Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Blood glycated haemoglobin (HbAlc), serum fructosamine (FA), serum glycated albumin (GA), and serum glycated total protein (GTP) were determined in 61 subjects (19 pregnant women with gestational diabetes, 24 pregnant women with insulin-dependent diabetes mellitus [IDDM] and 18 nonpregnant subjects with IDDM). FA, GA, and GTP correlated with HbAlc similarly (r = 0.791, 0.816, and 0.794, respectively, p < 0.001). In a subgroup of 22 subjects data on blood glucose home monitoring was recorded and used for calculating mean blood glucose as an index of average glycaemia preceding sampling of the glycation products. Mean blood glucose levels preceding sampling of HbAlc by 2 months and FA, GA, or GTP by three weeks correlated significantly with HbAlc (r = 0.668, p < 0.001) and GA (r = 0.441, p < 0.05) whereas no significant correlation was found between mean blood glucose and FA (r = 0.003) or GTP (r = 0.252). In conclusion, such methods which measure specifically the non-enzymatic glycation of a single species of protein (i.e. FPLC for HbAlc and affinity chromatography for GA) are to be preferred for assessing glycaemia.
 ...
PMID:Blood glycated haemoglobin, serum fructosamine, serum glycated albumin and serum glycated total protein as measures of glycaemia in diabetes mellitus. 148 24

The authors revealed during dispensarization of pregnant women suffering from essential hypertension that the disease is relatively frequently associated with some metabolic disorders, i. e. obesity, gestational diabetes or impaired glucose tolerance. They draw attention to a similarity with Reaven's syndrome in non-pregnant women. The authors recommend to screen for diabetes all obese pregnant women and those with hypertension to detect an impaired glucose metabolism and prevent foetopathies in neonates of thus affected mothers. The authors consider obesity one of the subsidiary criteria in the differential diagnosis of essential hypertension and preeclampsia.
 ...
PMID:[Gestational diabetes mellitus and disorders of glucose tolerance in pregnant women with essential hypertension]. 149 70

In order to determine the prevalence of glucose intolerance in pregnancy, 2,230 consecutive women attending the antenatal clinic at the Aga Khan University Medical Centre in Karachi, Pakistan were subjected on the first antenatal visit, irrespective of gestational age, to a 75 g glucose challenge followed 2 hr later by plasma glucose determination. The test, was repeated at 28-32 weeks of gestation for those patients who had an abnormal initial screen at less than 28 weeks gestation followed by a normal glucose tolerance test and for those who had a risk factor for gestational diabetes even though the initial screen at less than 28 weeks gestation was normal. The initial glucose challenge test was abnormal (2 hr plasma glucose greater than 140 mg%) in 8.6% of the screened population. An oral glucose tolerance test on these patients revealed a prevalence for the entire population of 3.5% of gestational diabetes and 1.9% of impaired glucose tolerance test based on the modified O'Sullivan criteria. Patients with abnormal glucose tolerance test were older, had higher parity, a past history of macrosomia and a family history of diabetes compared to the controls. These patients also had a higher incidence of preterm labour and caesarean section. In the neonates hypoglycemia and hyperbilirubinemia were similarly higher. The fetal abnormality rate was 5.6% and the perinatal mortality was 28/1,000 which were higher than the controls.
 ...
PMID:Experience with screening for abnormal glucose tolerance in pregnancy: maternal and perinatal outcome. 150 44

Modern oral contraceptive pills are safe for the majority of American women. The most important contraindications to oral contraceptive pill use are a history of thrombophlebitis or thromboembolism while on the pill or during pregnancy, smoking over 15 cigarettes daily if over 35 years of age, active liver disease, hypertension, diabetes, a lipid disorder, or breast cancer. A history of gestational diabetes is not an absolute contraindication to oral contraceptive pill use, but women with such a history must be encouraged to exercise and eat properly to reduce the high risk of developing overt diabetes. Couples should be encouraged to use condoms to reduce the risk of sexually transmitted diseases. Most antibiotics do not decrease the effectiveness of the pill. Nonuse of contraception among adolescents and older couples is the most common reason for failure. Postcoital contraceptive pills are available but are not completely effective. The use of modern contraceptives is almost always safer than nonuse.
 ...
PMID:Update on oral contraceptive pills and postcoital contraception. 150 69

