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

On the basis of the data from the registry of cerebral stroke (CS) cases in Novosibirsk (covering 937 patients and 314 healthy control subjects) the authors have made a mathematical analysis of 19 factors of the risk of disease development. Nine factors have been isolated whose varying combinations were most contributory to the risk of the development of CS in the studied population: cardiac diseases, transient disorder of the cerebral circulation, arterial hypertension, atherosclerosis, aggravated heredity for cardiovascular diseases, intermittent claudication, diabetes mellitus, systematic alcohol abuse, and hypodynamia. The authors have developed a practicable and reliable system for predicting the development of cerebral stroke in apparently healthy subjects (the accuracy of prediction is 86%).
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PMID:[Experience of prognosis and the risk factors of stroke in Novosibirsk]. 336 95

A cross-sectional study on the prevalence of atherosclerotic vascular disease (ASVD) and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects was carried out from 1982 to 1984 in East Finland (Kuopio) and West Finland (Turku), two areas known to differ markedly in prevalence of ASVD in the nondiabetic population. A total of 510 diabetic and 649 nondiabetic subjects aged 45-64 yr were examined in East Finland and 549 diabetic and 724 nondiabetic subjects of the same age in West Finland. In both areas and in both sexes the prevalence of coronary heart disease (CHD), stroke, and intermittent claudication was higher in diabetic than in nondiabetic subjects. Both in diabetic and nondiabetic subjects the prevalence of ASVD was higher in East Finland than in West Finland. In men, the East-West difference in the prevalence of symptomatic CHD and claudication was greater in diabetic than in nondiabetic subjects. In both areas and in both sexes the serum lipid pattern was more atherogenic and hypertension was more frequent in diabetic than in nondiabetic subjects. In both diabetic and nondiabetic subjects, serum total-cholesterol level was somewhat higher and hypertension was more frequent in East Finland than in West Finland. The East-West difference in serum total-cholesterol was greater in diabetic than in nondiabetic subjects. In multiple logistic analyses including cardiovascular risk factors, diabetes status, and area of residence, residence in East Finland was found to be, in addition to diabetes, a strong independent factor associated with CHD, particularly in men.
Diabetes Care 1988 Jun
PMID:Atherosclerotic vascular disease and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects in Finland. 340

To define the prevalence of large vessel disease in Ethiopian diabetic patients, the protocol of the World Health Organisation Multinational Study of Vascular disease in Diabetics was used in the Diabetic Clinic of Yekatit 12 Hospital, Addis Ababa: 221 of the possible 261 patients aged 35 to 54 years were examined during 6 months. One hundred seven were diagnosed diabetic 1 to 6 years before study, 74, 7 to 13 years and 40, 14 years or more before the study. Forty-two percent were taking insulin; 18% had retinopathy, 7% heavy albuminuria. Body mass index (BMI) of less than 18 kg/m2 was found in 13.6%; 6.4% of men had BMI more than 27 and 50% of women more than 25. Only 30 patients had ever smoked cigarettes. The plasma cholesterol was less than 6.72 mmol/l in 90% of the 221 patients. Vascular disease led to the diagnosis of diabetes in 3 patients. At study, 19.9% were hypertensive but only 5% at the time of diagnosis. Only 1 patient had had ischaemic gangrene, 1 a stroke, 4 intermittent claudication, 4 angina pectoris and 1 a myocardial infarction. Electrocardiograms, centrally Minnesota-coded in London, were interpreted as Coronary Disease Probable in only 6 patients, and Coronary Disease Possible in 25; the other 190 tracings were normal. It is concluded that macrovascular disease is uncommon in middle-aged Ethiopian diabetic patients in Addis Ababa.
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PMID:Macrovascular disease in middle-aged diabetic patients in Addis Ababa, Ethiopia. 341 58

