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

Nutrient requirements do not change markedly with advancing age, but life style, socioeconomic status, psychologic changes, and the presence of chronic disease alter nutrient intake in the elderly. It is important to recognize and deal with these factors in attempting to correct malnutrition and in prescribing dietary treatment. Malnutrition includes a variety of disorders: undernutrition, nutrient deficiencies and imbalances, and obesity. Frequent small feedings, with nutritional supplements for patients with profound weight loss, are the initial treatment for undernutrition. Iron supplements and a diet of foods rich in iron and in promoting iron absorption are required in treating iron deficiency anemia. Management of macrocytic anemia should include specific nutrient therapy plus improvement of diet to include leafy vegetables and animal foodstuffs. Diet is an important adjunct in treating chronic diseases. Maturity-onset diabetes mellitus often can be managed by diet alone, with attention to correct proportions of fat, carbohydrate, and protein and to the decreased caloric requirements of elderly patients. The importance of continuing dietary modifications in hyperlipidemia and hypertension is well known. Although dietary manipulation in osteoporosis is not curative, a diet high in calcium and containing adequate floride and vitamin D affords maximum dietary protection against progress of the disease.
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PMID:Guidelines for maintaining adequate nutrition in old age. 64 78

For women beyond the desire for childbearing, the contraceptive options are discussed as appropriate for the age and in light of risks and benefits. Reeducation and careful history taking are important. A pregnancy for a woman 40 years places a woman at greater risk for an elective abortion and greater risk of maternal mortality from abortion; low dose contraceptive use can have beneficial effects for menopausal women. Methods are grouped as contraceptive steroids (combination pills, progestin-only pills, oral preparations, implants, and injections), IUDs, barrier methods (diaphragms, cervical caps, vaginal sponges, spermicides, and contraceptive film), condoms, sterilization, and natural family planning. Empowering women means providing current scientific information and urging women to examine their lives, and to review how and why contraceptive choices were made, and the consequences of the choices. Sexually transmitted disease counseling is appropriate for women in new relationships. A positive attitude toward menopause needs to be conveyed. Combination pills at the lowest dose possible are recommended for women 35 years who are healthy, nonsmoking (or smoking 15 cigarettes/day), blood group O, and able to derive benefits from the pill. Benefits include a 30% reduction in uterine fibroids and protection against endometrial cancer, and decreased risk of ectopic pregnancy, pelvic inflammatory disease (PID), and iron deficiency anemia. Multivitamin use with the pill is recommended due to reduced liver stores of vitamin A. Women 40 years with a parent dying of cardiac disease 50 years or with a history of hypertension, diabetes, or hyperlipidemia are not suitable candidates. 35 mcg preparations are recommended for women 35-45 years, and 20 mcg for women over 45 years. Progestin-only pills are recommended for those with contraindication to estrogen, but have a higher pregnancy rate. IUD use among older women may be difficult due to cervical or pelvic surgery; there is a higher incidence of PID and ectopic pregnancy with IUD use. Barrier methods are more successful for older women due to the changing vaginal anatomy. Vasectomy is the safest sterilization procedure.
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PMID:Contraception for midlife women. 159 31

The primary aim of the study was to evaluate practice differences in reported morbidity in the second and third national morbidity surveys (1970/71, 1981/82) and to discuss their cause. A secondary aim concerned the validation of trends identified from analysis of the data from the total populations in the practices. Altogether 19 practices participated in both surveys. Annual prevalences (that is, the number of patients attending the general practitioner with a condition per 1000 persons at risk) were examined for: all conditions; each of three categories of seriousness of disease; diseases aggregated by chapter of the International classification of diseases; and each of 130 rubrics of the disease classification. Annual prevalence for 'all conditions' was approximately the same for males in both surveys, whereas for females there was an increase. In both sexes, annual prevalence for 'serious conditions' increased slightly and for 'trivial conditions' increased substantially. For 'intermediate conditions', there was a modest decrease in males. In the analysis at ICD chapter level, substantial increases in prevalence occurred in infectious diseases, nervous system diseases, circulatory diseases, genitourinary diseases, musculoskeletal diseases, symptoms, signs and ill-defined conditions, injuries and poisonings. Decreases were found in blood diseases, mental disorders and digestive diseases. Among 130 individual conditions examined, increased annual prevalence was found for mumps, fungal infections, hypothyroidism, diabetes, gout, senile dementia, angina, left heart failure, catarrh, hay fever and asthma, orchitis, acne, osteoarthritis and for some symptoms. Decreases were found for iron deficiency anaemia, anxiety state, refractive errors, haemorrhoids, chronic bronchitis, functional disorders of the stomach, carbuncle and skin infections.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Changes in practice morbidity between the 1970 and 1981 national morbidity surveys. 187 71

Plasma ferritin was measured in 420 apparently healthy active elderly subjects living in the community. Mean values were comparable to other published results for elderly subjects. Higher values were obtained in men and in diabetic subjects. Mean values for men and women after exclusion of subjects with diabetes and other diseases were not significantly lower. It is concluded that a) the age-related rise in plasma ferritin observed in other studies represents a physiologic change, with pathologic processes only playing a small part in contributing to the increase, b) reference intervals appropriate to the elderly should be used, and c) plasma ferritin may not be a useful screening test for iron deficiency anemia or hemochromatosis in the elderly.
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PMID:Plasma ferritin in an elderly population living in the community. 276 82

