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

In order to investigate the combined effects of diabetes and hypertension on the pathogenesis of cardiovascular disease, adult male and female SHR rats which develop hypertension spontaneously were given a single, 10 mg or 15 mg/100 g body wt. injection of alloxan s.c. to induce moderate or severe diabetes. Insulin was deliberately withheld. Animals were examined by autopsy daily for 7 days post-alloxan and after 4 and 8 weeks. Mortality was high--only 52% of the males survived as against 80% of the females. Most deaths occurred on Day 5 and were associated with adrenal haemorrhage and hyperplasia, thymus galnd involution, fatty liver and marked hypotension despite elevated aldosterone levels. During the first week, corticosterone levels increased significantly in the male; in females they showed little change. After 4 weeks, the severly diabetic animals became emaciated and moribund; corticosterone and aldosterone levels fell to very low levels despite adrenal hyperplasia. The beta cells of the moderately diabetic animals eventually lost their ability to secrete insulin and these animals too became cachetic and moribund with concomitant elevation of lipid, glucose and BUN levels, as well as myocardial infarction, fatty liver, and generalized hyalin arteriolo-, arterio-, and nephrosclerosis. It is suggested that the combined hormonal and metabolic alterations of diabetes and hypertension reinforced one another in these spontaneously hypertensive rats, leading to intense stimulation of the hypothalamic-pituitary-adrenal system, the exacerbation of those cardiovascular degenerative changes known to be associated with uncontrolled diabetes or hypertension, eventual impaired adrenocortical steroidogenesis, hypotension and death.
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PMID:Alloxan diabetes in spontaneously hypertensive rats: gravimetric, metabolic and histopathological alterations. 86 Nov 67

Left ventricular function was assessed by measuring sytolic time intervals in insulin-requiring diabetics with and without significant microangiopathy. The results were compared with those in normal controls. Significant microangiopathy was defined as proteinuria over 3 g/24 h or proliferative retinopathy. Left ventricular function was also assessed one and a half years later by echocardiography in four patients with microangiopathy. Patients with angina, previous myocardial infarction, hypertension, and alcoholism were excluded. All had normal electrocardiograms and chest radiographs. Diabetics with microangiopathy had impaired left ventricular function, whereas those with uncomplicated diabetes had normal function. This finding supports the existence of a specific diabetic cardiomyopathy due to microangiopathy rather than the metabolic defect. The association of microangiopathy and impaired left ventricular function may explain the high immediate mortality and the high incidence of cardiogenic shock and congestive heart failure after myocardial infarction in diabetics.
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PMID:Diabetic cardiomyopathy: the preclinical phase. 86 81

The blood sugar content was determined in 142 patients with myocardial infarction on the 1--3rd, 7-10th, 28--30th days of the disease by the Hagedorn-Jensen method. The standard glucose tolerance test was conducted in 64 patients on the 30th day of the disease and repeated in 20 patients 18 months after infarction. It was concluded that transient hyperglycemia developed in 47.8% of patients with myocardial infarction in the acute period, predominantly in those with a sugar curve of the diabetes-decipiens type. Carbohydrate tolerance was reduced in two thirds of the patients. In some of them this disorder was attended with clinical signs of diabetes and a severe course of myocardial infarction. In patients with diminished carbohydrate tolerance the sugar curve remained abnormal 18 months after the disease. Obvious diabetes developed in 6 out of 20 patients examined. Among relatives of patients with disturbed carbohydrate metabolism diabetes mellitus was encountered more frequently and the incidence of ischemic heart disease and hypertension was higher.
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PMID:[Hyperglycemia and the glucose tolerance test in the acute period of myocardial infarct and in the remote post-infarct period]. 92 75

A review of 132 consecutive patients 65 years of age and older who had a myocardial infarction showed that two-thirds of them experienced pain at onset. Pain was the only symptom leading to bedside diagnosis in one-fourth of the patients. Pain at onset combined with sudden or increased dyspnea was present in one-fifth of the patients and pain associated with other symptoms in one-sixth. Dyspnea unaccompanied by pain heralded onset of infarction in one-fifth of the patients, and in almost 7 percent, onset was marked only by other symptoms. Cerebral symptoms dominated onset in one-tenth of the patients. Preexisting coronary heart disease, hypertension, or diabetes was not predictive of painless infarction. To avoid pitfalls and facilitate bedside diagnosis of infarction, physicians should be aware of the different clinical presentations of painless infarction in the aged, which occurred in over one-third of the patients in this cohort. They also should suspect the possibility of myocardial infarction in any patient in whom symptoms are not clear, even when they are mild and unobtrusive. Questioning of the elderly patient, his family, or others around him as early as possible after the onset of an acute attack is likely to elicit a history of pain, which may lead to the correct diagnosis.
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PMID:The initial manifestations of acute myocardinal infarction. 93 23

