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

Arteriosclerosis obliterans (ASO) of the lower extremities was found in 32 cases (1.9%) among 1673 Japanese diabetic patients. Comparison with age-and sex-matched control patients revealed that male sex, older age, hypertension and neglect of treatment of diabetes were positively correlated with ASO, but obesity, smoking and hyperlipidemia were not correlated with ASO. Proteinuria, cerebral vascular disease and myocardial infarction were significantly associated with ASO. The arterial pulses of the foot were examined in 451 diabetic patients. The pulse of A. dorsalis pedis was absent in 29 (6.4%) and was significantly related to the clinical signs and symptoms of ASO. The loss of the pulse of A. dorsalis pedis increased with age and was more frequent in men than in women. The results indicate a lower frequency of ASO in Japanese than in Western diabetic patients.
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PMID:Arteriosclerosis obliterans in Japanese diabetic patients. 668 May 33

This study presents an obstetric protocol offering better management and prediction for normoglycemic insulin-dependent patients (White Class D4, F, R, or RF) who conceived after they were diagnosed as having vascular disease secondary to diabetes mellitus. Normoglycemia was accomplished during the pregestational phase, and conception occurred only after the glycosylated hemoglobin level was documented to be normal. Normoglycemia was maintained during pregnancy in the outpatient setting through the use of blood glucose monitoring performed by the patient. The obstetric protocol emphasized three additional areas of attention: (1) assessment of fetal growth by serial uterine fundal measurement and ultrasonography at gestational weeks 21 to 22; (2) assessment of fetal movement by patient-perceived fetal movements for 1 hour a week starting at week 35, increasing to 2 hr/day at week 37, and increasing to 3 hr/day from week 38 onward; and (3) cervical assessment at week 37 and preparation for vaginal delivery. Eight patients had a creatinine clearance of less than or equal to 80 ml/min prior to conception (mean = 66 +/- 6 ml/min). By 6 to 12 weeks' gestation all eight showed an increase in creatinine clearance (mean = 91 +/- 20, p less than 0.01). There was no change in the third trimester, and postpartum creatinine clearance was at antepartum levels. Proteinuria increased significantly by the end of the first trimester in all eight women and regressed post partum. Proteinuria (greater than 150 mg/24 hr) did not occur in the 14 women with normal antepartum creatinine clearance. Of 11 women with background retinopathy, six showed improvement in retinal status by fundus stereophotography whereas five showed no change. Of 11 women with proliferative retinopathy, five improved, five required laser therapy, and one remained in stable condition. Despite hemoglobin A1 levels in the normal gestational range (3% to 7.5%), there was a significant correlation of these levels with infant birth weights. None of the 22 infants died, and only one had any perinatal disease. Thus this protocol with its emphasis on fetal growth and size resulted in improvement in both maternal and infant outcome in pregnancies complicated by diabetes mellitus with vascular compromise.
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PMID:Obstetric management when normoglycemia is maintained in diabetic pregnant women with vascular compromise. 674 44

The prevalence of retinopathy and proteinuria was assessed in 212 and 230 type 1 diabetics in Iceland respectively. They represent 78% and 84% of all such patients identified in the country. Retinopathy was present in 33.5%, background lesions only in 27.4% and more severe retinopathy in 6.1%. After 5-9 years of diabetes (mean 6.9) the prevalence of retinopathy was 18.8%, including 2.1% proliferative, and rose to 76.7% after 20 years or more of diabetes (mean 26.7), including 16.2% in the proliferative stage. Blindness was found in 2.4% of the patients. Diabetics diagnosed at the age of 0-19 years had a lower prevalence of retinopathy during their first 20 years of diabetes than those diagnosed later in life (p less than 0.05). Proteinuria was present in 14%, intermittent in 10% and continuous in 4%. After 10 years or more of diabetes (mean 19.3) the prevalence of intermittent and continuous proteinuria was 13.0% and 8.3%, respectively.
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PMID:Prevalence of retinopathy and proteinuria in type 1 diabetics in Iceland. 675 93

A prospective examination was conducted of a five man group practice in Mosgiel, Otago. The incidence of diabetes was ascertained, and the frequency of proteinuria in that diabetic population. Thirteen percent of those examined showed proteinuria. Proteinuria appeared best related to the presence of retinopathy, and the known duration of the diabetes.
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PMID:Proteinuria in an Otago diabetic population. 693 May 88

