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

413 NIDDM Sudanese patients were studied. The patients' ages at the onset of diabetes ranged from 20-72 years, with the majority of patients (44%) developing diabetes at the age between 40-50 years. Female to male ratio was 1.9:1. 46.2% of patients were obese and a family history of first degree relatives was obtained in 63% of patients. Complications of diabetes in this study were as follows: Neuropathy (31.5%), retinopathy (17.4%), cataract (16%), nephropathy (9.2%), coronary heart disease (5.1%), cerebrovascular disease (4.4%) and peripheral vascular disease (3.4%). Microangiopathic complications of diabetes were significantly related to the duration of diabetes and the degree of hyperglycaemia (P less than 0.001 using chi 2 test). Macroangiopathic complications were significantly related to aging and hyperglycaemia. Patients with good metabolic control (blood glucose less than 160 mg%) had less prevalence of complications than uncontrolled patients. We conclude that NIDDM is a common type of diabetes in our diabetic clinic. It is a disease with severe complications and morbidity and needs more attention regarding metabolic control, since good control reduces the prevalence of diabetic complications.
Diabetes Res Clin Pract 1991 Jan
PMID:Features of non-insulin-dependent diabetes mellitus (NIDDM) in the Sudan. 201 36

Since the late 1970s patients with diabetic nephropathy have formed an increasing proportion of new entrants to the Hospital renal dialysis and transplantation programme, reaching 28% for the three year period to December 1988. Between 1 January 1975 and 31 December 1988, 87 diabetic patients were accepted for treatment. Fifty-one per cent were European, predominantly type I diabetics. Maori (9% of the total reference population) accounted for a disproportionately high 47% due to an over-representation by type II diabetic patients (34 of 41 Maori). These findings cannot be explained by the higher prevalence in Maori of type II diabetes but appear to be due to a more prevalent and/or aggressive diabetic renal lesion in this group. On commencing treatment, nearly all patients had retinopathy and the majority had evidence of peripheral vascular disease, hypertension and neuropathy. CAPD was the initial mode of renal replacement therapy in 70% of patients. Overall patient survival was 77% at one year and 42% at three years, and survival on CAPD was 76% and 37% at one and three years, respectively. Patient survival on transplantation was 63% at one year and 58% at three years. Graft survival was 51% at one year and 46% at three years. Although the short term outlook for diabetic patients on renal replacement therapy is encouraging, longer term survival compared to non-diabetic patients is poor. Vascular disease is the major cause of death and an important factor in patient morbidity.
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PMID:Diabetic end stage renal failure--the Wellington experience 1975-1988. 203 73

To determine if lipid peroxidation by-products are increased in the serum of elderly diabetic patients, serum concentrations of conjugated dienes were measured in 45 Type 2 diabetic men over the age of 60 years, and the results were compared to those of 24 age-matched healthy men. Patients with diabetic complications such as retinopathy, nephropathy, neuropathy, peripheral vascular disease, coronary or cerebrovascular disease, (n = 22) had significantly increased serum levels of conjugated dienes (0.4951 +/- 0.065 O.D./mL) compared to healthy controls (0.2368 +/- 0.028 O.D./mL) (P less than 0.01). The level of conjugated dienes in diabetic patients without complications (0.3854 +/- 0.0316 O.D./mL) was intermediate between the level found in control subjects and the level in patients with diabetic complications. The serum levels of conjugated dienes correlated best with serum triglyceride concentration (r = 0.51) and to a lesser extent with serum glucose concentration (r = 0.36). It is concluded that elderly patients with diabetes, especially those with complications, have increased serum levels of lipid peroxidation by-products. This can not be totally attributed to alterations in serum cholesterol, phospholipid, or triglyceride levels.
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PMID:Increased serum conjugated dienes in elderly diabetic patients. 196 Mar 72

