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

Thirty-one growth-hormone-deficient dwarfs were re-examined after a period of 10 to 12 years. These subjects had initially shown glucose intolerance, insulinopenia and hyperlipidemia comparable to those of diabetic patients matched for age and sex, but vascular complications were not present in dwarfs. After 10 years glucose tolerance became progessively more abnormal in dwarfs than could be accounted for by expected deterioration with age, and hyperglycemia after mixed meals remained greater than in control subjects. Serum lipid and serum lipoprotein concentrations were abnormal in over one third of the dwarfs. Despite the metabolic similarity to the diabetic patients, clinical complications of diabetes were absent in dwarfs: retinopathy did not occur, and the prevalence of hypertension and arteriosclerosis was considerably lower in dwarfs than in the diabetic subjects in both study periods. The follow-up data support the hypothesis that growth hormone has at least a supportive role in the pathogenesis of vascular disease in the diabetic state.
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PMID:A follow-up study of vascular disease in growth-hormone-deficient dwarfs with diabetes. 65 62

Much of the difficulty in assessing the progress of diabetic angiopathy and effects of experimental modes of therapy arises from the lack of quick, simple, inexpensive, and noninvasive tests to perform on the circulatory system of human subjects. We report here on values obtained by the use of mercury-in-rubber strain gauge plethysmography on 15 middle-aged, adult-onset diabetics who had minimal clinical evidence of microangiopathy. Standard tests are described for assessing forearm vascular function at rest, during tonic exercise of the fingers, and after interrupted repetitive exercise of the fingers. When matched against a similar aged nondiabetic group, the diabetics had slightly higher forearm vascular resistance at each level of exercise, a marked reduction (approximately 50 per cent) in capillary filtration coefficient, which is believed to be related to vascular filtering surface area, and a slight reduction in venous capacitance at all levels of exercise. The method of mercury-in-rubber strain gauge venous occlusion plethysmography provides the clinician with a sensitive and inexpensive tool with which to follow the evolution of angiopathy in diabetic patients.
Diabetes 1978 Jul
PMID:Forearm hemodynamics and responses to exercise in middle-aged adult-onset diabetic patients. 65 18

Hyperparathyroidism was diagnosed in a 67-year-old diabetic man treated for 20 years with isophane insulin suspension, 40 to 45 units/day. It was also diagnosed in a 64-year-old diabetic with severe retinopathy and vascular disease, who was not dependent on insulin. In the first case, removal of a parathyroid adenoma resulted in frequent hypoglycemic attacks, which led to a reduction of the administration of insulin isophane suspension to 20 units/day. In the second case, there was a notable improvement in the glucose tolerance testing that followed surgery, accompanied by a decrease in total plasma insulin response from 17,838 to 5,605 units, by planimetry. These observations suggest that hyperparathyroidism worsens coexisting diabetes mellitus and that one must be aware of increased insulin sensitivity and the possibility of severe hypoglycemia in cases that require insulin after surgical correction of the hypercalcemic state.
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PMID:Hyperparathyroidism and coexisting diabetes mellitus. Altered carbohydrate metabolism. 70 71

A positive fluorescein angiographic (FLAG) finding is a frequent occurrence in ophthalmoscopically negative cases. By repeated FLAG examinations good follow-up of the variability of the finding is possible. After 4--8 years of diabetes, ophthalmoscopically diagnosable retinopathy is to be expected in the patients in whom the initial FLAG examination showed signs of angiopathy.
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PMID:Prognostic value of fluorescein angiography of the funds in diabetic children. 71 67

Haemoglobin AIc (Hb AIc), a glycohaemoglobin present in normal human blood, is elevated in glucose intolerant individuals. In non-pregnant diabetic subjects, a direct relationship has been established between per cent Hb AIc and blood and urinary glucose levels over weeks and months. In this study, Hb AIc level and mean random blood glucose concentration in the third trimester of pregnancy were found to correlate directly in 12 diabetic women without vascular disease (P less than 0.001). In this same group of women, third trimester Hb AIc levels also correlated significantly with infant birth weight (P less than 0.05) and birth weight adjusted for gestational are (P less than 0.01). Finally, third trimester mean blood glucose concentrations also correlated directly with birth weight (P less than 0.05) and adjusted birth weight (P less than 0.001). In pregnancies complicated by diabetes, rigid glucose control has been recommended to achieve optimal fetal and maternal outcomes. Hb AIc is a new tool with which to assess blood glucose control during diabetic pregnancy.
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PMID:Haemoglobin Aic (glycohaemoglobin) in diabetic pregnancy: an indicator of glucose control and fetal size. 71 7