Seventy-seven women discharged from hospital with a diagnosis of myocardial infarction and 207 control patients were investigated. All were under 45 years of age at the time of admission. Heavy cigarette smoking, reported treatment for pre-eclamptic toxaemia, and type II hyperlipoproteinaemia were found to be independent risk factors for myocardial infarction. Reported treatment for hypertension and diabetes are probably also independently associated with subsequent development of the condition, but the associations between myocardial infarction and reported treatment for obesity and psychiatric illness appear to be secondary. Previous publications have suggested that use of oral contraceptives is an independent risk factor. Examination of the effect of several factors combined, suggests that they act synergistically, the presence of three or more factors increasing the risk 128-fold.
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PMID:Risk factors for myocardial infarction in young women. 95 82

The importance of diabetic angiopathy for prognosis and course of diabetes mellitus, possibilities and basis of angiological therapy Complications originating from the vascular system determine life expectancy of the diabetic patient. He is particularly endangered by apoplexy, heart attack, arteriosclerosis of the lower extremities, retino- and nephropathy. Microangiopathy is a specific diabetic problem, the development of which shows a clear dependency on the quality of metabolism. Conventional therapy of circulatory problems today is less concerned with the vascular system than with the qualities of blood viscosity. In this context, viscosity is of main concern. Particularly in microcirculation viscosity is dependent on blood factors such as: haematocrit, plasmaviscosity, erythrocytes and thrombocytes. Their changed behaviour results, in the case of diabetes mellitus, in an increase in viscosity partly dependent on metabolism. A promising concept of treatment is available by pharmaceutically influencing the alteration of erythrocytes.
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PMID:[Diabetes mellitus and microcirculation. Significance of diabetic angiopathy for the prognosis and course of diabetes mellitus, possibilities and bases of angiologic therapy]. 96 91

It is believed that diabetic patients with clinical evidence of diabetic capillaropathy have a greater risk of myocardial infarction than those with the same duration of disease but no evidence of capillaropathy. If the hypothesis presented here is correct, then early attention to diet, perhaps as a means of slowing the rate of atherosclerosis, will be as important as insulin in reducing current mortality statistics.
Diabetes 1976
PMID:The relationship between diabetic capillaropathy and myocardial infarction: a hypothesis. 97 96

In a study of thromboembolism and oral contraceptive drugs, 136 cases of myocardial infarction in women aged 30 to 44 years were identified, a rare disease in women of this age group. Data from their hospital medical records were compared with those of several other groups, including women without chronic disease admitted for various acute or elective conditions unrelated to thromboembolism, patients with thromboembolic disease other than myocardial infarction, and women queried or examined in the National Health Survey. The following attributes were found to be associated with myocardial infarction in younger women: presence of diabetes; hypertension; history of increased cigarette smoking; and hypercholesterolemia. A history of the use of oral contraceptive drugs was found with greater frequency in cases than in controls. The literature on the possible association of myocardial infarction and the use of oral contraceptives was reviewed.
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PMID:Myocardial infarction in younger women. Associated clinical features and relationship to use of oral contraceptive drugs. 97 71

Factors involved in the development of coronary atherosclerosis and the possible role of estrogens in its development are discussed. Risk factors in the development of atherosclerosis include hyperlipemia, hypertension, cigarette smoking, and diabetes. However, the incidence of heart disease and presence of risk factors are also related to heredity, geography, and socioeconomic conditions, and to diet, exercise, and emotional stress. Contrary to previous belief, high doses of estrogens aggravate the condition of men and menopausal women at risk of heart attack. Although estrogens do not markedly alter cholesterol levels, they do tend to elevate triglyceride levels and contribute to hyperlipemia. They are also associated with diabotegenic sequelae and hypertension. Pregnancy and estrogens increase blood clotting Factors VII and X, accelerate prothrombin time, shorten clotting time, and incre ase platelef aggregation. Further research into the role of estrogens in the development of atherosclerosis is recommended.
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PMID:Estrogens and atherosclerosis. 99 76

The effects of dietary linoleic acid on arterial thrombus formation in rats were compared with the inhibitory effect of intravenous or intraaortic administration of PGE1, a potent inhibitor of platelet adhesion and aggregation. The "rat aorta-loop" model proved to be a useful method to induce a stable thrombus, obstructing the aortae of standard-fed rats with an obstruction time (OT) of about 96 h. Increasing the amount of dietary linoleic acid from 2.5 cal% to 30 cal% doubled OT to about 200 h. A constant intravenous PGE1 infusion of 10 mug/h increased OT significantly from the control value of 126.6 h to 160.1 h. When the same amount of PGE1 was infused intraarteriallu, the increase in OT was higher and doubled to 255.7 h. Using the "Filtragometer method" - in which platelet aggregatibility is measured in flowing human venous blood - a significant decrease in platelet stickiness was found in a group of patients consuming 12 cal% linoleic acid as compared to a similar group of patients with only 4 cal% linoleic acid in the diet. As similar results were obtained in patients with diabetes mellitus and in survivors of a myocardial infarction, increasing the amount of dietary linoleic acid may be of great therapeutic value for patients at risk of arterial thrombotic processes. These data support the hypothesis that part of the excess of dietary linoleic acid can lead to increased PGE1 concentrations.
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PMID:The effects of linoleic acid and prostaglandin E1 on arterial thrombosis. 100 52


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