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

Long-term ambulatory continuous subcutaneous insulin infusion was undertaken under serial blood-glucose control in nine insulin-dependent diabetics. Before this treatment was started, haemoglobin A1 was increased (more than 13%), diabetic lipoid necrosis was present in three, proliferative diabetic retinopathy in one, treatment-resistant Candida oesophagitis in one and Addison's disease in one. During the total of 630 weeks (range 6-135 weeks) of continuous subcutaneous insulin infusion it was found that (1) the metabolic state of the patients improved significantly, the previously non-responding oesophagitis healed and one of three patients with diabetic lipoid necrosis was markedly improved; (2) the risks of insulin treatment, hypoglycaemia (especially with Addison's disease) and keto-acidosis (for technical reasons) remained; and (3) in long-standing diabetes of type I even good control of blood glucose levels (mean 113 mg/dl) could neither prevent the occurrence of proliferative diabetic retinopathy nor loss of sight.
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PMID:[Continuous subcutaneous insulin infusion: long-term treatment in an unselected group of insulin-dependent diabetics]. 640 20

On 42 patients (25 males, 17 females) at the age of 46.1 +/- 13.4 years with a proliferative diabetic retinopathy clinical and laboratory examinations were performed for the proof of a renal lesion. This disease was found in 59.5% of the cases. In the foreground of the pathological findings were a proteinuria, a restriction of the creatinine clearance and of the concentration power of the kidneys as well as the hypertension. The diabetic nephropathy had its peak of frequency between the 50th and 60th year of age and showed significant relations to the duration of diabetes as well as to be early age of manifestation. Close ophthalmological and nephrological examinations, particularly of the juvenile diabetics, should render possible an early recognition and treatment of the diabetic microangiopathy.
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PMID:[Kidney changes in patients with proliferative diabetic retinopathy]. 648 27

Basal serum C-peptide concentrations were determined in a series of adult males referred to a diabetic retinopathy clinic. Degree of retinopathy of the most affected eye of each subject was classified using stereoscopic fundus photographs and fluorescein angiograms. A positive correlation was found between low C-peptide concentration (3.0 +/- 2.1 ng/ml) and proliferative or pre-proliferative diabetic retinopathy. A significantly higher (p less than 0.01) C-peptide level was found in subjects with non-proliferative diabetic retinopathy (6.0 +/- 3.7 ng/ml). Determination of fasting C-peptide levels after the first five-year period of insulin-dependent diabetes appears to be useful as a predictor of risk for proliferative disease.
Diabetes Res 1984 Sep
PMID:Circulating C-peptide and diabetic retinopathy. 652 87

A 24-year-old woman had insulin-dependent juvenile diabetes for 15 years. She developed Sheehan's syndrome (postpartum pituitary necrosis) and diabetic nephropathy at 20 years of age. She had multiple sessions of argon laser photocoagulation for proliferative diabetic retinopathy. Histologically, loss of outer retina and pigmented epithelium occurred at the laser sites. Trypsin retinal digest preparations revealed microaneurysms and markedly decreased numbers of pericytes. The kidneys displayed nodular glomerulosclerosis (Kimmelstiel-Wilson syndrome). The anterior pituitary showed cystic degeneration and old hemorrhage.
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PMID:Histopathology of argon laser photocoagulation in juvenile diabetic retinopathy. 668 74

Visual acuity was measured in a population-based study of diabetic retinopathy in southern Wisconsin. Persons diagnosed prior to 30 years of age and taking insulin (younger onset, n = 996) and those diagnosed at 30 years of age or older (older onset, n = 1370) were examined. Best corrected visual acuity was determined using the Early Treatment of Diabetic Retinopathy Study protocol. In the younger onset group, 1.4% had moderate visual impairment (best corrected visual acuity in the better eye of 20/80 to 20/160) and 3.6% were legally blind (visual acuity in the better eye of 20/200 or worse). Visual impairment in this group was associated with older age at examination, longer duration of diabetes, presence of proliferative retinopathy, and presence of senile cataracts. In the older onset group, 3.0% had moderate visual impairment and 1.6% were legally blind. Visual impairment in this group was associated with older age at examination, longer duration of diabetes, presence of senile cataract, presence of macular edema, and proliferative diabetic retinopathy. When assigning causes of impaired vision, diabetic retinopathy was responsible in part for 86% of eyes with visual acuity of 20/200 or worse in younger onset persons and for 33% in older onset persons.
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PMID:Visual impairment in diabetes. 670 12