One hundred and eleven cases of diabetic glomerulosclerosis (biopsies n=106, autopsies n=5) are divided into three groups: Diffuse diabetic glomerulosclerosis (n=74), mixed diffuse-nodular glomerulosclerosis (n=14) and nodular diabetic glomerulosclerosis (n=23). The clinical parameters, data concerning duration of diabetes and of renal disease, as well as types of therapy, were correlated with the different morphologic groups. The following results could be observed: nodular glomerulosclerosis very frequently occurs in women, often accompanied by a diabetes-manifestation beyond the fourth decade of life. This correlated with the longest duration of diabetes and frequently showed a greatly increased serum-creatinine level. Proteinuria of about 90% is the most frequent and first symptom of diabetic glomerulosclerosis. Therapy with insulin apparently shows an advantageous influence on proteinuria. In summary, however, the variability of clinical symptoms and signs should be emphasised, preventing in some cases a diagnosis being made on clinical findings alone.
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PMID:[Morphologic-clinical correlation in different forms of diabetic glomerulosclerosis]. 713 30

We assayed plasma activities of beta-galactosidase, beta-hexosaminidase, alpha-fucosidase and alpha-galactosidase involved in degradation of the glycoprotein molecule in 110 insulin-dependent diabetics aged 3-1/2 to 19 years and compared them to a group of normal youngsters. We correlated the plasma enzyme activities with the duration, control and sequelae of insulin-dependent diabetes. Insulin-dependent diabetics had a significantly higher plasma activity of beta-hexosaminidase and alpha-mannosidase (p less than 0.01) and a significantly lower plasma activity of alpha-fucosidase and alpha-galactosidase (p less than 0.01). Of the 5 enzymes studied, only plasma beta-hexosaminidase correlated with fasting and postprandial blood sugar (p less than 0.01), cholesterol and triglycerides (p less than 0.05). Additionally, poor control of diabetes was also associated with a significantly higher plasma beta-hexosaminidase activity (p less than 0.01). Proteinuria or an abnormal Addis count suggestive of renal involvement was associated with various changes in plasma acidic hydrolases. These changes may be related to insulin deficiency rather than hyperglycemia and may be genetically determined.
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PMID:Plasma acidic glycohydrolases in insulin-dependent diabetes mellitus. 730 74

Proteinuria was analysed quantitatively and qualitatively in 156 diabetics and 63 matched controls. The study was limited to patients with a proteinuria of less than 100 ng/min in the recumbency. The urinary proteins were analysed using cellulose acetate electrophoresis, immunoelectrophoresis and sodium dodecylsulfate poly-acrylamide gel electrophoresis. Abnormal urinary protein patterns were more frequent in diabetics than in the controls (p less than 0.01). However, when the subjects were divided into 2 groups according to their age, the limit being arbitrarily chosen at 60 years, the differences were statistically not significant in the older group. By contrast, in the younger group, the proportion of perfectly normal patterns was significantly decreased in diabetics as compared to the controls (p less than 0.005). In our diabetic population, chosen on the basis of a quantitatively normal proteinuria, no clear relation could be found between the abnormalities of the urinary protein electrophoretic patterns and the patient's clinical data, with the exception of vascular and cardiac complications. Our results suggest that qualitative changes of urinary proteins might be the first signs of renal complications in diabetic patients and that diabetes might constitute an additional cause of aging for the kidneys.
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PMID:[Initial aspects of the changes in diabetic proteinuria]. 736 49

Antihypertensive treatment can slow down the decline in glomerular filtration rate (GFR) with time. In patients with diabetic nephropathy, angiotensin converting enzyme (ACE) inhibition has been shown to be more effective in this regard than conventional antihypertensive therapy. Whether this applies to the much larger population of patients with essential hypertension is not yet known. In the present study, the effects of two different antihypertensive therapies on the loss of GFR with time, determined with Cr51-EDTA clearance after 6, 12 and 24 months of treatment, were assessed in a prospective, randomised, double-blind trial in 257 patients with essential hypertension. All had normal renal function and none had diabetes mellitus or glucosuria. Proteinuria (dipstick positive or trace) was detected in 7 patients initially. The two therapeutic modalities were the ACE inhibitor cilazapril and the beta-adrenoceptor blocking agent atenolol. Both therapies were equally effective in lowering systolic blood pressure (e.g. from 168 mmHg to 152 mmHg with cilazapril and from 170 mmHg to 155 mmHg with atenolol after 6 months, p < 0.001 for both). However, atenolol was slightly but significantly more effective in lowering the diastolic blood pressure at 6, 12 and 24 months. The decline in GFR with time was significantly smaller with cilazapril than with atenolol. After 6 months the reduction in GFR was 1.0 vs. 4.0 ml/min x 1.73 m2, p = 0.008 (cilazapril vs. atenolol) and after 12 months the corresponding changes were 2.0 vs. 4.5 ml/min x 1.73 m2, p = 0.04 and after 24 months 3.0 vs. 4.0 ml/min x 1.73 m2, respectively (n.s.).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:ACE inhibition preserves renal function better than beta-blockade in the treatment of essential hypertension. 759 59

