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

An ektacytometric extension for the Contraves LS-30 viscosimeter is described, as well as the procedure to measure erythrocyte deformability and rouleau formation with this combination. The method error (coefficient of variation) for the measurements of the erythrocyte elongation index appeared to be less than 1%, while both intra- and interindividual variation were around 2%. Preliminary clinical experiments performed on blood from different patient groups (i.e., diabetes, uraemia, sickle cell anaemia) clearly demonstrated more rigid erythrocytes than normal. It can be concluded that it is possible now to analyse with 1 instrument: plasma viscosity, whole blood viscosity at shear rates from 0.01 to 236 s-1, erythrocyte deformability and rouleau formation.
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PMID:Laser diffraction ellipsometry of erythrocytes under controlled shear stress using a rotational viscosimeter. 365 48

The haemoglobin glycosylation in uraemia was studied by determination of labile and stable HbA1 in patients and by kinetical experiments in vitro. The influence of uraemia on stable and labile HbA1 was investigated in a clinical study of 32 non-diabetic and 20 diabetic patients with uraemia compared with controls. Glycosylated haemoglobin (GHb) was determined with ion-exchange chromatography (IEC). A highly significant elevation of stable as well as labile HbA1 was found in uraemic non-diabetics and of stable HbA1 in uraemic diabetics. This elevation was not related to blood glucose level. Labile HbA1 does not significantly affect the increased total level of GHb. An in vitro study using IEC and affinity gel chromatography on erythrocytes sequentially incubated in glucose and saline showed identical kinetics of GHb formation and elimination in uraemic and in non-uraemic patients. No indication of changed glycosylation by the uraemia was found.
Diabetes Res 1986 Feb
PMID:Kinetics of glycosylated haemoglobin in uraemia determined on ion-exchange and affinity chromatography: no increase in the rate of glycosylation. 369 80

Zygomycosis often occurs in patients with an underlying disease, e.g., diabetes mellitus, leukemia, and lymphoma, or an immunocompromised state. This report discusses a case of a 21-year-old woman with systemic lupus erythematosus complicated by uremia, acidosis, steroid therapy, prolonged antimicrobial therapy, and disseminated zygomycosis.
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PMID:Disseminated zygomycosis masquerading as cerebral lupus erythematosus. 376 68

Aluminum-associated bone disease is a special problem in uremic patients on hemodialysis. We have observed this disorder in uremic patients with insulin-dependent diabetes soon after the start of dialysis treatments. We therefore studied bone biopsy specimens from 18 diabetic patients on hemodialysis to determine whether aluminum accumulates on bone surfaces at an accelerated rate in diabetes. We also measured the rates of bone formation, because lower rates may enhance the accumulation of aluminum on bone surfaces. As compared with 18 nondiabetic controls with uremia who were matched for age and duration of dialysis, the patients with diabetes had a higher rate of aluminum accumulation on bone surfaces (2.1 +/- 0.7 vs. 0.4 +/- 0.2 percent per month, P less than 0.01) and a lower rate of bone formation (117 +/- 50 vs. 396 +/- 81 microns 2 per square millimeter per day, P less than 0.01). Also, the patients with diabetes whose cumulative aluminum intake exceeded 0.5 kg had higher serum aluminum levels after an infusion of deferoxamine, as compared with controls matched for aluminum intake (P less than 0.01). These measurements reflected a higher aluminum content in the whole body in patients with diabetes. We suggest that the enhanced rate of aluminum accumulation on bone surfaces in uremic patients with diabetes occurs as a result of a low rate of bone formation and an increased accumulation of aluminum in the whole body.
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PMID:Early deposition of aluminum in bone in diabetic patients on hemodialysis. 380 61