Combined estrogen-progestin high-dose oral contraceptives increase the risk of impaired glucose tolerance which is estimated at approximately 12% of oral contraceptive current users. Glucose tolerance is adversely affected by the chemical structure of the progestins contained in oral contraceptives such as estrane (norethindrone, ethynodiol) and particularly gonane (norgestrel). The women at high risk to develop an impaired glucose tolerance on high-dose, oral contraceptives are those with previous gestational diabetes, with a positive family history of diabetes mellitus in a first-degree relative, or who are obese or older. Low-dose oral contraceptives with a reduced content of estrogen and progestogen such as levonorgestrel or desogestrel as well as the triphasic oral contraceptives containing a low daily dose of levonorgestrel or gestodene, are associated with a significantly lower risk of impaired glucose tolerance, even in women with previous gestational diabetes. Noteworthy however is the ability of low-dose progestogen containing oral contraceptives, such as low dose gonane or estrane oral contraceptives, to induce glucose intolerance by increasing the plasma insulin response to oral glucose. Impaired glucose tolerance is often reversible within 6 months of discontinuing oral contraceptives, except for oral contraceptive users with previous gestational diabetes. Development of diabetes mellitus in high-dose oral contraceptive users is rare.
 ...
PMID:Effect of oral contraceptive use on the incidence of impaired glucose tolerance and diabetes mellitus. 151 55

In obesity, impaired glucose tolerance (IGT), non-insulin-dependent diabetes mellitus (NIDDM), and gestational diabetes mellitus (GDM), defects in glucose transport system activity, contribute to insulin resistance in target tissues. In adipocytes from obese and NIDDM patients, we found that pretranslational suppression of the insulin-responsive GLUT4 glucose transporter isoform is a major cause of cellular insulin resistance; however, whether this process is operative in skeletal muscle is not clear. To address this issue, we performed percutaneous biopsies of the vastus lateralis in lean and obese control subjects and in obese patients with IGT and NIDDM and open biopsies of the rectus abdominis at cesarian section in lean and obese gravidas and gravidas with GDM. GLUT4 was measured in total postnuclear membrane fractions from both muscles by immunoblot analyses. The maximally insulin-stimulated rate of in vivo glucose disposal, assessed with euglycemic glucose clamps, decreased 26% in obesity and 74% in NIDDM, reflecting diminished glucose uptake by muscle. However, in vastus lateralis, relative amounts of GLUT4 per milligram membrane protein were similar (NS) among lean (1.0 +/- 0.2) and obese (1.5 +/- 0.3) subjects and patients with IGT (1.4 +/- 0.2) and NIDDM (1.2 +/- 0.2). GLUT4 content was also unchanged when levels were normalized per wet weight, per total protein, and per DNA as an index of cell number. Levels of GLUT4 mRNA were similarly not affected by obesity, IGT, or NIDDM whether normalized per RNA or for the amount of an unrelated constitutive mRNA species. Because muscle fibers (types I and II) exhibit different capacities for insulin-mediated glucose uptake, we tested whether a change in fiber composition could cause insulin resistance without altering overall levels of GLUT4. However, we found that quantities of fiber-specific isoenzymes (phopholamban and types I and II Ca(2+)-ATPase) were similar in all subject groups. In rectus abdominis, GLUT4 content was similar in the lean, obese, and GDM gravidas whether normalized per milligram membrane protein (relative levels were 1.0 +/- 0.2, 1.3 +/- 0.1, and 1.0 +/- 0.2, respectively) or per wet weight, total protein, and DNA. We conclude that in human disease states characterized by insulin resistance, i.e., obesity, IGT, NIDDM, and GDM, GLUT4 gene expression is normal in vastus lateralis or rectus abdominis. To the extent that these muscles are representative of total muscle mass, insulin resistance in skeletal muscle may involve impaired GLUT4 function or translocation and not transporter depletion as observed in adipose tissue.
Diabetes 1992 Apr
PMID:Gene expression of GLUT4 in skeletal muscle from insulin-resistant patients with obesity, IGT, GDM, and NIDDM. 153 55

