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

Coronary atherosclerosis and calcification score were assessed angiographically in 30 uremic patients receiving dialysis (8 patients with diabetes mellitus [DM dialysis group] and 22 patients without DM [non-DM dialysis group] who were suspected of having coronary artery disease because of their clinical symptoms and electrocardiographic findings. Thirty non-uremic subjects (11 with DM and 19 without DM) served as controls. Twelve dialysis patients (40%) did not have significant coronary artery disease, and the rate of significant coronary artery disease in dialysis patients overall was less than that in the control subjects. The calcification score of dialysis patients was significantly higher than that of the control patients (P < 0.0001), and also scores of the non-DM dialysis group and the DM dialysis group were higher than those of each group of control subjects. The scores were significantly correlated with the duration of dialysis in uremic patients as a group (r = 0.52; P < 0.01) and the non-DM dialysis group (r = 0.70; P < 0.01), but were not correlated with the duration of dialysis in the DM dialysis group. The scores were correlated with serum phosphate concentration, but not with serum calcium concentration, calcium phosphate product, alkaline phosphatase levels total cholesterol or age. Calcification scores were extremely high (> 21) in six uremic patients who had high serum c-terminal parathyroid hormone concentrations. These findings indicate that serum phosphate concentration, serum c-terminal parathyroid hormone concentration, and the duration of dialysis are closely associated with coronary calcification in long-term dialysis patients.
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PMID:[Angiographic study of stenosis and calcification of coronary vessels in long-term dialysis patients: examination of risk factors for coronary calcification]. 870 14

The pancreatic somatostatinoma belongs to the type of rare endocrine tumors of the pancreas. We report the observation of a 54 year old woman. Previously she was suffering from diabetes mellitus. An abdominal ultrasonography revealed an endocrine tumor of the pancreatic tail. There was no specific symptomatology, with the exception for the hyperglycaemia. The diagnosis of somatostatinoma was certified post operatively by the immunocytochemistry of the tumor. Then, the patient developed a hypercalcaemia associated with an increase of parathyroid hormone. The surgery of the neck revealed three hyperplastic parathyroids, inducing this association as a multiple endocrine neoplasia type 1 (MEN 1). The patient did not develop pituitary tumor. Afterwards, scintigraphy with 111 Indium- octreotide showed a residual tumor at the head of pancreas. Basal levels of somatostatine and calcium, pentagastrine test, computed tomography scan, arteriography were negative. The presence of a second somatostatinoma was confirmed by surgery and immunohistology. One year after the surgery, the patient remains clinically well. The pancreatic localization of the somatostatinoma in a MEN 1 is poorly documented. Its malignant nature can only be assured by the presence of metastases. The genetic detection of the MEN 1 becomes possible. Above all, the treatment is based on surgery and/or chemotherapy (Fluoro-Uracile; Streptozotocine). In our case, 111 In-octreotide scintigraphy was the only method demonstrating a residual focus, suggesting it could be an element of reference for the diagnosis and survey of somatostatinoma the watch of patients having a treatment for somatostatinoma.
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PMID:[Pancreatic somatostatinoma and MEN 1. Apropos of a case. Review of the literature]. 873 92

To evaluate the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are polyunsaturated fatty acids, on diabetic osteopenia, we measured the bone fragility in streptozotocin-induced diabetic rats. The fragility of femur was increased in diabetic rats, which was prevented in part by EPA or DHA. Moreover, EPA prevented osteopenia even in diabetic rats fed a low zinc feed, which was a potent accelerator of diabetic osteopenia. Plasma alkaline phosphatase activity and parathyroid hormone level showed no difference between the two groups of diabetic rats with or without EPA. Urinary excretion of calcium and phosphate was increased and plasma inorganic phosphate level was high in diabetic rats, suggesting severe mineral loss. In diabetic rats fed EPA, although urinary and plasma calcium levels did not change significantly, urinary phosphate excretion and plasma inorganic phosphate concentration were slightly lowered, which suggested that EPA may have an effect in suppressing phosphate release from bones in diabetic rats. These data suggest that EPA and DHA could be effective on diabetic osteopenia, but to elucidate the precise mechanisms, further examinations will be needed.
Diabetes Res Clin Pract 1995 Oct
PMID:Effect of eicosapentaenoic acid and docosahexaenoic acid on diabetic osteopenia. 874 4

