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

With the help of a comparative analysis of the cardiovascular risk profile of 150 patients with diabetes mellitus, 62 patients with condition after myocardial infarction and 50 control patients of a rural district with 30,000 inhabitants was established that the spectre of the risk factors widely corresponds. According to a point valuation the diabetics on an average reached 3.36 points and the patients with a condition after myocardial infarction reached 2.66 points. In comparison of the curves a nearly identical course with "a shift to the right" of the patients with diabetes mellitus about the factor of the disturbance of the glucose metabolism could be proved. Concluding from this a general conception of the treatment was described. In this case the aim is a balanced therapy of the factors of risk and a preventive physical conditioning of diabetics with a high risk of infarction. In our investigations was furthermore conspicuous, deviating from literature, a very large proportion of patients with a hyperuricaemia (33.3% of the diabetics, 41.9% of the patients with infarction).
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PMID:[Diabetes mellitus and coronary disease--common problems in long-term care]. 42 85

1496 women age 55 to 74 were studied in an effort to determine heart disease risk factor differences attributed to postmenopausal estrogen (PME) use. 39% of the females reported using estrogen at the time of the study, with peak hormone use in the 55 to 59 year age group. Analysis of the following possible confounding variables, social class, current cigarette smoking, family history of heart attack or diabetes and obesity found that only obesity was statistically significant ( P .001) and thus further analysis of PME use was adjusted for obesity. Results showed average cholesterol level was 9.4 to 20.4 mg/dL lower among PME users compared to nonusers. Although triglyceride level was higher in PME users at all ages it was only statistically significant for women aged 60-69 years. Mean systolic and diastolic blood pressures were 2 to 4 mm Hg lower in PME users and the average fasting plasma glucose level was significantly lower in young PME users only. Multivariate Hotellings T statistic was used to test for independence. While the study examined the net cumulative effect of PME use of putative heart disease, it did not examine specific estrogens, dosage or duration of use differences. The authors concluded that further studies are needed before final conclusions can be made regarding the use of PME as a risk factor reducer in heart disease.
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PMID:Heart disease risk factors and hormone use in postmenopausal women. 43 Aug 17

Platelet adhesiveness was measured in a total of 589 healthy volunteers and patients. Patients suffered from heart failure, diabetes mellitus, myocardial infarction and deep vein thrombosis have a significant higher platelet adhesiveness as healthy volunteers. The effect of the socalled stressors on platelet adhesiveness was shown in vivo; the same values of platelet adhesiveness were seen as in patients. Therefore it can be concluded that stressors constitute a risk factor in patients with altered vessel walls.
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PMID:[Effects on platelet functions]. 43 58

A prospective study of mortality in 3,113 diabetics was carried out in Edinburgh over a period of eight years; 1,272 patients (41 %) died. Death rates for females equalled those for males and, in relation to the general population, there was a considerable excess mortality which was greater for females. Statistical analysis indicated that the important mortality risk-factors are age, duration of diabetes of greater than ten years and treatment. The risk of oral therapy or insulin were approximately equally greater than that of diet therapy and probably reflected severity of disease. Using international coding for diagnosis, 27 % of deaths were classified as directly due to diabetes and 49 % to vascular disease. Reclassifying the terminal cause of death left only 26 patients (2 %) recorded with diabetes as the direct cause of death. Three hundred and thirty five males (66 %) and 561 females (73 %) died of vascular disease. There was a predominance of myocardial infarction in males and cerebrovascular disease in females. These percentages were a little lower when post-mortem information was available. These results provide additional evidence that diabetes reduces life expectancy by inducing premature vascular disease and that the effect is greater in women than in men.
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PMID:Diabetic mortality in Edinburgh. 47 85

