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

A reversible deterioration of the oral glucose tolerance has been reported in subjects with initially impaired glucose tolerance when starting to take oral diuretics. This does not seem to be the case in subjects with an initially unimpaired glucose tolerance. A deterioration in the diabetic state is commonly seen when diuretics are given to subjects with clinical diabetes. Our knowledge about the effect of beta-blockers on the glucose tolerance is limited. As for diuretics there seems to be an overrepresentation of diabetics among subjects taking beta-blockers. This overrepresentation can probably be explained by an association between diabetes and disturbances in which diuretics and beta-blockers are commonly used such as arterial hypertension and ischaemic heart disease.
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PMID:Impairment of glucose metabolism during treatment with antihypertensive drugs. 3 6

Comprehensive ascertainment of all possible new cases of stroke appearing between January 1, 1970 and June 30, 1971, and admitted to three major hospitals in Winnipeg, Manitoba, has been achieved by reviewing the Manitoba Health Services Commission claim reports. The medical records of these cases were reviewed, pertinent data were abstracted, and rigid criteria for diagnosis were followed. Also, data were obtained from death certificates, autopsy reports and long-term hospital records. A total of 606 ascertained cases (410 infarction, 137 hemorrhage, and 59 undetermined type) were matched for age, sex, residence and year of admission with 606 controls from admissions for other than cardiovascular and cerebrovascular disorders. The data were analyzed for elucidating the possible risk factors for infarction (INF) and hemorrhage (HGE). The findings suggested that hypertension was the main risk factor in hemorrhage, whereas in infarction, along with hypertension, other factors such as diabetes, heart enlargement in chest x-ray, ECG abnormalities, and smoking were suggested as risk factors. There was an association also between infarction, on one hand, and the history of receiving anticoagulants, diuretics, and medications for the heart, and the occurrence of myocardial infarction, on the other hand. These features indicate that infarction and ischemic heart disease have similar risk factors. Hemoglobin and hematocrit were higher in infarction cases than in their controls only when measured at stroke admission. No difference was revealed when they were measured prior to stroke. Their association with infraction therefore may be secondary to other factors and of no significance for its risk.
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PMID:Relative role of factors associated with cerebral infarction and cerebral hemorrhage. A matched pair case-control study. 13 18

A group of 149 diabetics and 98 healthy subjects without evidence of diabetes or ischaemic heart disease were studied. Untreated diabetics under 40 years old and 40 years of age and over showed statistically raised fasting serum turbidity, triglycerides, and raised beta and pre-beta lipoprotein levels but not raised cholesterol levels over the age and sex matched normal subjects. Further, some 63% of all diabetics showed a distinct split pre-beta lipoprotein pattern as seen on polyacrylamide disc electrolphoresis as compared with 17% in the control group. Raised lecithin and phosphatidylethanolamine (PE) levels were found in male diabetics and raised PE levels in young diabetic women. In patients under treatment with insulin, chlorpropamide, or phenformin the diabetes was well controlled in most cases, but these patients did not have significantly lower lipid levels. Diabetics on a low carbohydrate diet showed improvement in triglycerides and pre-beta lipoprotein levels, but beta lipoproteins were not lowered. It is suggested that diabetics may benefit by the inclusion of clofibrate in the treatment.
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PMID:A lipid and lipoprotein profile of treated and untreated diabetics. 17 34

The mechanism of action of the acute abnormal rise of plasma free fatty acids (FFA) in the provocation of arrhythmia in ischemic heart was studied by means of electron spin resonance (ESR) spectrometer. A sudden and abnormal rise of plasma FFA caused a significant fall of the respiratory control index (RCI) of the amount of free radical myocardial mitochondria in state 4 respiration. Based on these findings, a sudden and abnormal rise of plasma FFA seems to further facilitate the uncoupling of oxidative phosphorylation in the myocardial mitochondria of the ischemic portion of the heart. These observations indicate that it may play an important role in the provocation of arrhythmia by high plasma FFA on the ischemic heart. Nicomol (2,2,6,6,-tetrakis (nicotinoyloxymethyl) cyclohexanol), an inhibitor for the rapid rise of plasma FFA, was effective in the treatment and prevention of arrhythmia in ischemic heart disease and diabetes mellitus.
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PMID:Arrhythmogenic effects of acute free fatty acid mobilization on ischemic heart. 20 97

