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

In a previous work, Segers and adl., the histological and histochemical study of the features of cellulitis is performed, expliciting the importance in this lipodystrophy of microangiopathy PAS positive. As a complement of that work, we study a group of 254 patients, all females, which came to us to be treated for their cellulitis, general clinical and local laser therapy. All of these patients presenting microangiopathy of their dermohipodermic capillary vessel confirmed by biopsy. These cases were divided in four groups according to the existence or not family antecedents of diabetes mellitus, and positivity or negativity to the test of glucose overcharge, sensibilized with corticoid (Fajans-Conn). The results are extensively described and discussed, and considerations are made referring to the aetiopathogenesis of both entities, diabetes and micro-pathological angiopathy, that could be generically and/or immunologically related.
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PMID:[Cellulitis. Study of microangiopathy in 254 cases]. 391 89

Nineteen children with insulin-dependent diabetes mellitus in the University Department of Paediatrics were assessed for complications of diabetes. 36.8% showed marked growth stunting, and half of the patients who attained puberty had a delayed onset of puberty. 42% showed limited joint mobility. Almost all the patients developed hypertrophic lipodystrophy while only 5 patients developed reversible lipoatrophy. Abnormal nerve conduction velocities were found in all 17 patients tested, with more of sensory nerve involvement. A significant correlation was found between duration of disease and the extent of neuropathy. Evidence of nephropathy was found in 5 patients, 2 of whom showed impaired renal function. One patient had background retinopathy, another had proliferative retinopathy and 2 patients developed cataracts. The high prevalence of microangiopathic complications in these children is probably related to their previous poor diabetic control and it is hoped that with home blood glucose monitoring to improve their control, these complications may be arrested or minimized.
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PMID:Assessment of complications in children with insulin-dependent diabetes mellitus. 403 84

A country-wide survey of the continuous subcutaneous insulin infusion (CSII) therapy was carried out in the summer of 1984 in Japan. Questionnaires were mailed to doctors of 456 diabetes clinics and other questionnaires were distributed to patients taking CSII therapy by salesmen of the infusion pump makers. 275 doctors and 86 patients responded to the questionnaires. CSII therapy was conducted in 110 clinics (40%), but it was done mostly in inpatients. Decrease in blood glucose (91%) and improvement of general body condition (65%) were achieved by the therapy, but cutaneous complications, such as skin reaction to the tapes (33%), pigmentation (46%), induration (35%) and lipodystrophy, and hypoglycemic (83%) or ketoacidotic (16%) episodes were experienced in many cases. 211 doctors predicted bright prospects for the CSII therapy, 86 (41%) speculated a spread in the popularity of the therapy and 44 (21%) opined that the therapy was a passing phenomenon (only a fashion).
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PMID:Continuous subcutaneous insulin infusion therapy in Japan, 1984: a survey by questionnaires. 403 93

Eight women with uncomplicated progressive partial lipodystrophy and two with progressive lipodystrophy and diabetes mellitus were studied. Plasma triglyceride levels were significantly elevated in the subjects with uncomplicated lipodystrophy; serum cholesterol, phospholipid, and plasma free fatty acid levels were normal. Paper electrophoresis showed increases in serum pre-beta lipoprotein and chylomicra. Thyroid function, as measured by radioiodine and stable iodine studies, was normal. Some subjects had a raised basal metabolic rate. Intravenous glucose tolerance was normal in patients with the uncomplicated disease.
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PMID:Blood lipid levels, thyroid status, and glucose tolerance in progressive partial lipodystrophy. 601 88

Recent advances in nutritional and biochemical research have substantiated the importance of inositol as a dietary and cellular constituent. The processes involved in the metabolism of inositol and its derivatives in mammalian tissues have been characterized both in vivo and at the enzyme level. Biochemical functions elucidated for phosphatidylinositol in biological membranes include the mediation of cellular responses to external stimuli, nerve transmission, and the regulation of enzyme activity through specific interactions with various proteins. Inositol deficiency in animals has been shown to produce an accumulation of triglyceride in liver, intestinal lipodystrophy, and other abnormalities. The metabolic mechanisms giving rise to these latter phenomena have been extensively studied as a function of dietary inositol. Altered metabolism of inositol has been documented in patients with diabetes mellitus, chronic renal failure, galactosemia, and multiple sclerosis. A moderate increase in plasma and nerve inositol levels by dietary supplementation has been suggested as a means of treating diabetic neuropathy, although excessively high levels, such as are found in uremic patients, may be neurotoxic. A thorough consideration of the biochemical functions of inositol and a further characterization of various diseases with the aid of appropriate animal models may suggest a possible role for inositol and other dietary components in their prevention and treatment
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PMID:The nutritional significance, metabolism, and function of myo-inositol and phosphatidylinositol in health and disease. 627 2

The present report discusses the immunogenic properties of insulin: the factors upon which immunogenicity depends, the characteristics of insulin antibodies, clinical aspects (insulin allergy, immunologic insulin resistance, lipodystrophy, etc.), as well as the significance of highly purified insulin products. The authors then review the role of autoimmunity in the etiopathogenesis of the diabetic disease as results from the association of diabetes with other autoimmune diseases, lymphocytic islet cell infiltration, phenomena of cell mediated and humoral mediated autoimmunity (islet cell antibodies). The present pathogenetic model of insulin-dependent diabetes (type 1) is marked by the predominance of these aspects. The last part of the report concerns immunologic functions in diabetics and the question of immune complexes.
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PMID:Diabetes mellitus and immunity. 636 73