The relationship of glucose tolerance to the incidence of coronary heart disease (CHD) has been investigated in two cohorts of Finnish men: 3267 men ages 40--59 yr from the Social Insurance Institution's (SII) Coronary Heart Disease Study and 1059 men ages 30--59 yr from the Helsinki Policemen Study. The relationship of plasma insulin level to the incidence of CHD was also investigated in the Helsinki Policemen Study. An oral glucose lead of 60, 75, or 90 g according to body surface area was used in both studies. In the SII Study, plasma glucose was determined from venous blood samples taken 1 h after glucose load. In the Helsinki Policemen Study, blood glucose was determined from venous blood samples taken at 0, 1, and 2 h, and at a 5-yr reexamination, plasma insulin was measured during OGTT at 0, 1, 2 h. In the SII Study cohort, the 4-yr mortality from CHD and the 4-yr incidence of nonfatal myocardial infarction (MI) did not show a definite relationship to 1-h postload plasma glucose. In the Helsinki Policemen Study cohort, the 5-yr incidence of "hard criteria" CHD (CHD death and nonfatal MI) was significantly related to high 1-h postload blood glucose level but not to fasting or 2-h postload blood glucose levels. 10-yr mortality from CHD was significantly higher in the top quintile of fasting and 1- and 2-h postload blood glucose levels, as was the incidence of "hard criteria" CHD. However, in multivariate analyses including age, systolic blood pressure, plasma cholesterol, and smoking, the blood glucose variables showed no statistically significant independent contribution in predicted risk of CHD. Univariate analyses by quintiles of plasma insulin levels measured at the 5-yr reexamination showed that the incidence of "hard criteria" CHD during the subsequent 5 yr was significantly higher in the top quintiles of fasting and 1-h and 2-h postload plasma insulin than in the combined lower quintiles. Multivariate analyses showed that the value of high 1-h or 2-h postload plasma insulin level for predicting CHD risk was independent of other risk factors, including blood glucose levels during OGTT.
Diabetes Care
PMID:Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: results from two population studies in Finland. 52 Jan 16

14 national groups have collaborated under WHO auspices to select, from local defined populations of individuals with clinical diabetes, groups of approximately 500 within the age range 35--55 yr stratified by age, sex, and known duration of diabetes. In each center, the selected patients were submitted to a standardized study protocol, which included systematic inquiry (WHO questionnaire) for the presence of symptoms of angina pectoris, history of myocardial infarction, presence of intermittent claudication, and cigarette smoking history. Examination included standard biometry, blood pressure measurement, 12-lead (centrally Minnesota coded) electrocardiography, and central laboratory measurement of serum cholesterol and creatine. Ophthalmoscopic and urinary examinations were also included. The prevalence of arterial disease symptoms and electrocardiographic abnormalities show very large variation between countries, the lowest rates generally being found in the Oriental samples and the highest in the European. "Risk factors" for arterial disease (blood pressure, serum cholesterol, and cigarette smoking) also vary widely between diabetic groups. Although data are not yet complete, these differences appear unlikely to explain the variation in the atherosclerotic morbidity observed. Diabetic women were at least as vulnerable to arterial disease as diabetic men. A high prevalence of nonspecific abnormalities of the repolarization phase of the ECG was found, even in groups where ischemic abnormalities were rare. The origin of these is uncertain; they may represent variable local changes or possibly diabetic cardiomyopathy. This preliminary report confirms and quantifies previous indications that the impact of atherosclerotic disease on persons with diabetes varies considerably between national groups, in broad terms, running parallel with the variations in prevalence in the populations in general and suggesting that cultural and/or ethnic factors are more important determinants of atherosclerosis in diabetic individuals than is the diabetic state per se.
Diabetes Care
PMID:The WHO multinational study of vascular disease in diabetes: 2. Macrovascular disease prevalence. 52 Jan 23

A five-year prospective follow-up study was done on 10,000 adult males in Israel. The end-points of diabetes mellitus--clinical and unrecognized myocardial infarction, angina pectoris, sudden death, and hypertension--were examined. The incidence rates rise with age and vary significantly by areas of birth, with the Middle Eastern and North African subjects having the highest incidence of diabetes but the lowest cardiovascular rates. A developmental medical model based on a historical-societal perspective is proposed to explain these findings. The major factors found on multivariate analysis in the development of diabetes mellitus are compared with those of the other cardiovascular end-points mentioned above. The similarities and differences between these risk factors are discussed, and I conclude that the prevention or alleviation of diabetic macrovascular disease needs a multifactorial approach against the major risk factors of the macrovascular complications as well as those related to diabetes, in the individual, family, and community.
Diabetes Care
PMID:Risk factors other than hyperglycemia in diabetic macrovascular disease. 52 Jan 33

