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

Chronic pancreatitis appears to be increasing likely because increase in alcohol consumption and improved diagnostic tools. So the diabetes due to chronic pancreatitis is gaining importance. In order to obtain a better understanding of that particular secondary diabetes, 179 patients with chronic pancreatitis were studied from 1970 to 1981. 154 patients were male and 25 female. Average admission age was 45, ranging from 25 to 86. All the patients underwent medical therapy, based on diet, pancreatic enzymes, pain control. 99 of them underwent even to surgery. The follow-up is ranging from 6 months to 10 years: during this period 18 patients died, 41 went lost. 120 patients are still under observation. Diabetes was found in the family history of 27 patients (15%). At hospital admission 41 patients (23%) had high fasting glycemia, 23 of them even glycosuria. Other 74 showed diabetic oral glucose tolerance test. During the follow-up time 27 became clinically diabetic, 3 died because hyperosmolar coma and 8 had to be readmitted more than once because diabetic metabolic decompensation. Among the 120 patients at the moment under control, 66 (55%) show abnormal fasting glycemia, 10 developed high blood pressure, 12 inferior limbs vasculopathy with paresthesias and intermittent claudication, 2 myocardiosclerosis and atrial fibrillation, 1 myocardial infarction, 2 chronic nephropathy, 1 diabetic retinopathy. Whereas surgery or medic therapy may relieve chronic pancreatitis typical symptoms, they appear to be useless remedy against the under lying diabetes. As the time goes on more and more patients develop glucose intolerance, quite early became insulin-dependent, are disposed to severe diabetic metabolic decompensation and can show vascular, cardiac or renal complication.
 ...
PMID:[Chronic pancreatitis and diabetes]. 633 49

The natural history of erectile impotence in diabetic men has been defined in a 5-year prospective study of 466 patients initially aged 20-59 years. Of the 275 who were originally potent, 78 (28%) have become impotent. Five features present at first interview were found to be independently predictive of the subsequent development of impotence; age (p less than 0.0001), alcohol intake (p less than 0.0001), initial glycaemic control (p = 0.03), intermittent claudication (p = 0.04) and retinopathy (p = 0.05). The development of impotence was also significantly associated with the appearance of neuropathic symptoms (p = 0.003) and poor glycaemic control in the intervening 5 years (p = 0.01). Only 11 out of 128 (9%) of those originally impotent regained potency; they were young, had short duration of diabetes, and often features of psychogenic impotence. Those with impotence originally but no clinically apparent micro/macrovascular or neuropathic diabetic complications developed retinopathy (p = 0.001) and neuropathy (p = 0.01) more frequently than their comparable potent counterparts. It is concluded that diabetic impotence rarely reverses, that it is strongly associated with neuropathic and vascular complications of diabetes, and that moderation of alcohol consumption and improvement of glycaemic control are possible preventative factors.
 ...
PMID:The natural history of impotence in diabetic men. 646 93

The influence of diabetes on leg blood flow in intermittent claudication has been assessed by comparing the systolic arm-ankle pressure gradient at rest and resistance to blood flow during reactive hyperemia in patients with non-insulin dependent diabetes and non-diabetic controls. Cases and controls were matched for age and sex. Smoking habits, blood pressure, and blood lipids didn't differ in the two groups. Diabetes was associated with a higher resistance to blood flow during reactive hyperemia and a greater arm-ankle pressure gradient at rest. Resistance to blood flow during reactive hyperemia was in the non-diabetics strongly correlated to the arm-ankle pressure gradient at rest (r = 0.84). Corresponding correlation coefficient was in diabetics 0.04. In one of four diabetic legs a high resistance to blood flow during reactive hyperemia didn't correspond to a big arm-ankle pressure gradient. The results in this study support the concept of both macro- and microvascular disease in diabetes.
 ...
PMID:Leg blood flow in intermittent claudication--a comparison between non insulin dependent diabetics and non diabetics. 649 53

