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

There is a definite need for replacement estrogen therapy in menopausal women exhibiting vasomotor symptoms or osteoporosis, particularly if the woman has had bilateral oophorectomy. There is a less clearly defined need in women complaining of emotional symptoms. Atrophic vaginitis and trigonitis is usually best treated with topical application of estrogen, which does not have systemic side effects if used weekly; more frequent use can lead to vascular absorption. Some of the problems associated with estrogen replacement are dose-related and can be eliminated by using smaller dosages. Uterine bleeding can usually be controlled by administering cyclically with progesterine. Hypertension, thrombosis, and adenocarcinoma are problems associated with administration of exogenous estrogens; use should be undertaken with great care in women exhibiting these conditions and patients should be followed closely to make sure such conditions are not developing. Other conditions which may worsen with estrogen therapy are diabetes mellitus, seizure disorders, migraine, multiple sclerosis, collagen diseases, cholelithiasis, and hyperlipidemia. None except hyperlipidemia is an absolute contraindication but risk/benefit ratios must be considered carefully in these cases.
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PMID:Estrogens for the menopause. Maximizing benefits, minimizing risks. 19 9

The osteopathy of the foot is a rare complication of diabetes mellitus. It is seen in the distal parts mostly. The arthropathy ("Charcot-joint") is even more rare, and is regularly combined with a neuropathy. The roentgen signs of the "diabetic foot" are demonstrated, as there are osteoporosis, iuxta-articular cortical defects, osteolysis of the bone ends, bone destruction and reconstruction, periost reaction and sklerosis of the bone shafts.
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PMID:[Exceptional diabetic arthropathy of the foot (author's transl)]. 43 86

Diabetic lesions in 25 patients with maturity-onset non-insulin-dependent diabetes, but with neuropathy and even other complications in spite of previous treatment, were studied. Distribution according to the duration of the diabetes and the age of the patients was comparable to that seen in insulin-dependent diabetes. The most frequent lesions are osteoporosis of the metaphysial line, interphalangeal arthrosis, and hallux valgus. A total of 7 perforating plantar ulcers were noted, and the physiopathology was similar to that described in insulin-dependent diabetes. Lowered insulin levels and the neuropathy which this produres are the major etiological factors, but foot deformities such as talipes equinus and/or flat-feet play a determining role. Treatment consists of insulin administration and avoidance of plantar pressure at the site of the lesions.
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PMID:[Foot lesions in non-insulin-dependent diabetes. A report on 25 cases (author's transl)]. 47 8

The authors discuss the main features of the complex pathophysiology of patients subjected to duodenocephalopancreatectomy, and particularly the difficulties inherent in clinical assessment of the digestive and metabolic impairment consequent upon the duodeno-gastro-pancreatic mutilation. Out of a total of 57 cases of this description, they singled out for recheck 23 patients who had undergone duodenocephalopancreatectomy not less than six months and not more than seven years before (chronic pancreatitis, 11 cases; various malignancies of the periampullar area, 10 cases; Zollinger-Ellison syndrome, 1 case; retroperitoneal lymphoma, 1 case). Seventy-six per cent of patients who had been gainfully employed were able to resume their jobs after surgery. Steatorrhea, assessed in terms of fecal fats, was present in all cases; notwithstanding, 70% of the patients gained weight (average increase 7 kg). All patients were on enzyme replacement therapy. Only 4% developed diabetes, and none developed postoperative peptic ulcers. Conversely there was a high incidence (65%) of bone structure reshuffling, signally osteoporosis, probably imputable to steatorrhea and vitamin D malabsorption, plus the often associated increase of serum alkaline phosphatase activity.
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PMID:[The biological results of duodenocephalopancreatectomy. Clinical evaluations based on a long-term follow-up]. 53 2

Nutrient requirements do not change markedly with advancing age, but life style, socioeconomic status, psychologic changes, and the presence of chronic disease alter nutrient intake in the elderly. It is important to recognize and deal with these factors in attempting to correct malnutrition and in prescribing dietary treatment. Malnutrition includes a variety of disorders: undernutrition, nutrient deficiencies and imbalances, and obesity. Frequent small feedings, with nutritional supplements for patients with profound weight loss, are the initial treatment for undernutrition. Iron supplements and a diet of foods rich in iron and in promoting iron absorption are required in treating iron deficiency anemia. Management of macrocytic anemia should include specific nutrient therapy plus improvement of diet to include leafy vegetables and animal foodstuffs. Diet is an important adjunct in treating chronic diseases. Maturity-onset diabetes mellitus often can be managed by diet alone, with attention to correct proportions of fat, carbohydrate, and protein and to the decreased caloric requirements of elderly patients. The importance of continuing dietary modifications in hyperlipidemia and hypertension is well known. Although dietary manipulation in osteoporosis is not curative, a diet high in calcium and containing adequate floride and vitamin D affords maximum dietary protection against progress of the disease.
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PMID:Guidelines for maintaining adequate nutrition in old age. 64 78