We describe the clinical findings and natural history of an autosomal dominant form of partial lipodystrophy found in four affected individuals from three generations in the same family. The lipodystrophy was present from infancy/early childhood, involved primarily the face and local areas on the buttocks, and was nonprogressive. Affected individuals also had the Rieger anomaly, midface hypoplasia, short stature, retarded bone age, and hypotrichosis. An affected woman developed insulinopenic diabetes mellitus at 39 yr and another had glucose intolerance at 55 yr.
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PMID:Autosomal dominant partial lipodystrophy associated with Rieger anomaly, short stature, and insulinopenic diabetes. 640 20

The literature of the past ten years shows that the introduction of highly purified heterologous and, lastly, homologous insulins has notably lowered the production of IgG and IgE specific insulin antibodies, but has not succeeded in completely eliminating clinical manifestations of the immune or hyper-immune response to insulin therapy. In particular, insulin allergy with or without lipodystrophy is still seen. Among the factors of insulin immunogenicity, there is a possible genetic control of the immune response in type I diabetes: determining HLA halloantigens (A, B, C, D) might identify specific immune response genes (Ir genes). Initial researches, performed until now almost exclusively upon diabetics treated with conventional heterologous insulin, seem to indicate a positive relationship between haplotype HLA - B15 - DR4 and an elevated immune response, whereas haplotypes HLA - B8 - DR3 and HLA - B18 - DR3 might protect against the formation of anti-insulin antibodies. Antigens D/DR3 and D/DR4 are known to be primitively associated to susceptibility for type I diabetes, whereas antigens B8, B15, B18 are secondarily associated to the rise in frequency of DR3 and DR4 for the "linkage disequilibrium" existing between alleles of B and D loci. The results of HLA typing are presented in 2 groups of insulin-dependent diabetics (ID) followed from an immunological viewpoint during therapy with monocomponent heterologous insulin for over 5 years. The first group is composed of 50 patients with low IgG anti-insulin antibody titers (less than 1 mU/ml, Christiansen: low responders); the second group is made up of 23 patients with high IgG anti-insulin antibody titers (greater than 2.5 mU/ml, Christiansen: high responders) and includes 5 subjects with insulin allergy (associated or not with insulin lipoatrophy) and high levels of insulin specific IgE antibodies. A study of the frequencies of various HLA-B antigens in both groups of patients, in regard to a control group of piemontese population, in relation to the intensity of association (relative risk) and to the statistical importance of frequencies, shows only a possible protective effect of the HLA-B18 phenotype (linkage disequilibrium with HLA - DR3) towards the production of anti-insulin antibodies and hyperimmune clinical manifestations, such as allergy. Reliable conclusions are not possible between low and high responders for the other phenotypes (HLA - B7, B8, B15) commonly implicated. HLA-B12 was noted in 3 of 5 patients with allergy, in 2 cases associated with B8.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[HLA typing and insulin antibody production in insulin-dependent diabetics]. 644 4

Recent advances in nutritional and biochemical research have substantiated the importance of myo-inositol both as a dietary component and a constituent of cellular phosphatidylinositol. This work has indicated the importance of acyltransferase reactions for the enrichment of membrane phosphatidylinositol in arachidonic acid and the formation of the 1-stearoyl 2-arachidonoyl molecular species which commonly predominate in mammalian tissues. Inositol deficiency in animals has been shown to produce an accumulation of triglyceride in liver, intestinal lipodystrophy, and other abnormalities. Cellular functions elucidated for phosphatidylinositol in biological membranes include mediating cellular responses to external stimuli and serving as a source of arachidonic acid for the biosynthesis of prostaglandins including thromboxane. An alteration in inositol metabolism has been documented in patients with diabetes mellitus and chronic renal failure which has led to clinical interest in modulating dietary inositol levels in the prevention and treatment of human disease.
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PMID:1982 Borden Award lecture. Nutritional, biochemical, and clinical aspects of inositol and phosphatidylinositol metabolism. 671 71

In an attempt to differentiate the effect of fenfluramine hydrochloride from that of caloric restriction on carbohydrate tolerance in patients with lipodystrophy, parameters of carbohydrate homeostasis were studied in patients with lipodystrophy during periods of fenfluramine treatment and during periods of caloric restriction. Although, carbohydrate tolerance appeared to improve initially in one patient when treated with fenfluramine, this improvement did not permit. No beneficial influence of fenfluramine on carbohydrate tolerance could be identified in the other patients studied. By contrast, all patients demonstrated an improvement in carbohydrate tolerance in response to caloric restriction. These data suggest that caloric restriction improved carbohydrate tolerance in patients with lipodystrophy whereas fenfluramine, in the absence of caloric restriction, has no long-term beneficial effect.
Diabetes Care
PMID:The effect of fenfluramine and caloric restriction on carbohydrate homeostasis in patients with lipodystrophy. 685 8


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