We reviewed the clinical course of 91 men with mild intermittent claudication who had been followed up for at least six months without operation. During 2.5 years' mean follow-up, 60% of the patients had more severe claudication. Actuarial analysis revealed an annual mortality of 4.5% and an annual operation rate of 9%. Historical factors, including age, race, smoking, exercise, diabetes, hypertension, and the ankle-brachial index (ABI), were analyzed to determine if these variables could predict clinical outcome. Only cigarette smoking, exercise, and the ABI were significant in this regard. Patients who had smoked at least 40 pack-years had an operation rate 3.3 times higher than those who smoked less. Major daily exercise was associated with stable claudication. The initial ABI did not correlate with clinical outcome. A subsequent decrease in the ABI of at least 0.15, however, was associated with an operation rate 2.5 times higher and a symptom progression rate 1.8 times higher than patients without this change in the ABI. When regression analysis was used, the preceding variables were only 63% to 79% accurate in predicting the clinical outcome of individual patients. Careful follow-up of patients with intermittent claudication is therefore recommended to allow timely operative intervention when required.
 ...
PMID:Intermittent claudication. Current results of nonoperative management. 670

The clinical manifestations and prognosis of peripheral vascular disease (PVD) depend upon the severity of limb hypoxia. Transcutaneous oxygen tension (Ptco2) is related to tissue oxygenation, but limb Ptco2 varies with changes in systemic as well as peripheral oxygen delivery (Do2). Previously we have found that simultaneous assessment of limb and chest Ptco2 yields a ratio, or regional perfusion index (RPI), that is independent of systemic Do2 and accurately reflects the adequacy of limb perfusion. Analysis of segmental limb Ptco2, RPI, and position-induced RPI changes was performed in 24 control limbs and 14 limbs with intermittent claudication (IC), 8 limbs with rest pain (RP), and 7 limbs with gangrene (G). Control limbs had high RPI values that varied little with position. The IC group had modestly decreased RPIs in the supine position, but extremity RPIs decreased markedly during leg elevation. Patients with RP had ischemia while supine, but the RPI improved to nearly normal upon standing. Feet with G were hypoxic even in the standing position. Segmental RPI decreases correlated with the presence of significant arterial lesions. This correlation was unaffected by diabetes. Analysis of regional transcutaneous oximetry allows classification of PVD by quantitative criteria based upon the adequacy of limb perfusion under functional conditions. RPI is characteristically high in normal persons and low in persons with G. Limbs with marginally compensated perfusion may have nearly normal RPI values under some conditions, but typical ischemic changes are elicited by positional change and exercise. The ease of such provocation of RPI decreases constitutes an index of the severity of disease. Such quantitative assessments of limb hypoxia can form the basis for a physiologic approach to arterial reconstruction.
 ...
PMID:Pathophysiologic classification of peripheral vascular disease by positional changes in regional transcutaneous oxygen tension. 672 5

Conservative medical treatment is indicated for patients who have stable symptoms of intermittent claudication without rest symptoms or signs, rapidly progressive disease, or disability interfering with gainful employment (see Fig. 1). Valuable general measures include meticulous care of the limbs, avoidance of trauma and infections, and maintenance of normal body weight. Cessation of tobacco smoking is extremely important, and a regimented exercise program is therapeutically beneficial (see Table 1). The high risk factors of diabetes mellitus and hypertension should be controlled. Hyperlipoproteinemia should be treated if present, but it is currently not known if treatment of elevated cholesterol or triglyceride levels prevents progression of or reverses the disease process. If a recent arterial occlusion is suspected, fibrinolytic therapy can be expected to benefit approximately one third of the patients. Anticoagulants and vasodilator drugs have not been shown to be of value. In patients with rest symptoms or signs, who are not candidates for surgical revascularization of the limb, bed rest with dependency of the limb in a warm environment, good foot care, and analgesics are most important. Ulcers should be treated with wet dressings to preserve granulation tissue, and parenteral antibiotics are used if infection is present. When rest symptoms or trophic lesions have disappeared or improved, the patient may be gradually ambulated but should continue to sleep with the head of the bed elevated and should maintain meticulous foot care.
 ...
PMID:Principles of conservative treatment of occlusive arterial disease. 683 16