Peripheral neuropathy, infection, and peripheral vascular disease can produce serious problems in diabetic patients, particularly in the lower limbs. Ulceration of the foot may progress to gangrene and ultimately necessitate amputation. Distal symmetric polyneuropathy causes sensory loss. Such loss in patients with peripheral vascular disease creates a high risk for foot ulcers, which are vulnerable to infection. Treatment includes relief of neuropathic pain and antibiotic therapy for infection. Pentoxifylline (Trental) improves microvascular flow and appears to be effective against peripheral vascular disease. Aldose reductase inhibitors are being investigated as therapy for diabetic neuropathy. Prevention is the mainstay of management in these patients. Patient education is essential to help maintain health and prevent the potential adverse effects of diabetes.
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PMID:Lower limb problems in diabetic patients. What are the causes? What are the remedies? 203 95

Diabetes mellitus and hypertension constitute two powerful independent risk factors for cardiovascular, renal and atherosclerotic disease. The frequent occurrence of the two diseases in the same individual doubles the risk of cardiovascular death, as well as substantially increasing the frequency of transient ischemic attacks, strokes, peripheral vascular disease with lower extremity amputations, as well as end-stage renal disease and blindness. Although hypertension usually occurs in IDDM in association with renal disease, in NIDDM the evolution of hypertension appears to be multifactorial and independent of renal disease. Obesity appears to be dissociable from hypertension and NIDDM with a common link between obesity, hypertension and NIDDM appearing to be hyperinsulinism and insulin resistance. It has been suggested that hyperinsulinism and insulin resistance may lead to hypertension through altered intracellular calcium metabolism, enhanced renal sodium reabsorption, or through an effect of insulin upon lipid and/or catecholamine metabolism. Further, insulin itself may have a direct effect upon the atherosclerotic process in the hypertensive diabetic patient. These considerations have been taken into account in the structuring of antihypertensive therapy in Type I and Type II Diabetes Mellitus.
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PMID:Diabetes and hypertension. 207 56

The objective of this study is the identification of the most important risk factors of atherosclerosis and the determination of its multicentricity, the goal being an efficient primary and secondary prevention of this disease. Over the course of eight years, at the Department of Diagnosis and Surgical Physiopathology of Peripheral Vascular Diseases, 829 subjects with atherosclerosis were examined, of whom 513 males and 316 females between 18 and 85 years old, as well as to 200 healthy control subjects. The risk factors in consideration were: age, sex, hypertension, diabetes, lipoidoproteinosis, smoking, alcohol and coffee intake. From the data obtained it was revealed that smoking represents the most important risk factor for atherosclerosis (65% of the cases, 40% of the controls), followed in decreasing order by hypertension (31% of the cases, 6% of the controls), diabetes (26% of the cases, 2% of the controls), lipoidoproteinosis (15% of the cases, 6% of the controls). Furthermore 21% of the subjects drank coffee and 28% ingested alcoholic beverages, compared with, respectively 19% and 24% of the controls. In 70% of the cases the presence of atherosclerotic lesions were found in more than one vascular region. Atherosclerosis has a multifactorial etiology as there exists a correlation between the predisposition of the patient to acquire the disease and environmental factors. It is difficult to distinguish the determining effects of a single risk factor, because often many risk factors are tightly interrelated in the same individual; a nearly direct relationship clearly exists between the number and entity of the risk factors and the clinical picture of the patient examined.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Risk factors and multicentricity of vascular atherosclerotic disease. Our experience]. 208 79

The prevalence of various diabetic complications, their association with each other and with many risk factors, has been assessed in 2,337 newly diagnosed Type 2 diabetic patients. The patients entered into the UK Prospective Diabetes Study were aged between 25 and 65 (mean age 52 yr) and 33% had either an abnormal ECG or retinopathy. Different macrovascular complications such as strokes, heart attacks or abnormal ECG, and peripheral vascular disease showed little association one with another, and each was associated predominantly with different risk factors, e.g., strokes with hypertension, heart attacks with hypertriglyceridaemia and peripheral vascular disease with smoking and a low HDL cholesterol. Retinopathy was associated with reduced vibration perception but not with other complications. Reduced vibration perception and absent reflexes were associated with absent foot pulses and ischaemic skin changes, raising the possibility of a macrovascular, as well as microvascular, contribution to peripheral neuropathy. Microalbuminuria was associated with hypertension, which might be a factor predisposing to renal microvascular disease or be a consequence of it. Microalbuminuria was also associated with an abnormal ECG. Retinopathy, with exudates and or haemorrhages rather than just microaneurysms, was associated with hyperglycaemia. The occurrence of a particular complication in a diabetic patient is probably dependent on a combination of specific risk factors, many of which are related to, and probably affected by, potentially avoidable factors such as hyperglycaemia, obesity, smoking and hypertension.
Diabetes Res 1990 Jan
PMID:UK Prospective Diabetes Study 6. Complications in newly diagnosed type 2 diabetic patients and their association with different clinical and biochemical risk factors. 209 90

