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

Idiopathic hemochromatosis (iH) is typically a disease of older males. The case presented here describes a 26-yr-old woman with problems presenting heart failure, insulin-dependent diabetes, hepatomegaly, and secondary amenorrhea. The diagnosis was established by serum iron and transferrin saturation measurements, liver biopsy, and bone marrow examination for iron. Twenty grams of iron were removed by phlebotomy over 30 mo, and the patient's symptoms improved. A review of the literature pertinent to people with symptomatic onset of IH before age 30 yr revealed 52 young people in addition to this case. In contrast to IH patients older than 30, there was an almost equal ratio between the sexes, a greater frequency of cardiomyopathy and hypogonadism, and a lower frequency of diabetes mellitus and hepatic involvement. An autosomal recessive mode of inheritance appears to be most likely in this young group.
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PMID:Idiopathic hemochromatosis in a young female. A case study and review of the syndrome in young people. 75 39

A 57-year-old obese woman with hypertension, diabetes mellitus, osteoporosis, and a 40-year history of secondary amenorrhea was diagnosed with corticotropin-dependent Cushing's syndrome. Dynamic endocrine testing and radiological evaluation did not reveal definitively the source of the excess corticotropin. Bilateral adrenalectomy was performed with resolution of the signs and symptoms of hypercortisolism. Four years later, the patient was noted to have rising serum corticotropin levels and an enlarging pituitary mass; hyperprolactinemia also was documented. A diagnosis of Nelson-Salassa syndrome was made, and she underwent a transsphenoidal adenomectomy. A histological examination of the specimen revealed two distinct, albeit contiguous, adenomas: a corticotroph adenoma and a lactotroph adenoma. Postoperatively, the serum prolactin and corticotropin levels decreased significantly. Although the stalk section effect resulting from compression by a pituitary adenoma can raise serum prolactin levels, a concurrent lactotroph adenoma should be considered in patients with nonfunctional or functional pituitary adenomas of other types associated with significantly elevated prolactin levels. The mechanisms underlying simultaneous adrenocorticotropic hormone and prolactin excess are discussed.
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PMID:Coexisting corticotroph and lactotroph adenomas: case report with reference to the relationship of corticotropin and prolactin excess. 131 62

A 27-year-old woman with type 1 diabetes mellitus was admitted to the Shimane Medical University Hospital because of secondary amenorrhea. She had been treated with insulin since July, 1986. Fasting plasma glucose and HbA1c levels were controlled within normal limits. However, body weight gradually decreased and amenorrhea started in 1988. Physical examination revealed emaciation with BMI of 17.3. Basal levels of plasma T3, somatomedin C, LH, FSH and estradiol levels were low, whereas HGH levels were slightly elevated. Plasma LH markedly increased in response to LHRH administration. She was diagnosed as having weight loss-related hypothalamic amenorrhea. Induction of ovulation was not obtained with clomiphene citrate. Treatment with subcutaneous pulsatile administration of LHRH (20 micrograms every 120 min) resulted in an increase in plasma levels of LH, FSH and estradiol, which was accompanied by ovulation and corpus luteum formation. Further treatment with pulsatile LHRH administration was followed by conception. Two gestational sacs were detected by ultrasonography. One of them was absorbed at the early stage of pregnancy. She was delivered of one healthy female infant without complications. These findings suggest that it is important not only to control plasma glucose levels but to keep the appropriate weight and support the psychological aspects of the subject in the treatment of diabetes mellitus. Subcutaneous pulsatile LHRH therapy may be effective for the induction of ovulation in clomiphene-resistant hypothalamic amenorrhea; however, it will be necessary to solve the problem of dosage and the interval of LHRH administration in the future.
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PMID:[A case of type 1 diabetes mellitus with hypothalamic amenorrhea: successful pregnancy following subcutaneous pulsatile administration of LHRH]. 158 22

To describe the age at menarche and the prevalence of menstrual disturbances in an unselected group of women with insulin-dependent diabetes mellitus compared to controls, we identified all women having debut of diabetes mellitus before the age of 30 yr and living in the County of Funen, Denmark on July 1, 1987 and being between 18 and 49 yr old. The women received a structured questionnaire inquiring information concerning menstrual conditions. An age comparable group of nondiabetic women was used as controls; 245 (94%) diabetic women and 253 (88%) controls answered the questionnaire. Among women with debut of diabetes before the age of 10 yr, the age at menarche was delayed 1 yr when comparing to controls (P less than 0.0001). During the past 6 months before answering the questionnaire, 8.2% of the diabetic women and 2.8% of the controls had experienced episodes of secondary amenorrhea (P less than 0.01). Corresponding figures for oligomenorrhea were 10.6% and 4.8% (P less than 0.02), for polymenorrhea 7.3% and 5.2% (NS), and for all types of menstrual disturbances 21.6% and 10.8%, respectively (P less than 0.005). Episodes of secondary amenorrhea occurring more than 6 months before answering the questionnaire had been experienced by 10.7% of the diabetic population vs. 4.8% of the controls (P less than 0.05); corresponding figures for primary amenorrhea were 4.9% and 1.2%, respectively (P less than 0.05). We conclude that the age at menarche among women having developed insulin-dependent diabetes mellitus before the age of 10 yr was delayed by 1 yr when compared to controls. The overall prevalence of menstrual disturbances is increased in diabetic women compared to nondiabetic controls.
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PMID:Epidemiology of menarche and menstrual disturbances in an unselected group of women with insulin-dependent diabetes mellitus compared to controls. 163 55