The Strong Heart Study, a study of cardiovascular disease among American Indians, was conducted to determine cardiovascular disease rates and the prevalence of risk factors among members of 13 tribal groups in South Dakota/North Dakota (SD/ND), southeastern Oklahoma, and Arizona. From 1989 to 1992, 4,549 tribal members aged 45-74 years (62% of eligible participants) were surveyed and examined for cardiovascular disease and its risk factors. Mean total cholesterol concentrations were over 20 mg/dl lower among the men and 27 mg/dl lower among the women than national mean levels for the same age groups. Cholesterol levels varied by tribal group; Arizona Indians had mean levels more than 20 mg/dl lower than those of SD/ND Indians. The prevalence of hypercholesterolemia was almost twice as high among SD/ND Indians as among Arizona Indians, but the rates for all three groups were much lower than total US rates (all races). Mean levels of high density lipoprotein cholesterol were lower among Indian men and women than in the US population as a whole. The prevalence of hypertension among Arizona and Oklahoma Indians was higher than that for the entire United States. SD/ND Indians had significantly lower mean blood pressures and prevalence rates of hypertension than Oklahoma and Arizona Indians and the United States as a whole. The prevalence of cigarette smoking was higher for all Indian groups except Arizona women in comparison with US rates. Smoking rates were highest in SD/ND and lowest in Arizona. Indian smokers smoked fewer cigarettes per day than the average US smoker. Arizona Indians had the highest prevalence of diabetes mellitus; over 60% of those participants were diabetic. In Oklahoma and SD/ND, one third of the men and over 40% of the women were diabetic. In addition, 13-20% of the participants had impaired glucose tolerance. Proteinuria was also a common problem; almost half of the Arizona Indians had micro- or macroalbuminuria, and 20% of Oklahoma and SD/ND Indians had significant proteinuria. The prevalence of obesity was high in all three groups, with Arizona Indians having the highest rates and the highest mean body mass indices. The prevalence of current alcohol use was lower among Indians than in the nation as a whole, but binge drinking was common among those who used alcohol. These results indicate that cardiovascular disease risk factors vary significantly among tribal groups. Prevention programs tailored toward decreasing the prevalence of risk factors are recommended for long-term reduction of cardiovascular disease rates in American Indian communities.
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PMID:Cardiovascular disease risk factors among American Indians. The Strong Heart Study. 763 31

The aim of the study was to evaluate the efficacy of enalapril and atenolol in decreasing the severity of proteinuria in hypertensive patients suffering from insulin-dependent diabetes mellitus. We studied 20 hypertensive patients. All patients had proteinuria (> 3 g/24 h) and were receiving insulin treatment. Proteinuria was measured monthly in the run-in period (3 months) and during the active drug treatment (8 months). Glomerular filtration rate, effective renal plasma flow, filtration fraction, and total renal resistance were determined after the run-in and treatment periods. The patients were randomly assigned to treatment with enalapril 20 mg/day or atenolol 100 mg/day for 8 months. In both groups blood pressure decreased significantly. After 8 months' treatment, severity of proteinuria significantly decreased both in the enalapril-treated group and in the group receiving atenolol. Glomerular filtration rate and effective renal plasma flow significantly increased, while total renal resistance decreased in the patients given enalapril, whereas glomerular filtration rate, renal plasma flow, and total renal resistance significantly decreased in the patients given atenolol. The results of this study show that enalapril and atenolol reduce proteinuria in hypertensive diabetic patients by a mechanism related to their antihypertensive effects; furthermore, the beneficial effects of enalapril might be also linked to intrarenal effects.
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PMID:Effects of atenolol and enalapril on kidney function in hypertensive diabetic patients. 769 59


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