The aim of this study was to assess the prevalence and the possible risk-factors for the development of peripheral vascular disease (PVD) in sulfonylurea-treated diabetic patients with proteinuria. Fifty non-insulin-dependent diabetics (NIDDs) with proteinuria (greater than 500 mg/24 h), with age less than or equal to 75 years and duration of diabetes greater than or equal to 5 years, and forty-eight NIDDs without proteinuria, matched for age, sex, body mass index (BMI), duration of diabetes and glycaemic control, were studied using Doppler ultrasound. Risk factors analysed included smoking, hypertension and metabolic indices (cholesterol, HDL-C, triglycerides). The prevalence of PVD was 44% in the proteinuric disease group compared to 14.6% in those without proteinuria (p less than 0.01). Among the risk factors analysed, hypertension and triglyceride concentration were significantly higher in the proteinuric diabetics (p less than 0.01), while HDL-C levels were found to be significantly lower in this group (p less than 0.05). We conclude that the prevalence of PVD was significantly higher in NIDDs with proteinuria. Furthermore, proteinuric patients had higher blood pressure and low HDL-C.
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PMID:The prevalence of peripheral vascular disease in sulfonylurea treated diabetic patients with proteinuria. 209 62

The records of 132 patients participating in clinical trials using fast neutron (n = 94), mixed neutron and photon (n = 16), or conventional photon (n = 22) irradiation for primary management of prostatic cancer were retrospectively reviewed to assess treatment-related neurological complications. With a median follow-up of 14 months (range 1 to 101 months), 31/132 patients (26 neutron, 3 mixed beam, 2 photon) have experienced either sciatica beginning during or shortly after treatment, or diminished bladder or bowel continence that developed at a median time of 6.5 months following treatment. Sciatica responded to oral steroids and was usually self-limited, whereas sphincter dysfunction appears to be permanent. Pre-treatment risk factors for complications included a history of hypertension, diabetes, cigarette smoking or peripheral vascular disease, with 81% of affected patients having one or more risk factors compared with 55% of unaffected patients (p = 0.01). Seven patients have moderate (5) or severe (2) residual problems, all in the cohorts receiving neutrons (6/7) or mixed beam therapy (1/7).
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PMID:Transient and chronic neurological complications of fast neutron radiation for adenocarcinoma of the prostate. 212 Jul 42

Diabetes mellitus and peripheral vascular disease often lead to infections that result in lower extremity amputations. Transcutaneous oxygen pressure (TcPO2) has been shown by many investigators to be a highly reliable means of assessing cutaneous blood supply and, thus, predicting healing potential. However, TcPO2 measurements are time-consuming and subject to technical difficulties. For this reason, a potential application of photoplethysmography (PPG) as a method for assessing the level of cutaneous circulation was investigated by comparing PPG peak-to-peak voltages with corresponding TcPO2 measurements. The comparisons were made at 37 locations in 20 patients with an age range of from 20 to 81 years (mean = 64.4 years). Although the two methods are intrinsically different and measure two different physiological parameters, the peak-to-peak voltages from PPG were compared with TcPO2 measurements since TcPO2 was reported to be the best single adjunct in determining healing potential after amputation. Linear regression analysis correlating output peak-to-peak voltages from PPG with TcPO2 yielded a correlation coefficient of 0.60. The anatomic locations did not affect the PPG or the TcPO2 measurement. The results of this study encourage further investigation of this technique and instrumentation as a method of assessing the level of cutaneous circulation and ultimately aid in determination of optimal amputation levels.
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PMID:Potential application of photoplethysmography technique in evaluating microcirculatory status of STAMP patients: preliminary report. 212 21


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