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

The aim of this study was to evaluate the relation of nocturia, somatic diseases, symptoms, and medication to nocturnal giddiness in a group of elderly men and women. A questionnaire survey was undertaken among 10,216 elderly subjects. The mean (+/-S.D.) ages of the men and women were 73.0 +/- 6.0 and 72.6 +/- 6.7 years, respectively. Nocturnal giddiness was reported by 14.1% of the men and 9.1% of the women. Poor health was reported by 44.4% (P < 0.0001) of the men with nocturnal giddiness and by 14.0% of the men without, and among the women these figures were 45.5% and 20.0% (P < 0.0001), respectively. In a multiple logistic regression analysis significant independent correlates of nocturnal giddiness were: nocturnal micturition episodes >or=3 versus nocturia <or=2 (odds ratio [OR]: 1.6; 95% confidence interval [CI]: 1.1-2.3); married or cohabiting versus living alone (1.5; 1.1-2.0); age, 70-79 years versus <70 years (1.7; 1.2-2.3); age, >or=80 years versus <70 years (2.5; 1.7-3.6); eyesight, poor versus good (1.8; 1.4-2.4); hearing, poor versus good (1.4; 1.1-1.9); pain in the cervical spine (2.1; 1.5-2.8); spasmodic chest pain (1.5; 1.1-2.0); diabetes (1.6; 1.0-2.4); analgesics (1.8; 1.3-2.4); and diuretics (1.4; 1.1-21.8). Sex, irregular heartbeats, and sleep medication were deleted by the logistic model.
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PMID:Nocturnal giddiness in relation to nocturia and other symptoms and to medication in the elderly. 1553 Oct 27

The aims of this study were to investigate the prevalence of nocturia among adults residing in the Matsu area of Taiwan, and to examine the association of this condition with sociodemographic and health characteristics. Between October 2002 and February 2003, all adults older than 30 years residing in the Matsu area were invited to participate in a health awareness campaign. A total of 1706 adults aged 30 to 91 years completed the study survey. Among them, 16.8% reported nocturia with > or = 2 voids per night. The prevalence of nocturia increased with age from 8.4% in the 30-39 years age group to 30.9% in the > or = 70 years age group (p < 0.001). No significant difference of nocturia prevalence was found between men and women. In addition to age, diabetes (odds ratio, 2.5; 95% confidence interval, 1.4-4.2) was also independently associated with nocturia. This study suggests the importance of nocturia as a health problem and the need for greater awareness and treatment.
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PMID:Prevalence and associated factors of nocturia among adult residents of the Matsu area of Taiwan. 1603 37

Nocturia is a common condition in the elderly that profoundly influences general health and quality of life. It appears to predict a higher risk of death. One consequence of nocturia is sleep deterioration, with increased daytime sleepiness and loss of energy and activity. Accidents, e.g. falls, are increased both at night and during the day in elderly persons with nocturia. Nocturia is caused by nocturnal polyuria, reduced voided volumes, or a combination of the two. Nocturnal polyuria can be caused by numerous diseases, e.g. diabetes insipidus, diabetes mellitus, congestive heart failure, and sleep apnoea. A disorder of the vasopressin system, with very low or undetectable vasopressin levels at night, is manifested as an increased nocturnal urine output, which in the most extreme cases reaches 85% of the 24-h diuresis: the prevalence of low or undetectable vasopressin levels at night has been estimated to be 3-4% in those aged >or= 65 years. Treatment of nocturia may include avoiding excessive fluid intake and use of diuretic medication in the afternoon rather than the morning, oral desmopressin at bedtime in cases of nocturnal polyuria, and antimuscarinic agents in the case of overactive bladder or impaired storage capacity of the bladder.
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PMID:Nocturia in relation to sleep, health, and medical treatment in the elderly. 1608 52

Our aim was to assess the association between lower urinary tract symptoms (LUTS) and erectile dysfunction by means of International Prostate Symptom Score (IPSS) and Sexual Health Inventory for Men (SHIM) questionnaire. A total of 69 eligible patients who were admitted to our outpatient clinic with lower urinary tract symptoms were included in the study. A self administered questionnaire of IPSS and SHIM were given to patients. Demographics and medical history data were recorded. Any risk factor that may be associated with erectile dysfunction, including coronary artery disease, diabetes, hypertension, and smoking status, was determined in each patient. Correlation tests were used to examine the relationship between lower urinary tract symptoms and erectile dysfunction by controlling the effects of age and comorbidities. Mean age was 58.6 +/- 13.1 31-86 years. Mean SHIM and IPSS total score was 14.3 +/- 7.5 and 11.5 +/- 8.1, respectively. Spearman correlation coefficient between IPSS and SHIM scores was found to be -0.41. There was a significant negative correlation with IPSS total scores of moderate degree when both age and presence of risk factor was controlled (r = -0.31; p = 0.009). Storage symptom scores showed significant correlation with SHIM scores (r = -0.33; p = 0.000). The association between SHIM score and each item of IPSS showed significant correlation for urgency, straining and nocturia when age controlled. The degree of bother by LUTS as determined by the IPSS quality of life question was also correlated with SHIM scores; however, this correlation was not significant when age or risk factor for ED was controlled. The presence of LUTS especially storage symptoms is strongly associated with erectile dysfunction independent of age and comorbidities.
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PMID:Association between lower urinary tract symptoms and erectile dysfunction. 1657 95