Forty patients with chronic renal failure (CRF) were enrolled into the study, none of whom had peptic ulcer disease, amyloidosis, a previous abdominal operation, diabetes mellitus or other factors that could influence gastric emptying. Twenty of the 40 patients had been receiving regular haemodialysis (HD) for at least 1 year prior to the study. Twelve of the 40 patients had upper gastrointestinal symptoms/signs (GI Sx). Radionuclide-labelled solid meals were used to calculate gastric emptying time (GET). Twenty-five normal volunteers comprised the control group. Of the 40 patients, 35 (88%) had an abnormal GET. The incidence of an abnormal GET in HD and non-HD patients was 95 and 80%, respectively; the incidence of an abnormal GET in patients with and without upper GI Sx was 83 and 89%, respectively. These differences in the incidence of an abnormal GET among the HD and non-HD patients, as well as in the patients with and without upper GI Sx, were not statistically significant. There were no significant differences between the normal and abnormal GET patients for any of the following clinical parameters and conditions: dialyser-specific proportionality constant x time/urea distribution volume (KT/V), protein catabolic rate (PCR), ferritin, serum blood urea nitrogen, creatinine, calcium ion, phosphate, intact parathyroid hormone, albumin, uric acid, haemoglobin, triglyceride and cholesterol, total dialysis time, creatinine clearance and daily urine protein. We conclude that in Chinese patients with CRF, both dialysed and undialysed, an abnormal GET is common. The pathogenesis seems to be multifactorial. The presence of abdominal symptoms cannot foretell an abnormal GET.
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PMID:Delayed gastric emptying in patients with chronic renal failure. 877 42

Somatostatin (SRIF) is effective in the nonoperative management of a variety endocrine tumors. A potential role of SRIF for treatment of patients with primary hyperparathyroidism (pHPT) has been suggested. In a controlled, prospective, triple-blinded, randomized clinical trial, the somatostatin analogue octreotide (SMS 201-995, Sandostatin) was evaluated in 40 patients with well documented pHPT. Amongst other biochemical parameters, serum calcium and-phosphate and levels of parathyroid hormone, calcitonin, and osteocalcin as well as octreotide were assessed before and for 4 hours after a single iv. application of 200 micrograms ocreotide or placebo. SRIF-receptor autoradiography was performed in parathyroid tissue samples. Baseline values revealed a constellation of biochemical parameters typically found in pHPT. Following 200 micrograms octreotide, no significant changes in any of the biochemical parameters investigated for were observed. Multivariate analysis was performed to identify patient subpopulations in which any given combination of laboratory parameters changed in response to either drug or placebo. However, no 'responders' to octreotide were identified. 45% of patients receiving octreotide, reported side effects. Parathyroid tissue samples were negative for SRIF-receptor expression. It is concluded that a single dose iv. application of octreotide does not result in appreciable changes of biochemical parameters relevant in pHPT and carries a high rate of side effects. Furthermore, absence of SRIF-receptors in parathyroid tissue from patients with pHPT, together with lack of octreotide effects, suggests that somatostatin-analogues may not be effective in the non-operative therapy of pHPT.
Exp Clin Endocrinol Diabetes 1995
PMID:Influence of somatostatin to biochemical parameters in patients with primary hyperparathyroidism. 878 13

Because of the previous controversial findings in non-insulin-dependent diabetes mellitus (NIDDM), we measured bone-mineral density (BMD) by two different methods, studied biochemical markers of bone remodeling and calciotropic hormones (parathyroid hormone and calcitonin) in women with NIDDM, and compared the results with age-matched controls. Forty-seven women with NIDDM and 252 healthy nondiabetic women as controls were recruited for this study. BMD was measured by dual X-ray absorptiometry (DEXA) and by quantitative computed tomography (QCT). Biochemical markers of bone remodeling included plasma alkaline phosphatase (AP), osteocalcin (BGP), tartrate-resistant acid phosphatase (TRAP), parathyroid hormone (PTH), calcitonin (CT), and 24-h urine calcium, hydroxyproline. Diabetic patients were more obese with a higher body-mass index (BMI) than controls. Bone mass was normal in NIDDM, both by DEXA and by QCT. Biochemical markers of bone remodeling, PTH and CT were also normal. There was no statistical correlation between bone mass and any of the other measurements studied. There is no evidence that NIDDM produces any change in bone metabolism or mass.
J Diabetes Complications
PMID:Bone mineral metabolism is normal in non-insulin-dependent diabetes mellitus. 883 19

A subset of patients on long-term hemodialysis have sustained hypotension, defined as a predialysis systolic pressure of < 100 mmHg. To determine the role of nitric oxide (NO), an important vasodilator, in this condition, the authors measured the plasma levels of nitrite (NO2-) and nitrate (NO3-), the known NO metabolites taken as an index of NO production, in 10 hypotensive patients on long-term hemodialysis. None of them had diabetes, cirrhosis of the liver, congestive heart failure, or infection. Fifteen age and gender-matched normotensive patients on hemodialysis were selected as control subjects. Measurements of plasma levels of nitrite and nitrate based on the Greiss reaction were made. There was no significant difference in hematocrit, serum intact parathyroid hormone, total calcium, inorganic phosphorus, albumin, heart rate, cardiac index, or interdialysis weight gain between these two groups. Plasma nitrite and nitrate levels did not correlate with either predialysis serum creatinine or blood urea nitrogen. The mean arterial pressure (MAP) was significantly lower and plasma nitrite and nitrate levels were significantly higher in chronic hypotensive patients than in normotensive patients (MAP: 68.30 +/- 3.24 mmHg vs 95.20 +/- 2.44 mmHg, p < 0.001; plasma nitrite and nitrate: 72.49 +/- 14.41 mumol/L vs 36.42 +/- 5.45 mumol/L, p < 0.05). In addition, MAP from hypotensive and normotensive patients on hemodialysis was inversely correlated with plasma levels of nitrite and nitrate (r = -0.54, p < 0.01). It was concluded that enhanced NO production in this subset of patients on hemodialysis may contribute to their chronic hypotension.
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PMID:Increased nitric oxide production in hypotensive hemodialysis patients. 894 14