Conventional insulin treatment fails to prevent the development of disabling and fatal complications in most patients with Type I diabetes. Improved metabolic control is achievable today with fractional insulin doses, or wearable pumps permitting continuous subcutaneous insulin infusion. None of the euglycemia regimens in hand for 1984 are easy or successful uniformly. Careful insulin administration by pumps or in fractional daily doses demands that the patient make expensive and time-consuming multiple finger stick blood glucose measurements each day. But, considering the high stakes involved in the gamble to permit suboptimal glucose regulation, it seems no longer rational to regard hyperglycemia as any more inevitable in the diabetic, than was "laudable pus" in the post-operative patient of yesteryear. Nearly constant euglycemia can be attained in many informed Type I diabetics. There are few complications in a tight control regimen, and patients feel better when their blood glucose level approaches the normal range most of the time. Should the long-term control versus complications trials now beginning show that the effort to maintain euglycemia was futile, little will have been lost. But, by stark contrast, if the euglycemia regimen is efficacious, how shall we console this generation of diabetics who, under "poor" glucose regulation, were the last to progress to uremia and blindness when trials now in progress are completed?
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PMID:Defensive medicine in diabetic nephropathy. 386 80

In a retrospective analysis of 125 patients and a prospective evaluation of 83 patients with terminal uremia undergoing kidney transplantation, juvenile diabetes mellitus was found to be a significant risk factor for the development of postoperative thromboembolism. We found a high frequency of objectively verified thromboembolism despite the relatively young age of the patients. Besides diabetes, no other clinical risk factor differed between patients with and without thrombosis.
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PMID:Juvenile diabetes mellitus--a risk factor for postoperative venous thromboembolism? 388 53

The University of Minnesota has the largest experience with pancreas transplantation of any institution, with 130 cases since 1966, including 116 in 98 patients between July 1978 and June 1985. Currently, 30 patients are insulin-independent, 19 for greater than one year, the longest for seven years. One-year patient and graft survival rates overall are 87% and 30%, respectively. Of 98 recipients, 49 had had previous kidney transplants, while 49 had not, and currently most of the pancreas recipients do not have uremia and have not had a kidney transplant but have early complications of diabetes. A total of 44 of the grafts were procured from related and 72 from cadaver donors. Although 32 of the 116 grafts (28%) failed for technical reasons, the most common cause of graft failure has been rejection. Various immunosuppressive regimens have been used in attempts to reduce the rejection rate, and one combination, low-dose cyclosporine-azathioprine-prednisone (triple therapy), has been particularly effective, with a one-year functional survival rate of 73% in recipients of technically successful grafts from human leukocyte antigen-mismatched cadaver or related donors (N = 20). The pancreas graft survival rates have improved gradually (43% for 1984 to 1985, N = 30; versus 27% for 1978 to 1983, N = 86) for transplants from both related and cadaver donors. Metabolic studies from most recipients with functioning grafts (insulin-independent) show normal or nearly normal results. Preliminary observations on secondary complications suggest a more favorable course in recipients whose grafts have functioned long term than in those whose grafts failed early.
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PMID:One institution's experience with pancreas transplantation. 391 96

From December 1966 through December 1984, there were 561 pancreas transplants reported to the American College of Surgeons/National Institutes of Health Organ Transplant Registry, including 60 from 1966 through June 1977, 206 from July 1977 through December 1982 and 295 from January 1983 through December 1984. One-year graft function-survival rates (insulin-independent) in each of the three periods were 3%, 20% and 40%, and the corresponding patient survival rates were 40%, 72% and 77%. Currently 140 patients have functioning grafts, 76 for more than one year. Of the transplants since July 1977, one-year graft survival rates according to technique are 41% for enteric drainage (N = 155), 30% for polymer injection (N = 260) and 29% for urinary drainage (N = 47). Pancreas graft survival rates at one year according to whether or not the recipients have had a kidney transplant were 35% for recipients of simultaneous grafts (N = 281), 28% in recipients of a pancreas after a kidney (N = 112) and 26% in recipients of a pancreas only who did not have uremia (N = 106); corresponding patient survival rates were 69%, 83% and 83%. Overall, one-year pancreas graft survival rates according to whether the patients did or did not have end-stage diabetic nephropathy were 33% versus 25% and the corresponding patient survival rates were 73% versus 84% (P < .01). Patient survival rates were significantly higher in those without than in those with end-stage diabetic nephropathy. An analysis of technically successful grafts according to principal immunosuppressant showed one-year function rates of 46% in 258 cyclosporine-treated recipients and 26% in 143 azathioprine-treated recipients. Pancreas graft survival rates have progressively improved and the procedure has become safer with advances in surgical technique and immunosuppression. Pancreas transplantation is currently applicable to patients with diabetes mellitus whose complications are, or predictably will be, more serious than the possible side effects of long-term immunosuppression.
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PMID:Pancreas transplantation--registry report and a commentary. 391 97