The vegetative response of the heart in 80 diabetic patients and 24 controls was evaluated by means of four tests: cyclic variations, Valsalva's maneuver, static muscular exercises and postural hypotension. This methodology indicates that vegetative alterations of the heart in the diabetic subjects are frequent (56.25 per cent). The parameters which are first affected are the cyclic variations and the Valsalva's maneuver, and that this disorder increases with the duration of the diabetes, showing a clear correlation with the appearance of peripheral somatic polyneuropathy. Although from a clinical point of view orthostatic hypotension is the more obvious manifestation, its implication in other situations, such as unexplained tachycardia, silent myocardial infarction and sudden death in the diabetic patient, lends great importance to this little-known form of degenerative disorder in diabetes mellitus.
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PMID:[Response of the autonomous nervous system of the heart in diabetes mellitus (author's transl)]. 52 62

In 305 patients operated upon for symptomatic ischaemic heart disease, a series of resting electrocardiograms, obtained during the first days after operation, was evaluated. A new Q wave was found in 10% of the patients. The genesis of this EGG change had not correlation with the patients' age and sex, presence of hypertension and diabetes mellitus, tobacco smoking, blood cholesterol level, functional calss of angina pectoris, previous myocardial infarction, the number of affected coronary arteries, duration of extracorporeal circulation or anoxic circulatory arrest, and peroperatively measured graft blood flow. A new Q wave after revascularization occurred more frequently in patients with multiple venous aortocoronary bypasses. The new Q wave is an EGG manifestation of myocardial necrosis with subsequent local disturbance of left ventricular function.
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PMID:A new Q wave in the electrocardiogram in patients operated upon for ischaemic heart disease. 53 2

The most important side effects of oral contraceptives (OCs) and their incidence, together with advice and monitoring of the patient at risk, are pointed out. There is a mild increase in blood pressure in longterm contraceptive use caused by increased angiotensinogen production by the liver. It is significant only for women with a history of familial hypertension, diabetes mellitus, or pre-eclampsia. Smoking increases this risk. Urinary tract infections are 25-50% more frequent in pill users. Glucose tolerance is slightly decreased. Contraceptives' diabetogenic effect is higher in women with hereditary tendency for diabetes, latent diabetes, and/or obesity. They are contraindicated in latent diabetes. Findings are contradictory in their effects on cholesterol and triglyceride serum level, but the pill is contraindicated in lipid metabolism disorders. There is an increased incidence in cholecystitis and cholelithiasis in pill-users (70-80 additional cases/100,000 user years). Liver diseases, intrahepatic cholestasis, occur rarely and benign liver tumors have not conclusively been proved to be caused by the pill. A variety of laboratory findings have been related to contraceptive use and drug interactions occur with barbiturates, rifampicin, hydantoin, and phenylbutazone. Blood coagulation is increased, partially by increased production of various blood coagulation factors; but more importantly, by a decreased synthesis of antithrombin III, a natural protective mechanism against intravascular coagulation. This increases thrombosis risk. Risk doubles with simultaneous cigarette smoking. Various epidemiological studies indicate a 5-10 fold increase in thromboembolism and thrombophlebitis, deep vein thrombosis, and pulmonary embolism. There is a correlation between contraceptive use and cerebrovascular disorders and myocardial infarction. This risk increases with age and years of pill use. The pill is contraindicated with symptoms of thrombophlebitis and thromboembolism, sickle cell anemia, proposed surgery, and longterm immobilization. Overall risk factors are not too high. Recommendations for rational pill use related to age are given and further contraindications are mentioned.
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PMID:[Adverse effects of oral contraceptives]. 55 52


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