Three patients (a 44-year-old woman, a 65-year-old man, and a 39-year-old woman) who had had diabetes mellitus for an average of 17 years had good vision and mild to moderate background diabetic retinopathy. These patients developed severe iron deficiency anemia from varying causes and their conditions rapidly progressed to a severe proliferative phase that necessitated panretinal photocoagulation and pars plana vitrectomy in two cases.
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PMID:Anemia and diabetic retinopathy. 403 31

Glycosylated haemoglobin (HbA1) was determined by a microcolumn technique using Biorex 70 resin in normal Nigerians and in patients with diabetes, iron deficiency anaemia, sickle cell disease and renal failure. Mean %HbA1 was 10.0 +/- 1.9% in controls which is higher than levels reported in Caucasians. HbAS but not HbSS had a reducing effect on the %HbA1 which was also found elevated in iron deficiency anaemia and diabetes mellitus. Factors peculiar to tropical medical practice affecting glycosylated haemoglobin must be appreciated and further investigated to assess the usefulness of HbA1 determination in the long term control of diabetes mellitus.
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PMID:Glycosylated haemoglobin (HbA1) for diabetic control in Africans; preliminary findings with the microcolumn technique. 667 Jan 18

The excessive storage of iron in idiopathic haemochromatosis leads to severe organic lesion up to life-threatening conditions (cardiac insufficiency, portal decompensation). The symptoms melanodermia , diabetes mellitus and other endocrine failures, liver cirrhosis, cardiac insufficiency and arthropathy appear together or in various combinations. The diagnosis is ascertained by the proof of iron storage, the multiple organic affection and by familial accumulation of the various laboratory diagnostic possibilities are particularly to be emphasized the serum iron value together with the percetal transferrin saturation (as search test), serum ferritin, the desferrioxamine test, simple ferrokinetic investigations and the quantitative determination of iron in the liver in the bioptate . For family examinations, apart from the search test, a HLA typisation is reasonable, in order to estimate the risk of the disease (particularly of brothers and sisters). The therapy of choice are blood- lettings (0.5 l once to twice a week) up to obtaining a permanent easy iron deficiency anaemia. The maintenance therapy should be performed with monthly to quarterly blood- lettings . Only in cases exception a desferal treatment is indicated. Endocrine failures and cardiac disturbances need a particular therapy.
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PMID:[Idiopathic hemochromatosis--diagnosis and therapy]. 673 May 91

A case of bilateral subcondylar impacted mandibular third molars is presented. Both impactions had associated dentigerous cyst, one of which was severely infected with Serratia marcescens and had a draining sinus tract. The patient also had uncontrolled diabetes mellitus and iron deficiency anemia, which altered her response to surgical treatment. This case illustrates the necessity for early identification of infective organisms and determining their antibiotic sensitivity, as well as the need for prophylactic removal of impacted teeth to prevent complications such as those presented.
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PMID:Serratia infection in a patient with bilateral subcondylar impacted third molars and associated dentigerous cysts: report of case. 698 53

Response to diet and drug therapy was assessed in a group of 85 Indian patients with non-insulin-dependent diabetes in the young (NIDDY). There was a significant decrease in fasting plasma glucose (FPG) values on therapy (pretreatment 13.3 +/- 0.5 mmol/l; post-treatment 9,7 +/- 0,4 mmol/l) (P less than 0,001). Prior to therapy the majority of patients had either moderate (40%) or severe (59%) diabetes; on therapy, the majority had either mild (21%) or moderate (62%) diabetes. Estimation of glycosylated haemoglobin (Hb A1) levels revealed that control was excellent (Hb A1 less than 10%) in 47% of patients and excellent or adequate (Hb A1 less than 12%) in 78%. Hb A1 levels correlated significantly with the FPG value (r = 0,78; P less than 0,001). In 8 patients with iron deficiency anaemia the HB a1 level did not fall within the correlation norms between Hb A1 and FPG. Treatment of the anaemia restored the correlative norms. Hb A1 levels were significantly higher in patients with microvascular complications (12,1 +/- 0,8%) than in those without any vascular complications (10,3 +/- 0,3%) (P less than 0,01).
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PMID:Fasting plasma glucose and glycosylated haemoglobin levels in the assessment of diabetic control in non-insulin-dependent diabetes in the young. 714 26

During the 20 years since the oral contraceptive was introduced, it has been used by some 150 million women around the world, and is perhaps the most carefully monitored medication in history. This vast body of research shows that for the overwhelming majority of healthy women under 30, the benefits of the pill continue to outweigh the risks. The most serious life threatening risks are those involving the cardiovascular system: heart attack, stroke, and throboembolism. However, deaths from these causes would be reduced by 1/2 if women using the pill did not smoke; further reductions would result if women with high blood pressure, high chloresterol levels and diabetes millitus did not use the pill. There is no evidence thus far to justify fears that the pill might be associated with an increased risk of cancer. Most studies show that not only is there no association between pill use and cancer of the ovaries, uterus and breast, but pill use may protect against ovarian and endometrial cancer. Women taking the pill are 1/4 as likely to develop benign breast lumps as nonusers, 1/14 as likely to develop ovarian cysts, 2/3 as likely to develop iron deficiency anemia, and 1/2 as likely to develop rheumatoid arthritis -- all relatively common conditions. In addition, pelvic inflammatory disease, a major cause of infertility, appears to occur only 1/2 as often among pill users as among nonusers. The risk to life among pill users younger than 30 who do not smoke is very small (virtually the same as that of users of the IUD, diaphragm, or condom) and is much lower than the risk of birth-related deaths among women who use no birth control.
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PMID:The pill at 20: an assessment. 720 90


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