The provision of ophthalmologic care to diabetic patients was examined in a large, geographically defined population-based study in southern Wisconsin. Of the total of 2,272 patients examined, 902 were taking insulin and were diagnosed before 30 years of age (younger onset) and 1,370 were diagnosed at or after 30 years of age (older onset). Approximately 26% of the younger-onset and 36% of the older-onset diabetic population had never had an ophthalmologic examination. Characteristics of the younger-onset and older-onset population associated with never having had an ophthalmologic examination included living in a nonmetropolitan county, being older at the time of diagnosis, having a shorter duration of diabetes, having fewer years of education, receiving their diabetes care from a family or general practitioner, and having better visual acuity. Eleven percent of younger- and 7% of older-onset persons with Diabetic Retinopathy Study high-risk characteristics for severe visual loss had never been seen or were seen more than two years before the time of the study. Because severe visual loss caused by proliferative diabetic retinopathy may be reduced by timely photocoagulation treatment, this study suggests that a large number of patients who would benefit from ophthalmologic care are currently not receiving it.
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PMID:Ophthalmologic care for persons with diabetes. 671 81

The effect of continuous subcutaneous insulin infusion (CSII) on diabetic retinopathy was studied in 19 patients with insulin-dependent diabetes mellitus (IDDM). All had diabetes before age 30. Three patients had no retinal abnormalities at the start of the study, 12 had minimal or mild background retinopathy, and 4 had a preproliferative retinopathy. The follow-up period was 12-14 mo. Fundus photography and fluorescein angiography was performed every 2-6 mo. Despite marked improvement of metabolic control, none of the patients with retinopathy showed reversal of the fundal abnormalities. In seven patients with background retinopathy the abnormalities remained unchanged; in five patients a slight worsening was noted. Four patients with moderate-to-severe background retinopathy showed a rapid and severe progression of the fundal abnormalities into a florid proliferative diabetic retinopathy 3-6 mo after initiation of CSII. A higher incidence of hypoglycemic episodes could not be demonstrated in this group. Two of these patients showed a marked reduction in glomerular filtration rate (GFR), 34% and 38%, respectively, during the course of their follow-up. This is compared with a decrease in GFR by only 5.6% for the group as a whole. The four patients with rapidly progressive retinopathy all had long-standing poorly controlled diabetes with preproliferative retinal changes, diabetic neuropathy, and, with the exception of one patient, signs of nephropathy at the start of CSII. The incidence of these features was nil or very low in the remaining 15 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes Care
PMID:Rapid deterioration of diabetic retinopathy during treatment with continuous subcutaneous insulin infusion. 673 93

Prostacyclin (PGI2) is the most potent endogenous inhibitor of platelet aggregation yet discovered. Thromboxane (TXA2) promotes aggregation and degranulation of platelets. It is hypothesized that an homeostasis exists between these pathways that is protective against vascular damage and is disturbed in several diseases such as diabetes. Circulating levels of PGI2-TXA2 in 35 patients with adult onset diabetes and 15 controls have been assayed. Twenty patients had background retinopathy, and 15 had proliferative retinopathy. Circulating levels of PGI were found to be elevated in 9/15 patients with proliferative diabetic retinopathy, 2/20 diabetic patients with background or no retinopathy, and 0/15 controls. PGI levels may correlate, therefore, with the severity of the retinopathy.
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PMID:Circulating prostacyclin and thromboxane levels in patients with diabetic retinopathy. 675 Apr 95

Ocular complications of diabetes in humans are reviewed briefly, and experimental models available for study of the complications are described. Potentially suitable models include not only diabetic animals, but also nondiabetic animals in which analogous lesions have been demonstrated. Many abnormalities of the lens, cornea, iris, and retina comparable to those of diabetes in humans may be observed in diabetic animals, although all abnormalities are not necessarily observed in every species. Retinal changes, in particular, may occur in diabetic animals of several species, but only in large animals (dogs, primates) have saccular capillary aneurysms been reproduced consistently, together with other retinal changes typical of diabetes in humans. A few examples of the uses of animal models are offered, and attention is called to a lack of animal models of proliferative diabetic retinopathy and of rubeosis iridis.
Diabetes 1982
PMID:Ocular complications. 681 71

General experience shows that proliferative diabetic retinopathy leads to blindness within only a short time, in spite of short-term improvements in the clinical picture. Long-lasting remission can occur, but seldom for more than a few years. We have observed 3 patients with proliferative retinopathy in whom remission continued for more than 15 years, in one case even lasting over 20 years. Good, useful vision was maintained during all this time. This was only true of one eye, however, while the other eye rapidly became blind. Of the other forms of angiopathy, little coronary heart disease and no peripheral vascular disease was observed in these patients. There were also no signs of nephropathy, i.e. diabetes-specific glomerular sclerosis. Thus, the total picture of angiopathy seems to be benign. The remission of the retinopathy seems to be in accord with this general trend, although it can perhaps be partly explained by unknown local factors in the eye itself.
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PMID:[Diabetics with proliferative retinopathy of unusual course (author's transl)]. 710 42


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