To explore the pathogenesis of non-insulin-dependent diabetes mellitus associated osteopenia, we examined age-related changes of the femur metaphyseal bone mineral density in genetically diabetic (db/db) mice and non-diabetic (+/+) mice of the same strain using single photon absorptiometry and characterized the osteopenia pharmacologically and biochemically. Bone mineral density increased with age in the +/+ mice from 5 to 16 weeks of age, but reached a plateau in the db/db mice at 8 weeks of age, and significant differences between the two groups were observed after 12 weeks of age. Ash weight (A) and dry weight (D) of the femur and A/D ratio were significant lower in the db/db mice than in the +/+ mice after 8 weeks of age. Significant elevations of serum calcium and parathyroid hormone (PTH) were observed after 8 weeks and 12 weeks of age, respectively. Serum 1alpha,25-dihydroxyvitamin D levels were significantly decreased in the db/db mice compared to the +/+ mice. Daily oral treatment with 1alpha-hydroxyvitamin D3 (1alpha-(OH)D3) for 4 weeks starting from 8 weeks of age significantly attenuated the bone loss in the db/db mice. These results suggest that an impaired bone mineralization probably by insufficient vitamin D activity and high PTH levels are involved in the osteopenia in the db/db mice. 1alpha-(OH)D3 exerted beneficial effects on the bone loss.
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PMID:Osteopenia in genetically diabetic DB/DB mice and effects of 1alpha-hydroxyvitamin D3 on the osteopenia. Basic Research Group. 900 43

A 56-year-old woman presented with diabetes mellitus and primary hyperparathyroidism simultaneously. Initial random blood glucose was recorded at 20.8 mmol l-1, serum calcium was 3.07 mmol l-1 (normal range 2.10-2.55 mmol l-1), and plasma parathyroid hormone estimation by intact assay was 110 ng l-1 (normal range 10-65 ng l-1). Initial glycated haemoglobin was 9.4% (non-diabetic range < 7.5%). Left lower parathyroidectomy was carried out and pathology confirmed the presence of a chief cell adenoma. The gland measured 10 x 5 x 5 mm. Following parathyroidectomy serum calcium normalized, glucose tolerance improved, and a subsequent 75 g oral glucose tolerance test was normal. The patient weighted 80 kg at presentation but the post-operative weight had risen to 81.5 kg. The most recent glycated haemoglobin was 4.6%. Primary hyperparathyroidism may have a reversible effect on glucose tolerance.
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PMID:Remission of non-insulin-dependent diabetes mellitus following resection of a parathyroid adenoma. 901 58

To clarify the demographic and clinicolaboratory features of postdialysis fatigue (PDF), we enrolled 85 patients on maintenance hemodialysis in a cross-sectional study using validated questionnaires and chart review. Forty-three patients complained of fatigue after dialysis. On formal testing using the Kidney Disease Questionnaire, the PDF group had statistically greater severity of fatigue and somatic complaints than the group of patients without subjective fatigue (P = 0.03 and 0.04, respectively). On a scale measuring intensity of fatigue (1 = least to 5 = worst), the PDF group average was 3.4 +/- 1.2. PDF subjects reported that 80% +/- 25% of dialysis treatments were followed by fatigue symptoms. In 28 (65%) of patients, the symptoms started with the first dialysis treatment. They reported needing an average of 4.8 hours of rest or sleep to overcome the fatigue symptoms (range, 0 to 24 hours). There were no significant differences between patients with and without PDF in the following parameters: age; sex; type of renal disease; presence of diabetes mellitus, heart disease (congestive, ischemic), or chronic obstructive lung disease; blood pressure response to dialysis; type or adequacy of dialysis regimen; hematocrit; electrolytes; blood urea nitrogen; creatinine; cholesterol; albumin; parathyroid hormone; ejection fraction; and use of antihistamines, benzodiazepines, and narcotics. In the fatigue group, there was significantly greater use of antihypertensive medications known to have fatigue as a side effect (P = 0.007). Depression was more common in the fatigue group by Beck Depression score (11.6 +/- 8.0 v 7.8 +/- 6.3; P = 0.02). We conclude that (1) postdialysis fatigue is a common, often incapacitating symptom in patients on chronic extracorporeal dialysis; (2) no routinely measured parameter of clinical or dialytic function appears to predict postdialysis fatigue; and (3) depression is highly associated with postdialysis fatigue, but the cause-effect relationship is unclear.
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PMID:Postdialysis fatigue. 915 12


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