overall coverage was 64.6%. This rate was higher in risk groups such as diabetes, heart disease and chronic airflow limitation. Rates of 74.9%, 81.8% and 94.11% were achieved in groups with two, three and four risk modifiers. The direct call was considered the most effective method of catchment. The major conclusion was that the attempted coverage rates were not achieved. We suggest that the "non-vaccinated" individual profile should be investigated and the motivation level of the health professionals should be improved to increase the yield of the influenza vaccination programs.
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PMID:[Influenza vaccination: evaluation of an integrated program in a basic urban health area]. 251 70

A survey of patients attending the Cosmopolitan International Diabetes Center showed that one third of those born prior to 1935 did not know their immunization status, and only 56% of this group remembered ever receiving tetanus vaccine. In contrast, of those born after 1935, 98% gave a history of being vaccinated for tetanus, either as a child (76%) or as an adult (22%). Eight of the 35 patients who could not remember or denied receiving pneumococcal vaccine had in fact received it. Most patients could remember whether and when they had received influenza vaccine. A microcomputer-based registry was used to generate summaries of clinical information at each patient visit. These summaries included prevention-related items. There was a three- to five-fold increase in immunization rates when the dates of the most recent vaccinations were prominently displayed on the summary at the time of each visit.
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PMID:Effect of a microcomputer-based registry on adult immunizations. 275 5

To assess the immunologic differences related to histocompatibility leukocyte antigen (HLA) haplotypes in patients with type 1 diabetes, trivalent killed influenza virus vaccine was given in the fall, when no influenza occurred, to 59 patients with diabetes (mean age 16 years) and 64 siblings without diabetes (mean age 36 years). All subjects had normal hemagglutination inhibition antibody responses at days 14 and 42 after vaccination, with no significant differences noted between patients with diabetes and those without diabetes. However, subjects with HLA haplotypes DR 3, DR 4, or both had lower antibody responses to influenza A/Chile and B/USSR at 14 days after vaccination (p less than 0.02) than DR x/x controls (who lacked 3 or 4). Lymphocyte transformation (LT) responses before and after vaccination were similar for patients with diabetes and those without diabetes. Of significance was that subjects with HLA haplotypes DR 3, DR 4, or both had 41.1% LT responders at 42 days after vaccination, compared with subjects with HLA-DR x/x (lacking 3 or 4) who had 22.6% responders (p less than 0.03), when influenza A/Chile was used as an antigen. Although not significant, influenza antigens A/Philippines and B/USSR each showed similar trends with increased postvaccine LT responses. The HLA associations were independent of sex, age, and the presence of diabetes. These studies suggest that HLA haplotypes DR 3 and DR 4, which were clearly linked to type 1 diabetes mellitus, were also associated with altered immune responsiveness to influenza viral proteins.
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PMID:Immune responses to killed influenza vaccine in patients with type 1 diabetes: altered responses associated with HLA-DR 3 and DR 4. 326 55

An 11-year-old boy developed influenza with glucosuria. An oral glucose test performed during the infection revealed values within the diabetic range. Type 1 diabetes was wrongly diagnosed and insulin therapy initiated. A 19-year-old overweight adolescent developed pneumonia with hyperglycemia but without polydipsia or polyuria. Further investigation revealed incipient type 1 diabetes. As insulin therapy was not initiated the diabetes rapidly decompensated. It is recommended that further investigations be conducted in patients with hyperglycemia following infections.
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PMID:[Diabetes or hyperglycemia?]. 335 3

The Italian death rates and years of potential life lost (YPLL) for all causes and for 12 selected aggregations of causes are reported for 1979 and 1983, with the latter compared to United States data. Cancer is the leading cause of YPLL in Italy (23.8 per cent of total YPLL), followed by unintentional injuries (16.3 per cent) and heart disease (11.2 per cent). Rates of YPLL for all causes decreased 12.0 per cent from 1979 to 1983, the strongest declines in absolute terms being observed for prematurity and unintentional injuries, and in percentage decline for pneumonia and influenza, and infectious diseases; during the same period, YPLL for diabetes increased. The rates of YPLL are higher for males than for females (rate ratio = 1.9) especially for causes related to lifestyle factors. Premature mortality is lower in Italy than in the USA, because of the striking difference in mortality from injuries and heart diseases.
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PMID:Years of potential life lost (YPLL) before age 65 in Italy. 340 20


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