The clinical course of angina pectoris was studied in a follow-up study of 427 patients with angina from a general population sample. The subjects were men aged 56-65 years at the time of follow-up. After a mean follow-up time of 5.8 years, 55% were still suffering from angina pectoris, 15% had died and a further 19% were either free from chest pain or had chest pain considered to be of different origin. In the group with definite angina pectoris at follow-up (n = 236), 29% had sustained a myocardial infarction, 23% had symptoms of intermittent claudication, 36% were treated for hypertension and 15% had diabetes. Many of the angina patients suffered from other chest conditions in addition to anginal symptoms. Most of the patients (56%) had infrequent attacks (a few times per month or less often) and were not severely incapacitated by their symptoms. Only one fifth worked full time compared with more than half of those in the same age groups in the general population. Only 16 of those interviewed had undergone bypass surgery and a further 16 had disabling angina but, for various reasons, they had not been operated on. The implications are that most angina patients do well on pharmacological treatment alone even though they are limited socially as well as physically. Precipitating factors other than physical activity were also investigated and associations were found between susceptibility to cold, early morning angina, angina at rest and attacks of long duration, possibly indicating a mechanism of vasospasm superimposed on a fixed stenosis.
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PMID:Clinical course and symptomatology of angina pectoris in a population study. 377 87

The prevalence of peripheral arterial disease and its relationship to cardiovascular risk factors was investigated in 133 patients aged 45-64 years with newly diagnosed non-insulin-dependent diabetes and in 144 randomly selected non-diabetic subjects of the same age. History of intermittent claudication, absent foot pulses, decreased ankle-arm blood pressure ratio (less than 0.9) and radiologically detectable arterial calcifications of the lower limbs were used as indicators of the presence of peripheral arterial disease. Peripheral arterial disease tended to be somewhat more common in men with newly diagnosed non-insulin-dependent diabetes than in non-diabetic men, whereas no difference was found in prevalence of peripheral arterial disease between diabetic and non-diabetic women. The association of various indicators of peripheral arterial disease with cardiovascular risk factors and coronary heart disease was low or absent.
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PMID:Peripheral arterial disease and its relationship to cardiovascular risk factors and coronary heart disease in newly diagnosed non-insulin-dependent diabetics. 377 96

Three hundred and twelve patients with peripheral arterial disease were followed up for 8 3/4 years or more (maximum 11 3/4 years) to assess the natural history of the disease and factors determining its outcome. Of the 312 patients, 188 (69%) died during the follow-up, 68% of the deaths having cardiovascular causes. The 10-year relative cumulative survival rate was 0.61 for males and 0.48 for females. The role of smoking as a risk factor could not be analysed without bias. In addition to known risk factors diabetes mellitus, cerebrovascular disease and coronary heart disease, the degree of peripheral arterial disease itself also proved to be a risk factor among men. The expected life lost for men with intermittent claudication was 20%, but 44.3% for men with advanced lower limb ischaemia (p less than 0.01). This difference could not be explained by the well-known association of advanced ischaemia and diabetes mellitus. The present results therefore suggest that the state of advanced ischaemia indicates larger involvement of the whole of the arterial tree and predicts fatal cardiovascular events among these patients.
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PMID:Peripheral arterial disease--natural outcome. 379 36

The present report is an analysis of the course of peripheral vascular disease (PVD) in 619 patients with non-insulin-dependent diabetes (NIDDM) recruited within 1 yr of diagnosis and followed quarterly for up to 14 yr (X = 10.5 yr). At 13 yr duration, the actuarially determined cumulative risks for intermittent claudication (IC), nonpalpable dorsalis pedis pulse (NPUL), and arterial calcification (CALC) were, respectively, 37.9%, 34.5%, and 60.9% for men and 24.3%, 37.6%, and 32.2% for women. Major amputations (AMP) occurred in only 1.3% of the patients, equivalent to approximately one case per 1000 patients per year. The corresponding incidences of IC, NPUL, and CALC were, respectively, 29, 27, and 47 per 1000 men and 19, 27, and 25 per 1000 women per year. CALC and NPUL were strongly related to mortality. Baseline risk factors with probability levels that suggest a relationship to PVD were, in women, age versus CALC (P less than 0.01), age versus NPUL (P less than 0.05), weight versus NPUL (P less than 0.05), systolic BP versus CALC (P less than 0.01), summed glucose tolerance test versus CALC (P less than 0.01), and triglyceride level versus CALC (P less than 0.05). In men, the only significant risk factors were diminished vibration perception, which was related to NPUL (P less than 0.05), and the serum triglyceride level, which was related to IC (P less than 0.05). In patients who are carefully followed prospectively, IC is far more common, but AMP is far less common than has been generally appreciated. Further studies are needed to clarify the roles of the diverse risk factors that are possibly related.
Diabetes Care
PMID:The course of peripheral vascular disease in non-insulin-dependent diabetes. 389 Dec 65