the total hydroxyproline excretion in urine was investigated in 82 patients with hyperthyroidism without data fro a concomitant disease, 50 clinically healthy subjects with euthyroid struma, 10 patients with non endocrine froms of osteoporosis, 4 diabetics with not stable diabetic compensation and 4 patients with primary hyperparathyroidism. The average hydroxyproline values, in the patients with active thyreotoxicosis in 24 hours urine are 56.01-6.03 mg and 16.74 +/- 7.38 mg, after reaching the therapeutic remission. The excretion is with an average of 17.52 +/- 6.03 mg in the patients with euthyroid struma. In patients with primary hyperoparathyroidism-121.60 +/- 18.2 and in patients with diabetes mellitus-51.10 +/- 3.11, in the subjects with osteoporosis-25.83 +/- 10.88 mg. The differences between the patients with active hyperthyroidism and euthyroid struma, as well as after coming to a terapeutic remission are statistically highly significant.
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PMID:[Urinary hydroxyproline in hyperthyroidism]. 89 28

In 428 non selected diabetics, the authors determined the metacarpus index of Barnett-Nordin. Upon comparing the data with those of the control group it was shown that opposite to most references one has not to reckon in diabetes with the development of porosis and also that the decrease of the calcium content concomitant with age, respectively, does not significantly differ from that of the control group. Spontaneous vertebral compression occurred more rarely in diabetics than would have been expected on the basis of the literary data. The relation was examined between the type of diabetes, the time of its persisting and osteoporosis. The difference in the observations--compared to the previous ones - is, by the authors, assigned to the fact that nowadays no such lasting and severe metabolic disturbances develop in diabetics that would lead to rare-faction of the bony system and also that hormonal factors can become effective against the development of osteoporosis.
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PMID:Diabetes mellitus and osteoporosis. 97 9

The ability of our implantable pump to provide continuous long-term drug infusion in abulatory animals has been demonstrated. Chronic heparinization has been achieved in the dog for 6 mos. Anticipated complications, hemorrhage and osteoporosis occurred, but not to a prohibitive degree. The successful performance of the pump in these animal studies has led us to plan a clinical trial using the pump for heparin anticoagulation in patients and to investigate employment of the pump in cancer chemotherapy, insulin for the treatment of diabetes, and other purposes.
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PMID:Chronic heparin anticoagulant in dogs by continuous infusion with a totally implantable pump. 114 26

According to a theory of the authors both senile osteoporosis and pathologic osteoporoses (rheumatic, in diabetes, bronchial asthma, pulmonary emphysema, portal hypertension and Cushing's disease) are due to disturbances of the circulation of the blood in bone. Every type of stasis in the sinusoids, be it due to reduced arterial supply or venous stasis or to a reduction of extravascular fluid-pressure will provoke an increase in osteoclastic activity and thus osteoporosis.
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PMID:[Osteoporosis -- due to reduced blood circulation of bone (author's transl)]. 121 86

A 57-year-old obese woman with hypertension, diabetes mellitus, osteoporosis, and a 40-year history of secondary amenorrhea was diagnosed with corticotropin-dependent Cushing's syndrome. Dynamic endocrine testing and radiological evaluation did not reveal definitively the source of the excess corticotropin. Bilateral adrenalectomy was performed with resolution of the signs and symptoms of hypercortisolism. Four years later, the patient was noted to have rising serum corticotropin levels and an enlarging pituitary mass; hyperprolactinemia also was documented. A diagnosis of Nelson-Salassa syndrome was made, and she underwent a transsphenoidal adenomectomy. A histological examination of the specimen revealed two distinct, albeit contiguous, adenomas: a corticotroph adenoma and a lactotroph adenoma. Postoperatively, the serum prolactin and corticotropin levels decreased significantly. Although the stalk section effect resulting from compression by a pituitary adenoma can raise serum prolactin levels, a concurrent lactotroph adenoma should be considered in patients with nonfunctional or functional pituitary adenomas of other types associated with significantly elevated prolactin levels. The mechanisms underlying simultaneous adrenocorticotropic hormone and prolactin excess are discussed.
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PMID:Coexisting corticotroph and lactotroph adenomas: case report with reference to the relationship of corticotropin and prolactin excess. 131 62


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