The aim of the present study was to determine whether skin fibroblasts derived from patients with ischemic heart disease (IHD), which could not be related to accepted risk factors, would show a metabolic abnormality with respect to lipid or lipoprotein metabolism. Male patients 30-52 years old suffering from IHD were subdivided into two groups: those in whom IHD was not associated with risk factors such as hypertension, hyperlipoproteinemia, diabetes or smoking (group I); and those in whom heavy smoking was the only major risk factor recognized (group II). The controls were patients with angiographically normal coronary arteries (group III). Skin fibroblasts obtained from these patients were cultured and investigated with respect to metabolism of low density lipoprotein (LDL), synthesis of cellular lipids and induction of cholesterol ester accumulation in the presence of chloroquine, an inhibitor of lysosomal hydrolases. After 24 h incubation, the uptake and degradation of LDL protein in cells from patients of group II was significantly higher than in the controls, group III, but not different from those of group I. Hydrolysis of [3H] cholesterol linoleate, and incorporation of [3H] oleic acid into total lipids and into cholesterol esters was similar in cell cultures of the 3 groups studied. After exposure to chloroquine and LDL, the cells from the different donors accumulated cholesterol ester to a similar extent. Thus, whereas no significant difference was encountered in the lipid and lipoprotein metabolism in cells of patients with IHD without risk factors and controls, some increase in LDL metabolism was seen in cells from patients with IHD and with a history of smoking. It remains to be determined whether this increase was causally related to smoking.
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PMID:Study of cultured skin fibroblasts from patients with and without ischemic heart disease. Metabolism of low density lipoprotein and cholesterol ester, synthesis of cellular lipids and effect of chloroquine on accumulation of cholesterol ester. 20 2

Progress in our understanding diabetic angiopathy has been slow, but we are now learning a number of lessons of interest to the cardiologist. Diabetic angiopathy is a collective term for conditions specific to the diabetic state and related to its duration more than to patient age. The angiopathy produces calcification of the media of larger arteries, but its major effects are in the microcirculation. Intense interest in one feature, skeletal muscle capillary basement membrane thickening, has dominated the last decade. Capillary basement membrane thickening, while characteristic of diabetes, is associated with little direct impairment of the microcirculatin. It appears to play no role in the pathogenesis of diabetes itself. The pathology of diabetic retinopathy and diabetic nephropathy suggests that arteriolar changes may be the major mediator of diabetic angiopathy. This concept is supported by the interactions between hypertension and diabetes in the eye and kidney. The course of diabetes of youthful onset differs from that of maturity onset. The relative frequency of diabetic angiopathy is higher, and of atherosclerotic complications is lower. This has made it difficult to demonstrate the potential value of preventive measures. Benefit to one type of problem may become hidden by worsening of the other. If the diabetic benefits from what is learned about how ischemic heart disease risk can be reduced, he will require even more effective management to prevent or control diabetic angiopathy.
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PMID:Diabetic angiopathy--its lessons in vascular physiology. 35 70

A survey is given of the literature on the influence of prostaglandins on the lipid- and carbohydrate metabolism. Some common pathobiochemical features in the development of diabetes mellitus and the ischaemic heart disease are outlined, which became apparent by examinations of the fatty acid pattern in patients. Thus a biochemical basis for that epidemiologically well known fact is given, that diabetes represents a risk factor for the ischaemic heart disease. Some of the latest results from the experimental research suggest that the vascular complications occurring in chronic diabetes are caused by a decrease in the formation of prostacyclin and possibly by an increase in the thromboxane A2 production. Similar changes in the prostaglandin metabolism occur in the ischaemic heart disease and myocardial infarction, too, as experimental results have shown.
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PMID:[Significance of prostaglandins for fat and carbohydrate metabolism with special reference to pathogenesis of diabetes mellitus ]. 36 61