Long-acting nifedipine tablets were given to 47 severely and moderately hypertensive patients with renal insufficiency, cardiovascular, cerebrovascular, and peripheral vascular disease, diabetes mellitus, asthma, and systemic lupus erythematosus. Nifedipine substituted vasodilators (n = 22), was added to beta blockers and thiazides (n = 14), and was used alone (n = 11). In all three groups blood pressure was significantly reduced without aggravation of angina pectoris, intermittent claudication, cerebrovascular disease, or renal failure. Side effects were mild and transient. We found nifedipine tablets convenient and safe, as well as efficacious in patients with serious conditions.
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PMID:Long-acting nifedipine in moderate and severe hypertensive patients with serious concomitant diseases. 401 94

Employees of a telephone company in Naples (N = 1376) were screened by oral glucose tolerance test (OGTT, 75 g). All those with impaired glucose tolerance (IGT) (N = 69) plus 138 normoglycemic controls, matched by sex, age, and body mass index (BMI, kg/m2), were selected to participate in this study. All participants were retested by OGTT under the same conditions as the first test. The prevalence of signs of impaired peripheral arterial circulation (IPAC) were investigated by different methods: Rose questionnaire on intermittent claudication, digital pulse plethysmography (inclination time), and ankle blood pressure measurement (ankle/arm systolic blood pressure). Very few persons had symptoms of IPAC: 2 (3.1%) and 3 (2.4%), respectively, in IGT subjects and controls. No difference in the prevalence of abnormal vascular parameters was detected between IGT and normoglycemic individuals according to either digital pulse plethysmography (6.1% versus 8.8%, P = 0.36) or ankle blood pressure measurement (10.8% versus 9.6%, chi 2 = 0.06, NS); similar results were obtained when the prevalence of abnormalities was evaluated according to both methods combined (16.9% versus 16.8%). The finding remained very much the same after controlling for the effect of smoking. Individuals with IGT at both OGTTs were compared with individuals with normoglycemia at both tests: once again no significant difference was detected between the two groups in the prevalence of abnormal vascular findings (22.6% versus 16.7%, chi 2 = 0.66, NS). This suggests that IGT is not associated with increased prevalence of atherosclerotic peripheral arterial disease.
Diabetes Care
PMID:Peripheral arterial circulation in individuals with impaired glucose tolerance. 407 46

In a health survey in 1981-82 in the city of Uppsala 819 subjects (443 females and 376 males), 47-54 years old, were examined. A 75 g oral glucose tolerance test OGTT was performed in each subject, and fasting and 2-h venous whole blood glucose values were determined. The 2-h value was somewhat higher in females, 4.7 mmol X l-1, than in males, 4.4 mmol X l-1 (p less than 0.01). Known or probable manifest diabetes was present in 1.9% of all subjects. Glucose values within the limits for WHO criteria of glucose intolerance were found in another 7.1% of all subjects after one OGTT. The rates were similar in both sexes. A history of diabetes in first-degree relatives was noted in 13.2% of all subjects. According to a questionnaire, 1.1% of all subjects had had hospital care for myocardial infarction, 4.7% had angina pectoris and 2.4% had intermittent claudication. The rate of subjects on antihypertensive treatment or with untreated high blood pressure greater than or equal to 170/105 mm Hg was 11.2%; of these only 1.8% had untreated high blood pressure. Of the treated subjects, the treatment was adequate in 82.9%. Obesity, defined as relative body mass index greater than or equal to 120%, was found in 34.0% of all subjects, more frequently in females than in males. The rate of smokers was 28.5%. A comparison was made with the results of a similar health survey of about 2 300 middle-aged men in Uppsala in 1970-73. The prevalence of angina pectoris was higher among the men of the present survey than among those of the 1970-73 survey, which may at least partly be due to differences in methodology. Relative body weight was higher, and fewer men were regularly active during leisure for at least 2-3 h per week in the present study. The rates of hypertension were similar, but fewer men had untreated high blood pressure and more men were on antihypertensive treatment in the present study. There was a lower frequency of smokers in this study.
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PMID:Findings in a health survey of middle-aged subjects in Uppsala 1981-82. Risk factors for diabetes mellitus and cardiovascular disease. 409 18


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