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

Single fibre electromyography was carried out in patients with polyneuropathy due to uraemia, diabetes, and alcohol. In the two former groups the fibre density within the motor unit and the impulse transmission were mainly normal. In the latter group the fibre density was significantly increased as signs of reinnervation. Impulse transmission was impaired in a number of the action potential complexes, which is typical of active reinnervation. The results may indicate that the diabetic and uraemic polyneuropathies are characterized in the main by demyelination, whereas the alcoholic type is dominated by axonal lesion even at an early stage.
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PMID:Single fibre EMG findings in polyneuropathies of different aetiology. 17 47

Necropsy of a patient who died of uremia complicating juvenile diabetes revealed selective calcification of the perineurial sheaths in the sciatic nerves. The calcium phosphate deposits were limited to the outer layers of the perineurium while the innermost lamellae were free. Structural analysis, including electron diffraction and X-ray microanalysis, showed electron-dense, spicular deposits, which were composed mainly of finely crystallized hydroxyapatite. The end-stage diabetic nephropathy of the patient was associated with an extremely high calcium phosphorus ion product known to favour metastatic calcification. The mechanism of the selective localization of the calcium phosphate deposits to the outer layers of the perineurial sheaths is discussed with reference to the structure and suggested barrier function of the perineurium in regard to phosphate ions.
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PMID:Calcification of the perineurium. A case report. 18 98

Although the diabetic patient is at high risk for transplantation and the progression of cardiovascular disease continues, results of our experience indicate that kidney transplantation can be performed with only slightly less favorable results than in the nondiabetic patients. We have found that the survival rate achieved by diabetics who receive a kidney graft is superior to that achieved by diabetic patients who receive dialysis. We also believe that some of the secondary complications of diabetes, which are aggravated by uremia, will be improved and that successful vocational rehabilitation is possible in the majority of diabetic patients.
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PMID:Kidney transplantation for the uremic diabetic patient. 19 45

The investigation covers the necropsic material of the Pathological Anatomy Chair, Medical Academy-Sofia, with a total of 3519 necropsies for a period of 5 years (1968--1970). In that material, 285 cases with uremia were established, due to chronic renal diseases, which might be referred to 13 nozological entities. The highest number of cases are with chronic pyelonephritis (64,96 per cent). The chronic glomerulonephritis, though it ranks second, is considerably rarely met (9,47 per cent). Endemic nephropathy, according to the incidence, follows--4,21 per cent, nephropathy in diabetes mellitus--3,86 per cent, subacute glomerulonephritis--3,16 per cent, amyloidosis--2,81 per cent, hypertonic disease--2,81 per cent, malignant tumors of the kidneys--2,81 per cent cystic kidneys--2,10 per cent, lupus erythematosus--1,05 per cent, sclerodermia--0,70 per cent, myeloma disease--0,70 per cent and polyarteriitis nodosa--0,35 per cent. As to the chronic renal disease, most frequently met in the material discussed, the chronic pyelonephritis, the authors discuss the factors that played certain role in its development as well.
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PMID:[Mortality due to uremia resulting from chronic kidney diseases]. 24 19

Renal disease, particularly glomerulosclerosis, is a major cause of morbidity and mortality in patients with juvenile-onset diabetes mellitus. Signaled by the onset of proteinuria after 15 or more years of insulin therapy, progressive renal insufficiency due to glomerulosclerosis terminates in uremia within five years. Although some patients have benefited from chronic dialysis programs, the outcome in uremic diabetics has been considerably better if successful renal transplantation can be accomplished. Extrarenal complications of diabetes mellitus and recurrence of diabetic lesions in transplanted kidneys have hampered the recovery and rehabilitation of transplant recipients. Other renal diseases encountered in juvenile diabetics are reviewed.
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PMID:Grand rounds: Nashville VA Hospital--Vanderbilt University. Saturday conference: renal disease in the juvenile diabetic. 37 Oct 5

Proximal gastric vagotomy without drainage is the operation of choice for uncomplicated duodenal ulcer. There are few contraindications for PGV as uremia, diabetes, hypertension, age over 65 years and a history of splenectomy. Only in cases of severe pyloric stenosis or bleeding ulcer or perforation in the pyloric area, a pyloroplasty should be added. The Wangensteen pyloroplasty is a safe drainage procedure and especially recommended in case of extensive scarring of the pylorus.
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PMID:[Proximal selective vagotomy with or without pyloroplasty?]. 42 62