Estimated maximum oxygen uptake of middle-aged nonelite road race entrants is around 45 to 50 ml/kg/min, which is 40 to 100% higher than values from the female general population. Endurance training, low bodyweight, and nonsmoking of runners explain part of, but not the whole, difference in aerobic capacity observed between athletes and the general population. Sedentary women can improve cardiorespiratory fitness through aerobic exercise programmes, and the women with the lowest level of initial fitness have the highest proportional improvement following training. Regularly exercising women have a significantly reduced risk of fatal and nonfatal coronary events, and low cardiorespiratory fitness is associated with an increased risk of death and nonfatal stroke. The influence of habitual running on the female blood lipid profile is not clear. Cross-sectional studies have found elevated HDL cholesterol concentrations in distance runners, but intervention studies on the effect of jogging on lipid and lipoprotein levels have provided equivocal results. A higher level of physical fitness is associated with a lower risk to subsequently develop hypertension. Experimental studies have shown that moderate intensity aerobic exercise (40 to 60% VO2max) is able to reduce blood pressure significantly in hypertensive subjects. An athletic lifestyle may be associated with a reduced risk of adult-onset diabetes mellitus (via an exercise-induced increase in insulin-sensitivity), and with a reduced risk of cancers of the reproductive system, breast, and colon. Recreational running is also correlated with better weight control. Surveys of recreational and elite distance runners show a great variability in the prevalence of secondary amenorrhoea, between 1 and 44%. Environmental factors determining the risk of amenorrhoea in runners are low body fat content, mileage, and nutritional inadequacy, with low intakes of calories, protein, and fat. Amenorrhoeic athletes in their third and fourth decade have lower vertebral bone density, which is improved after resumption of menses but does not completely reach age-specific average values. Regardless of menstrual status, the effectiveness of exercise to maintain bone mass throughout life is an important issue. Habitual exercise is associated with increased bone density of the spine both in premenopausal and postmenopausal women. Several controlled training studies suggest that postmenopausal women may at least retard their bone loss with regular aerobic exercise. Running-related injuries and complaints are common in recreational joggers, even though the reported 1-year incidence, varying between 14 and approximately 50%, depends on injury definition. Mileage and a history of previous running injury are known risk factors.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Health effects of recreational running in women. Some epidemiological and preventive aspects. 201 82

To investigate the cause of secondary amenorrhoea in insulin-dependent diabetes gonadotrophins, sex steroid hormone levels and residual beta cell activity (C-peptide index) were estimated in a group of 43 women with IDDM. Among 26 women with residual insulin secretion, the C-peptide positive (CpP) group, 5 had secondary amenorrhoea (CpP-Am); among 17 women without endogenous beta cell activity, the C-peptide negative (CpN) group 6 had secondary amenorrhoea (CpN-Am). In this study two different types of secondary amenorrhoea in insulin-dependent diabetics were observed. All CpP-Am women have the classical hormone profile of the polycystic ovary syndrome (increased (LH/FSH ratio, increased serum testosterone, decreased SHBG) together with a history of oligomenorrhoea and excess weight before the onset of diabetes. On the other hand, all CpN-Am women had decreased LH levels as well as low LH/FSH ratio and testosterone levels. These results strongly suggest that a lack of residual pancreatic beta cell activity influences hypothalamus-pituitary function in insulin-dependent diabetes. It might be concluded that PCOS is independent of diabetes while low LH amenorrhoea seems to be the consequence of diabetes and is strongly associated with a lack of residual insulin secretion.
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PMID:The effect of residual beta cell activity on menstruation and the reproductive hormone profile of insulin-dependent diabetics. 267 77