Men drafted into the Army, hospitalized during 1944 to 1945 for service-connected trauma to the extremities, and consequently separated for disability were followed for mortality from January 1946 to April 1977. Three groups were established consisting of those whose injury resulted in (a) limb amputation, (b) disfiguration without loss of body part, (c) loss of part of hand or part of foot. Group (a) had a mortality, standardized for age and calendar time, 1.4 times that of Group (b), matched on age and length of service at admission, and 1.3 times that of Group (c), similar on age and length of service to Group (a). The excess mortality of limb amputees was statistically significant (P less than .05) for ischemic heart disease, other diseases of the cardiovascular system, suicide by poisoning, alcholic cirrhosis, and cute pancreatitis. Possibly (P less than .1) there was also an increased risk of diabetes and cancer of the buccal cavity and pharynx.
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PMID:Report to the Veterans' Administration Department of Medicine and Surgery on service-connected traumatic limb amputations and subsequent mortality from cardiovascular disease and other causes of death. 39 10

The Paris prospective study in an epidemiological study of 7,453 middle-aged men born in France, and initially free from ischaemic heart disease. The current mean follow-up time is 4 years. The mean annual incidence is 5.1 per 1000, which is about one half that found in similar american studies. This incidence is related to the cholesterol level, to the blood pressure, to cigarette consumption when the smoke is inhaled, to diabetes mellitus, and to major abnormalities on the electrocardiogram. These five factors are mutually independant in their prediction of the risk of future illness. A formula has been derived by statistical analysis, and takes these five factors into account: the incidence of illness rises exponentially as a function of this formula. New cases of ischaemic heart disease are distributed, but with a very patchy incidence, in this population, of which only a very small number remain disease-free. A table has been drawn up to show the probability of a middle aged male contracting ischeamic heart disease within 4 years, and takes the 5 factors into account: this probability varies between 0.5 per cent and 34 per cent.
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PMID:[Incidence and evaluation of the risk of coronary disease. Prospective study in Paris]. 40 66

Japanese migrants and their offspring on the island of Hawaii and Japanese living in Hiroshima were examined for diabetes mellitus and its vascular complications. the same methods and investigators were used in both locations. Death certificates of Japanese and Caucasians dying on the island during the past 26 yr were analyzed. Diabetes, defined as a venous serum glucose concentration of at least 200 mg/dl 2 h after a 50-g oral glucose load, was significantly more common in the Hawaiian Japanese than in the Hiroshima Japanese subjects. This suggests that diabetes is more prevalent in Japanese in Hawaii than in Japan, although lack of knowledge about the total population of Japanese migrants in Hawaii makes this generalization uncertain. The proportion of deaths attributed to diabetes was much higher in Japanese migrants and their offspring in Hawaii than in Japan. During the 1950s, the proportional death rate from diabetes was about half as large in Japanese Hawaiians as in Caucasian Hawaiians, but it increased to become 1.6 times the Caucasian rate during the 1970s. A nutritional study revealed that the total caloric intake was similar in Japanese in Hawaii and Hiroshima, although the estimated level of physical activity was less in the Hawaiian subjects. Consumption of animal fat and simple carbohydrates (sucrose and fructose) were at least twice as high in Hawaiian as in Hiroshima Japanese. Conversely, Hiroshima Japanese consumed about twice the amount of complex carbohydrate as the Hawaiian Japanese. These observations support the hypothesis that a high fat, high simple carbohydrate, low complex carbohydrate diet and/or reduced levels of physical activity increase risk of diabetes. The proportion of deaths attributed to ischemic heart disease was higher in both diabetic and nondiabetic Japanese Hawaiians than in diabetic subjects in Japan. The rates were similar for Japanese and Caucasians in Hawaii. There was no evidence of an environmental influence on the development of microangiopathy (retinopathy) in diabetes, as the prevalence of diabetic retinopathy (stratified for diabetes duration) was similar in Japanese subjects in Hawaii and in Japan, and it was similar to previous reports from England. On the other hand, diabetes alone did not appear to account for the greater prevalence of macroangiopathy in Hawaiian Japanese than in Hiroshima. Thus environmental factors, possibly including diet, appear to be involved in the development of macrovascular complications of diabetes.
Diabetes Care
PMID:Diabetes mellitus and its vascular complications in Japanese migrants on the Island of Hawaii. 52 Jan 20


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