Forty percent of patients with insulin-dependent diabetes will develop nephropathy during the course of their disease, thus being the most important single disorder leading to end-stage renal failure (ESRF). Intensive metabolic control delays onset of diabetic nephropathy, the first omen of which is appearance of subclinical albuminuria, also termed microalbuminuria. Moreover, it is now established that intensive treatment of hypertension reduces rate of decline in GFR and thus postpones ESRF. When uremia eventually sets in, a range of biochemical and endocrine abnormalities can be included among those characteristics of diabetes mellitus per se. These include elevated plasma levels of growth hormone, glucagon and free fatty acids, which may participate in the uremic insulin resistance superimposed on the preexisting diabetic carbohydrate intolerance. Hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) are two established modalities of renal replacement therapy in diabetes mellitus. Controlled clinical trials for comparison of CAPD versus HD treatment of diabetics are, however, still needed. The survival rate is approximately 80 and 65-95% in insulin-dependent diabetic patients at 1 year during treatment with HD and CAPD, respectively. However, it is general experience that diabetics on CAPD exhibit a glycemic control, superior to that attained during HD. It has not been proved that patient survival after cadaveric renal transplantation is better than on dialysis. The degree of vascular heart disease seems to be the major determinant for survival of kidney-transplanted diabetic patients.
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PMID:End-state renal failure in diabetic nephropathy: pathophysiology and treatment. 391 47

In an attempt to elucidate the nature of the bleeding tendency in uremia, some in vitro functions of platelets from eight patients undergoing long-term hemodialysis were studied. None of the patients had diabetes. All had bleeding times longer than eight minutes. Threshold aggregating concentrations for collagen, adenosine diphosphate, and epinephrine, when used singly or in pairs, were two to three times higher than normal in platelet-rich plasmas from these patients. In contrast, those for arachidonic acid and U-46619, a cyclic endoperoxide/thromboxane A2 analogue, were within the normal ranges. Thromboxane B2 formation was normal in response to arachidonic acid (0.2 to 1 mM), whereas it was decreased by 30 to 50 percent in response to thrombin (0.5 to 10 units/ml), collagen (0.5 to 10 micrograms/ml), and the combination of collagen with adenosine diphosphate or epinephrine. There was a partial (about 35 percent) reduction of the platelet granular content of adenosine diphosphate. Secretion of adenosine triphosphate by 5 units/ml of thrombin was 25 to 50 percent less than in normal subjects. Thus, there was a storage pool defect as well. Similar but less severe defects were found in platelets from uremic patients who had never undergone hemodialysis. Partial correction of aggregation and thromboxane B2 formation was seen after dialysis, although platelet adenosine diphosphate content did not increase. It is concluded that the platelet dysfunction in uremia is multifaceted. There appears to be an aggregation and secretion defect related to impaired arachidonic acid release from platelet phospholipids as well as a storage pool defect. The first is improved with dialysis; the second is not.
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PMID:Platelet dysfunction in uremia. Multifaceted defect partially corrected by dialysis. 393 40


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