Although gestational diabetes may have serious consequences for both mother and fetus, it is usually symptomless. The diagnosis can be missed unless all pregnant women are screened to determine those who need a full oral glucose tolerance test. When gestational diabetes is diagnosed, it is essential to (1) achieve euglycemia with diet and, if needed, insulin and (2) monitor for potential complications. Glucose tolerance must be reevaluated in the post-partum period and periodically thereafter to detect continuing intolerance or diabetes.
 ...
PMID:Gestational diabetes. What are the implications? 156 Nov 73

The periodicity of the standard 100-g glucose tolerance test (GTT) was examined in a prospective study of 194 pregnant patients to determine how well gestational diabetes could be identified. A simplified formula, the GTT periodicity, was used to estimate the time for the GTT curve to return to the fasting level. One hundred one study subjects had all normal glucose values by the National Diabetes Data Group criteria (0-abnormal group), 47 had one value greater than normal (1-abnormal group), and 46 had more than one value abnormal or gestational diabetes. The 0-abnormal patients had a significantly shorter GTT periodicity than did 1-abnormal or gestational diabetic mothers (3.6 versus 4.8 versus 6.6 hours, respectively; P less than .04). Calculating the periodicity for the corresponding insulin excursions yielded significantly increasing values in a graduated fashion for each group (5.2 versus 6.9 versus 9.6 hours, respectively; P less than .05). Examination of the oscillation of the GTT curve about the fasting level allows a physiologic description of normal and abnormal glucose responses in pregnancy. Furthermore, our findings suggest that glucose and insulin periodicities are useful predictors of gestational diabetes in patients with positive screening.
 ...
PMID:Glucose tolerance test periodicity as a descriptor of glucose tolerance abnormality. 157 16

Gestational diabetes constitutes 90% of all pregnant diabetic patients, whereas insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) together account for the remaining 10%. Diabetes is considered a heterogeneous disease with a continuous spectrum between IDDM and NIDDM. It is believed that gestational diabetes is also a heterogeneous disorder representing, at least in part, patients who are destined to develop in later life either IDDM or NIDDM. Studies in identical twins have shown clear-cut differences in the genetic inheritance of IDDM and NIDDM. Nearly 100% of identical twins were found to be concordant for NIDDM; whereas in IDDM the concordance rate ranges between 20 and 50%. This concordant pattern indicates a higher genetic contribution in NIDDM than IDDM. Furthermore, IDDM is an HLA-linked disorder, and NIDDM is not. The exact mechanism of inheritance of IDDM and NIDDM is not known; therefore the information used in genetic counseling is based on empirical risk estimates. Recent information demonstrates that IDDM is transmitted less frequently to the offspring of diabetic mothers than diabetic fathers (1.3% versus 6%). The estimated risk of recurrence of IDDM to offsprings with one already affected sibling and unaffected parents is 5 to 6%. Additionally, the empirical risk of NIDDM first-degree relatives developing diabetes is much higher than the observed in IDDM relatives, 15% for first-degree relatives and 60 to 75% when both parents have NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Diabetes mellitus in pregnancy and periconceptional genetic counseling. 159 Aug 74

Current classification, diagnostic and therapeutic guidelines of diabetes in pregnancy are briefly reviewed in this paper. Obstetricians mainly are confronted with the insulin-dependent diabetic (IDDM) prior to conception and during pregnancy. Intensive interdisciplinary co-operation is considered a prerequisite for treatment of the diabetic patient planning or carrying a pregnancy. The following subspecialties should work together in diabetic pregnant care: Reproductive Medicine incl. high-level endocrinological diagnostics, Diabetology with a teaching facility, and--within a perinatal center--an obstetric and neonatal department experienced in diabetic care. Preconceptional metabolic adjustment as well as surveillance of fetal and maternal condition during the first trimester of pregnancy are considered the mainstay in diabetic patient's care. Possible complications of diabetic pregnancy are described. Only in rare cases, pregnancy is contraindicated because of retino- or nephropathy. The screening program for gestational diabetes is based upon the patient's history, fasting-blood-glucose-levels, 50-g-oral-glucose-tolerance-test (OGTT) and a 24-h-blood-glucose-profile. Measurement of insulin levels in amniotic fluid are recommended for cases that remain yet undiagnosed.
 ...
PMID:[Diabetes and pregnancy--optimal management]. 159 5


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>