Simple bedside measurements of blood pressure and systolic pressure response to the Valsalva maneuver will confirm a clinical impression of orthostatic hypotension. Careful questioning of the patient usually elicits other symptoms of autonomic nervous system dysfunction, such as impotence, urinary and fecal incontinence, constipation or diarrhea, blurred vision, or sweating changes. Drugs are the most common cause of autonomic dysfunction, and their benefits should be weighed against the severity of the dysfunction. In addition, diabetes mellitus, uremia, amyloidosis, acute intermittent porphyria, myeloma, tabes dorsalis, and alcohol-nutritional problems may produce symptoms of autonomic dysfunction. Thus, patients who present with autonomic features but no history of dysfunction-producing drugs should undergo complete laboratory evaluation. A regimen of tyramine or L-dopa or a diet rich in cheese, processed meats, and wine (a monoamine), coupled with a monoamine oxidase inhibitor have beneficial effects in patients with orthostatic hypotension due to preganglionic autonomic dysfunction. Patients who do not respond to catecholamine precursors have stable, isolated orthostatic hypotension or a polyneuropathy such as that caused by diabetes.
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PMID:Evaluating dysfunction of the autonomic nervous system. 63 67

In order to define the mechanism of glucose intolerance in acutely uremic rats, various studies were carried out 24 hours after bilateral nephrectomy. Glucose removal following intravenous glucose was significantly (p is less than 0.001) decreased in uremic rats compared with sham-operated rats (k = 2.1 +/- 0.03 per cent vs. 5.1 +/- 0.2 per cent). This deterioration in glucose tolerance was associated with higher insulin levels in uremic rats from one to 40 minutes after glucose administration, suggesting that insulin resistance accounted for the decrease in glucose removal by uremic rats. To identify the site of the insulin resistance, we compared the ability of insulin to enhance net glucose uptake by isolated perfused liver and muscle (hindlimb) preparations obtained from uremic and sham-operated rats. Insulin suppressed glucose outflow from perfused livers of uremic rats at least as well as it did from livers of sham-operated rats, and suppression occurred at both maximal ( greater than 600 micromicron./ml.) and threshold (75 micromicron./ml.) perfusate insulin levels. In contrast, there was a significant decrease in the ability of insulin (mean perfusate level = 225 micromicron./ml.) to enhance glucose uptake of perfused hindlimbs of uremic as compared with sham-operated rats. These results suggest that the insulin resistance of acute uremia may be due primarily to decreased insulin-mediated uptake of glucose by skeletal muscle without any decrease in sensitivity of the liver to insulin.
Diabetes 1978 May
PMID:The site of insulin resistance in acute uremia. 64 47

Using clearances of microaggregated iodinated human serum albumin in a serial 'stress test,' defective phagocytosis by the Kupffer cells has been demonstrated in diabetic patients with K.W. nephropathy and proliferative retinopathy. This indicates a disturbance of phagocytic cell function that has implications for the cellular pathology of microangiopathy. The effect is not due to uremia, but could be due to T3 deficiency or lipid deposition. In hypothyroidism, there is defective RES phagocytosis, and alcoholics with hyperlipidemia can have impaired clearances. Hence, patients with advanced diabetes, hypothyroidism, and some alcoholics are at risk from infection.
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PMID:Reticuloendothelial cell dysfunction in diabetes and hyperlipidemia. 69 80

The amino acid pattern following total hip replacement is characterized by increases in muscle of the branched chain amino acids (leucine, isoleucine and valine), the aromatics (phenylalanine and tyrosine) as well as methionine. The nonessential amino acids in muscle tend to decline, glutamine having the most marked change. Plasma levels of the essential amino acids increase while the nonessentials tend to decrease. This pattern differs from that observed in other catabolic states (uremia, starvation, untreated diabetes) and is significantly different from the effects of inactivity and starvation combined. This suggests that injury can be characterized by a unique pattern of muscle and plasma amino acids.
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PMID:Muscle and plasma amino acids after injury: the role of inactivity. 73 57


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