From observations of female type I diabetics, we collected data on menarche, menstrual cycle and fertility. 337 women answered our questionnaire which had been published in journals for diabetic patients. The data were correlated with age, diabetes duration, and the onset of diabetes. The mean age at menarche was inversely correlated with the age of the patients; in diabetics it was 0.8-2 years higher than in the population in which diabetes developed after menarche. As compared to a population of non-diabetics we observed an increase in mean age at menarche of 0.4-1.3 years. The increase was most pronounced if diabetes developed between the age of 3-8 years. The prevalence of primary amenorrhoea in diabetics was 3.6%, in the controls and in diabetics with late onset 1.5%. Irregularities of the menstrual cycle were observed more often in diabetics than in the controls. The prevalences of oligomenorrhoea and secondary amenorrhoea were 14 and 7% in the group of patients with diabetes onset before menarche. In the group with late onset of diabetes the prevalence of secondary amenorrhoea was 12%. Irregularities of the menstrual cycle were found more frequently at the time of diabetes onset, although 76% of the patients had not remarked any change in the frequency of menstrual bleedings. With increasing diabetes duration, the frequency of bleedings normalized. 70.5% of the patients aged 35 or more had spontaneous conceptions, 2.1% were sterile. Both values are not significantly different from the data of the control group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Menarche, menstrual cycle and fertility in diabetic patients]. 270 25

We report the case of a 22-year old woman who presented skin lesions of acanthosis nigricans, hirsutism and secondary amenorrhoea. She had high plasma levels of adrenal androgens and low plasma levels of sex steroid binding protein. Polycystic ovaries were discovered in the course of a laparotomy performed for paraovarian cyst. An oral glucose tolerance test revealed a state of hyperinsulinism with intolerance to carbohydrates, while the body mass index was normal. This insulin resistant state corresponded in vitro to a decrease in the number of erythrocyte insulin receptors without decrease in their affinity for insulin. Following paradoxical improvement during a full-term pregnancy, there was gradual deterioration of diabetes control requiring insulin therapy. This metabolic decompensation was accompanied by major hyperlipaemia followed by acute haemorrhagic pancreatitis. This case illustrates the course of a type A insulin resistance syndrome which was detected at an early stage in front of an hirsutism-acanthosis nigricans association. The underlying pathogenic mechanisms of these pathologies are discussed.
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PMID:[Acanthosis nigricans, hyperandrogenism, insulin resistance and mixed hyperlipemia]. 297 81

In order to investigate the dopaminergic activity in diabetic women with secondary amenorrhoea we studied the response of prolactin to a dopamine receptor antagonist metoclopramide (MTC - 10 mg i.v.) in three groups of women: 5 insulin-dependent diabetic women with secondary amenorrhoea, 5 insulin-dependent diabetics with normal menstrual cycles and 6 non-diabetic women with regular cycles. Patients with diabetes and secondary amenorrhoea had significantly lower basal LH levels (P less than 0.001) and FSH levels (P less than 0.005) than normally cycling diabetic women. Basal and metoclopramide stimulated prolactin levels were lower in diabetic women with secondary amenorrhoea compared to normally cycling diabetics and control subjects. Evaluation of C-peptide levels in peripheral blood revealed that all amenorrheic diabetics had no endogenous beta cell function while diabetic women with normal cycles (except 1 patient) had preserved residual pancreatic beta cell secretion.
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PMID:Blunted prolactin response to metoclopramide in insulin-dependent diabetic patients with secondary amenorrhoea. 312 73

The effect of improving diabetic control on secondary hypogonadotropic amenorrhea was investigated in patients with insulin-dependent diabetes mellitus (IDDM). Second, the hypothesis that increased central (hypothalamic) opiate inhibition may have been responsible for the suppression of gonadotropin-releasing hormone (GnRH) was tested by observing the effect of a four-hour naloxone infusion (1.4 mg/hour) on serum gonadotropin levels. All known causes of secondary amenorrhea were excluded before patients were eligible for the study. The median duration of amenorrhea was six years, and median body weight was 101 percent of ideal. After six months of improved metabolic control (n = 5) using intensified conventional therapy or continuous subcutaneous insulin infusion, the level of glycosylated hemoglobin dropped from 11.8 +/- 0.9 percent to 8.5 +/- 0.5 percent (p less than 0.005), and body weight increased from 60.5 +/- 1.8 kg to 64.7 +/- 1.4 kg (p less than 0.02). Menses did not, however, return in any patient. There was no significant change in serum levels of estradiol, progesterone, dihydroxyepiandrosterone, testosterone, prolactin, basal or GnRH-stimulated luteinizing hormone, or follicle-stimulating hormone. There was no change in the levels of luteinizing hormone or follicle-stimulating hormone during the naloxone infusion either during poor metabolic control or after six months of improved metabolic control. In conclusion, a form of secondary hypogonadotropic amenorrhea was identified in patients with IDDM that did not remit with sustained improvements in metabolic control. It did not appear to be mediated through increased central opiate tone.
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PMID:Hypogonadotropic secondary amenorrhea in diabetes: effects of central opiate blockade and improved metabolic control. 333 66


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