In vivo platelet survival was estimated, in 31 diabetic patients, using 51Cr-labelled autologous platelets. A mathematical analysis attempted to measure the "potential" life span (senescence process) and the degree of a superimposed aleatory destruction (consumption process). The potential platelet life span in diabetics did not differ from normal values. However, excessive consumption was observed in one third of the studied cases, without correlation with the age of the patients, the clinical duration of diabetes, and the degree of vascular impairment. Thus, platelet kinetic studies did not provide presently useful indications, in a particular patient, regarding the prognosis of the vascular disease, and the justification of anti-aggregant therapy.
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PMID:In vivo platelet kinetics in 31 diabetic patients. Correlation with the degree of vascular impairment. 72 53

One hundred and thirty-two newly diagnosed Asian diabetic patients (39 Malay, 30 Chinese and 63 Indians) have been studied in Kuala Lumpur. The highest proportion of diabetic patients were Indian and the lowest were Chinese. Vascular complications were equally common in Asian diabetic patients as in Europeans; coronary heart disease was relatively more common in Indians and cerebral vascular disease in Chinese. Twenty percent of all Asian diabetic patients requiring admission to hospital also had coronary heart disease, 9% had cerebral vascular disease and 8% had gangrene or ulceration of the feet. In Kuala Lumpur, diabetes is a very important risk factor for coronary heart disease: 17% of all patients admitted to the General Hospital with coronary heart disease were already diabetic.
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PMID:Diabetes and its vascular complications in Malaysia. 74 78

Cystoid macular edema has become the most common and troublesome complication following cataract extraction. New techniques in cataract extraction, such as phacoemulsification and intraocular lens implants have not eliminated the problem, and careful studies are needed to determine whether they exacerbate or diminish it. Cystoid macular edema occurs in many areas of ophthalmology: cataract surgery, retinal surgery, uveitis, ocular tumors, diabetes, and arteriosclerotic vascular disease. Every ophthalmologist must, therefore, be thoroughly acquainted with methods for its recognition and with the inflammatory and vascular factors in its development. Prognosis and treatment are discussed, and the major gaps in our present understanding of pathogenesis are indicated, including the manner by which the vitreous changes following lens extraction lead to inflammation and the reason for the specific susceptibility of the mascular and disc capillaries to the inflammatory stimulus. Some hypotheses are presented.
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PMID:Cystoid maculopathy. 78 52

The controversy as to the relationship between the degree of control of diabetes and the progression of the complications of the disease has not been solved. However, in this review, various studies suggesting a relationship between the metabolic abnormality and the diabetic complications are examined. The disadvantages of the uncontrolled diabetes mellitus can be divided into two major categories-short-term and long-term. The short-term disadvantages of controlled diabetes mellitus include the following: (1) ketoacidosis and hyperosmolar coma; (2) intracellular dehydration; (3) electrolyte imbalance; (4) decreased phagocytosis; (5) immunologic and lymphocyte activity; (6) impairment of wound healing; and (7) abnormality of lipids. The long-term disadvantages of uncontrolled diabetes melitus include the following: (1) nephropathy; (2) neuropathy; (3) retinopathy; (4) cataract formation; (5) effect on perinatal mortality; (6) complications of vascular disease; and (7) the evaluation of various clinical studies suggesting the relationship of elevated blood glucose levels and complications of diabetes mellitus. It is suggested that until the question of control can absolutely be resolved, the recommendation is that the blood glucose levels should be controlled as close to the normal as possible.
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PMID:Why control blood glucose levels? 81 31

An increased sensitivity of platelets to aggregation from ADP and epinephrine is described in diabetics with or without vascular disease. This sensitivity correlates with elevated levels on von Willebrand factor (vWF), which, in turn appears to be influenced by growth hormone. VWF activity correlates with previously described "plasma factor" activity. Platelets from diabetic subjects are more sensitive than platelets from normal subjects to arachidonic acid-induced aggregation. This sensitivity is abolished by aspirin, which is a prostaglandin synthetase (cyclo-oxygenase) inhibitor. Platelets from diabetc subjects synthesize increased amounts of PGE2-like material (iPGE) in response to ADP, epinephrine, collagen, and arachidonic acid. The latter finding suggests that a fundamental mechanism for increased platelet aggregation in diabetes is increased prostaglandin synthetase activity. Therapeutic endeavors that would lower growth hormone levels, vWF activity, and/or prostaglandin synthetase activity may be of benefit in the prophylaxis of diabetic vascular disease. Prospective studies are needed to explore these hypothesis, as are more studies on the precise mechanisms and platelet aggregation in diabetes mellitus.
Diabetes 1976
PMID:Altered platelet function in diabetes mellitus. 82 64


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