Storage symptoms such as urgency, frequency, and nocturia, with or without urge incontinence, are characterized as overactive bladder (OAB). OAB can lead to urge incontinence. Disturbances in nerves, smooth muscle, and urothelium can cause this condition. In some respects the division between peripheral and central causes of OAB is artificial, but it remains a useful paradigm for appreciating the interactions between different tissues. Models have been developed to mimic the OAB associated with bladder instability, lower urinary tract obstruction, neuropathic disorders, diabetes, and interstitial cystitis. These models share the common features of increased connectivity and excitability of both detrusor smooth muscle and nerves. Increased excitability and connectivity of nerves involved in micturition rely on growth factors that orchestrate neural plasticity. Neurotransmitters, prostaglandins, and growth factors, such as nerve growth factor, provide mechanisms for bidirectional communication between muscle or urothelium and nerve, leading to OAB with or without urge incontinence.
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PMID:Pathophysiology of overactive bladder and urge urinary incontinence. 1698 23

The aim of the study was to compare the incidence of obstructive sleep apnoea syndrome (OSAS) symptoms in relatives of subjects with OSAS and in relatives without OSAS but with clinical symptoms of this disease. The study group consisted of 186 relatives of patients with OSAS and 117 relatives of patients with symptoms of OSAS in whom the disease was not confirmed by polysomnography. They were all mailed a questionnaire with questions concerning anthropometric data, the presence of symptoms typical for OSAS and the presence of concomitant diseases. Analysis of the obtained data revealed an increased frequency of snoring, sleep apnea and nycturia in the relatives of patients with OSAS when compared to relatives of patients without OSAS, but the difference was not statistically significant. The incidence of daytime OSAS symptoms was significantly higher in the group of relatives of patients with OSAS. No differences in the incidence of arterial hypertension, ischaemic heart disease and diabetes mellitus were found.
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PMID:[Familial clustering of symptoms typical for OSAS]. 1717 78

This study examined the relationship between metabolic control and enuresis in youths with type 1 diabetes. Participants were 203 youths with type 1 diabetes at an outpatient pediatric diabetes clinic. Outcome measures included HbA(lc), nocturia, blood glucose, polydipsia, frequency of daytime urination, and diabetic ketoacidosis. The mean fasting blood glucose (FBG) level of children with enuresis (FBG = 192 mg/dl) was significantly higher than that of children without enuresis (FBG = 160 mg/dl, p = .03). Differences in HbA(lc) levels between children with enuresis and those without enuresis approached significance (9.2% vs. 8.6%, p = .07). Findings indicate that metabolic control indices (FBG, HbA(1c), polyuria, and polydipsia) are related to nocturnal enuresis in youths with type 1 diabetes. Further studies should determine the mechanism by which this relationship occurs to initiate appropriate interventions.
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PMID:Metabolic control and nocturnal enuresis in children with type 1 diabetes. 1723 93

Normal pressure hydrocephalus (NPH) is one of the few reversible causes of dementia in older adults and accounts for approximately 6% of all dementias. The cardinal sign of NPH is a hypokinetic gait disorder in which the older adult's feet look as though they are glued to the floor. The gait also has been described as magnetic. People with NPH also may have mild dementia and bladder and bowel incontinence. A 78-year-old man exhibited symptoms of NPH for at least 4 years before being diagnosed. A neurological assessment of the patient revealed gait, posture, and balance abnormalities; mild dementia; and urinary urgency, frequency, nocturia, and incontinence at least once a day. His risk factors for NPH included diabetes and hypertension. A computed tomography (CT) scan revealed dilated lateral ventricles in the brain. A lumbar puncture was used to remove 50 ml of cerebrospinal fluid, which resulted in a transient improvement in his gait for approximately 18 hours. A ventriculoperitoneal shunt was then inserted in the patient, and during a 1-year period his symptoms gradually improved. He recovered without any complications and was eventually able to resume his usual activities. When the gait associated with NPH is observed in an older adult, he or she should be referred to a neurologist or multidisciplinary team for a comprehensive evaluation. If an individual receives treatment for NPH, he or she may have an improved quality of life and the opportunity to reduce functional limitations and disability. Families may also experience positive outcomes, such as having a loved one who is cognitively improved and requires less care.
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PMID:Gait disorder is the cardinal sign of normal pressure hydrocephalus: a case study. 1759 8

Recent epidemiological, biological, and behavioral evidence suggests that sleep disorders may contribute to the development of diabetes; conversely, diabetes itself may contribute to sleep disorders. Sleep appears to moderate the neurohormones that regulate blood glucose. Sleep deprivation and sleep disorders contribute to pathophysiological changes associated with the development of type 2 diabetes. In people who already have diabetes, sleep deprivation contributes to elevations of hemoglobin A1c. Symptoms that occur as a result of diabetes, such as nocturia and neuropathic pain, may in turn contribute to sleep disturbance and exacerbate sleep deprivation. The purposes of this article are to examine the scientific basis for the associations between diabetes and sleep, identify gaps in the understanding of the empirical underpinnings of these relationships, and propose directions for future research.
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PMID:Sleep disorders, glucose regulation, and type 2 diabetes. 1807 76

Nocturia, one of the most bothersome urologic symptoms, has been poorly classified and understood. Multiple factors may cause nocturia, such as behavioral or environmental factors and pathologic conditions, including cardiovascular disease, diabetes mellitus, lower urinary tract obstruction, anxiety or primary sleep disorders, and sleep apnea. Nocturia caused by any combination of these and other conditions may be attributed to nocturnal polyuria, diminished nocturnal or global bladder capacity, global 24-hour polyuria, or a combination of these factors. Distinction among these classes of nocturia is made by a simple arithmetic analysis of the 24-hour voiding diary. Nocturia has been poorly studied and only recently classified according to its etiology and pathogenesis. After reviewing the current state of knowledge, we present a scheme for rational diagnosis of patients suffering from loss of sleep due to nocturnal micturition. This article reviews the current state of knowledge and presents algorithms for the diagnosis and classification of nocturia.
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PMID:New aspects of the classification of nocturia. 1870 19


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