Over an 8-year period, 140 patients underwent 172 vascular reconstructions (187 reconstructed limbs) to relieve disabling intermittent claudication: bilateral aortoiliac or aortoileofemoral thrombendarterectomy (30 limbs), unilateral iliac or ileofemoral thrombendarterectomy (41 limbs), simultaneous unilateral ileofemoral thrombendarterectomy and femoropopliteal saphenous vein bypass graft (23 limbs), femoropopliteal saphenous vein bypass graft alone (93 limbs). The cumulative 5-year limb patency rates varied between 100 and 85.6% in the four groups. Age and diabetes did not influence patency rates. Only 2 limbs required amputation. These results indicate that reconstruction can be undertaken with a high rate of long-term patency and symptomatic relief In patients with restricting claudication due to aortoiliac, ileofemoral and/or femoropopliteal occlusion.
 ...
PMID:Reconstructive vascular surgery for intermittent claudication. 714 6

Systolic blood pressures at toe and ankle were measured in 459 consecutive patients with occlusive arterial disease. Fifty-eight per cent had intermittent claudication with arterial disease of all degrees of severity. Seventeen per cent complained of rest pain having toe systolic pressures below 30 mmHg, half had arterial lesions proximal to the groin. None had diabetes. Fourteen per cent non-diabetic patients had chronic ulcerations on the foot with arterial lesions similar to those in patients with rest pain. Eleven per cent diabetic patients with chronic ulcerations had less pronounced occlusive arterial disease which was located distally on the legs. A classification in three groups is suggested: (1) ischemia only during exercise; (2) ischemia at rest with or without ulcerations: and (3) diabetics with chronic ulcerations.
 ...
PMID:Classification of peripheral occlusive arterial diseases based on symptoms, signs and distal blood pressure measurements. 741 45

A total of 220 non-insulin-dependent diabetics aged over 45 (139 with a history of chlorpropamide-alcohol flushing and 81 without such a history) were examined for the prevalence of large-vessel disease. Large-vessel disease was significantly more common in the group without a history of flushing (41% v 24% of the two groups respectively; p < 0.05). A history of myocardial infarction was found in 14 (17%) of the patients without flushing but in only 10 (7%) patients with flushing. Similar differences were detected in the prevalences of angina, intermittent claudication, and absent foot pulses. There were, however, no significant differences in the prevalence of cerebrovascular disease or hypertension between the two groups. These results suggest that patients with non-insulin-dependent diabetes who flush in response to chlorpropamide and alcohol are significantly less likely to develop large-vessel disease than those who do not. Hence such flushing is probably related to the pathogenesis not only of small-vessel but also of large-vessel disease.
 ...
PMID:Chlorpropamide-alcohol flushing and large-vessel disease in non-insulin-dependent diabetes. 742 35

Diabetes mellitus is a disease distributed on a worldwide scale. Although the therapeutic approach to diabetes mellitus and its complications in current use brings about considerable prolongation of the life expectancy in diabetics, the frequency of cardiovascular complications is constantly augmenting; the latter are taken to be the underlying cause of death in this contingent of patients. The lower extremities are usually affected by chronic arterial insufficiency. The aim of this study is to analyze the results of surgical treatment of the occlusive arterial lesions in the lower extremities of diabetics, and specify the indications and type of intervention. Over a 6-year period (1987-1992), 760 arterial operations of the lower extremities are performed. Ninety-six reconstructions are done in diabetics-12.15 per cent. The youngest patient is 39 years of age, and the eldest--80 years. 75 per cent of the patients are given treatment with oral antidiabetic drugs. Most of them have concomitant diseases--72 cases (75 per cent). Seventy-one (73.96 per cent) present clinical manifestation of rest pain and/or ulcerations, and only 25 cases (26.4 per cent)--intermittent claudication according to R. Fontain. Those with arterial lesions in both segments prevailed--aorto- or iliofemoral lesion. Doppler sonography is performed in all patients with the exception of two studied by angiography. The operative procedures performed include: femoropopliteal--35, aorto-bifemoral--33, aorto- or ilio-femoral bypass-9, arterial reconstructions in both segments--14. The postoperative results are good and fair in 85 cases (88.5 per cent).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Surgical treatment in patients with diabetic macroangiopathy]. 747 51


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>