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

Low-protein diets in nondiabetic renal failure may slow the progressive loss of renal function in some patients, but few studies have detailed the nutritional consequences of these diets in patients with diabetic nephropathy. We studied 7 patients with insulin-dependent diabetes mellitus and chronic renal insufficiency [mean +/- SEM creatinine clearance (S, U): 28.3 +/- 6.5 ml/min (0.47 +/- 0.11 ml/s x 1.73/A)] for 15 weeks who were prescribed a diet of 0.6 g protein/kg ideal body weight. Midarm muscle circumference (24.1 +/- 1.8 at onset vs. 24.5 +/- 1.5 cm at completion), triceps skinfold thickness (21.6 +/- 3.1 vs. 21.0 +/- 1.5 mm), body weight (71.8 +/- 4.1 vs. 71.2 +/- 4.6 kg), and serum albumin [3.0 +/- 0.1 vs. 3.2 +/- 0.1 g/dl (30 +/- 1 vs. 32 +/- 1 g/l)] remained stable. Based on urinary nitrogen excretion, diet diaries overestimated the degree of dietary protein restriction; there was good adherence to the diet as evidenced by a reduction in urinary urea nitrogen (average 32%). Blood glucose control was maintained despite increased carbohydrate intake. On average, creatinine clearance did not change significantly, but proteinuria diminished slightly (1.8 +/- 0.2 vs. 1.5 +/- 0.6 g/day). These results indicate that 0.6 g/kg/day protein diets did not cause protein depletion in insulin-dependent diabetic patients. Longer-term studies are indicated to assess more fully the efficacy of these dietary regimens in reducing proteinuria or benefiting diabetic nephropathy.
 ...
PMID:Protein-restricted diets in diabetic nephropathy. 271 Feb 67

Low-protein diets are being increasingly used as a treatment for early nephropathy associated with diabetes. Recent research studies have shown a decrease in proteinuria while serum albumin levels and weight have been maintained. A level of 0.6 g protein/kg ideal body weight has been suggested. In structuring these diets, fat should be restricted to approximately 30% of calories, with the remainder supplied as carbohydrate calories after the protein content has been calculated. In some persons, simple sugars need to be included to avoid excessive amounts of high-bulk, high-fiber carbohydrate foods. Insulin and oral agent dosages may need adjustment to compensate for increased glucose levels. Self-monitoring of glucose levels can provide valuable feedback for medication adjustment. Intensive dietary education is needed with these patients, as the diet is sometimes radically different from diets previously used. A hypothetical patient is described and diet calculations provided using the ADA Exchange Lists with accompanying menus.
Diabetes Educ
PMID:Implementation of low-protein diets for treatment of persons with early diabetic nephropathy. 271 93

The paper is devoted to a study of the role of serum glycoprotein fructosamine and serum albumin in the pathogenesis of a severe course of insulin dependent diabetes mellitus (IDDM) in children. Fructosamine was determined in 43 pediatric patients with IDDM by direct spectrophotometry using Hoffman-La-Roche kits; albumin, C-peptide and malonic aldehyde were also determined. Disorder of the mechanism of regulation of homeostasis by albumin was shown to play an important role in the pathogenesis of a severe course of IDDM in children. It could be caused by its enhanced glycosylation and a decrease in liver synthesis in some cases as a result of considerable reduction of insulin secretion. A prognostically unfavorable sign was a raised ratio of fructosamine to albumin and enhanced lipid peroxidation against a background of low insulin secretion. The determination of serum levels of fructosamine and albumin can be a valuable diagnostic criterion in examination of children with diabetes mellitus.
 ...
PMID:[Clinical significance of the determination of serum fructosamine and albumin in children with diabetes mellitus]. 271 69

The glycosylated hemoglobin (Hb) is a useful marker for monitoring blood glucose concentrations over the prior one or two month period. A variety of method has been described for the determination of glycated Hb, but many of them have serious pitfalls. In this report, a radioimmunoassay for glycated Hb was developed and its clinical significance was described. The antiserum was obtained by immunizing guinea pigs with reduced glycated human serum albumin. This antiserum was capable of identifying glucitollysine residues on glycated Hb of normal and diabetic individuals after reduction with NaBH4. The RIA described here had satisfactory reproducibility as judged by the intra-assay (1.6-3.7%) and inter-assay (1.7-5.4%) precision. To evaluate the usefulness of this RIA method, HbAlc values measured by HPLC method were compared with values by this RIA method. According to the criteria of the WHO Expert Committee on Diabetes Mellitus, 80 subjects were divided into normal group (N), impaired glucose tolerance group (IGT), and diabetic group(DM). Average of glycated Hb values obtained by this RIA in 20 IGT subjects was significantly higher (p less than 0.001) than that of 30 normals and 17 IGT subjects exceeded upper normal range (mean + 2SD). But there was no significant difference between N and IGT in the levels of HbAlc by HPLC and all IGT subjects remained normal range. In a patient treated with continuous subcutaneous insulin infusion therapy failure of normalization of the glucose balance was discernible by an elevation of glycated Hb values by RIA. In contrast, HbAlc values fell within the normal range in this patient. From these results it appears that determination of glycated Hb by this RIA represents a more sensitive parameter for long-term than HbAlc by HPLC and is suitable for monitoring even small fluctuation of blood glucose.
 ...
PMID:[Radioimmunoassay for the determination of glycated hemoglobin and its clinical significance]. 272 28

There has been considerable interest in the serum fructosamine assay as a measure of glycated serum proteins. We have measured serum fructosamine in three groups of patients--those with uraemia; those with multiple myeloma; and those with acute inflammatory conditions--none of whom were known to have diabetes. Serum fructosamine was significantly higher in the uraemic group than in the other two, and also than in a control group. When allowance was made for prevailing serum albumin levels fructosamine was shown to be increased in the acute inflammatory group also. There was a significant correlation between random plasma glucose and serum fructosamine only when fructosamine was adjusted for prevailing albumin levels. In control and uraemic subjects there was a significant positive correlation between serum fructosamine and albumin levels, whereas in the myeloma group there was a negative correlation with serum protein. These data would suggest the need to take into account serum albumin levels and protein composition if serum fructosamine is accurately to reflect short-term integrated glycaemia.
 ...
PMID:Serum fructosamine in uraemia, myeloma and acute inflammatory disorders--relationship to serum glucose and albumin levels. 273 48

Eighty patients required surgical drainage of infections in the pleural space or lung during a four-year period (1984-1987). Thirty-nine patients had a history of heavy intravenous drug use and 28 of those not addicted to drugs were addicted to alcohol. Impaired immunity was believed to be present in 72 (90%) due to malnutrition (45 patients), acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (13), hepatic cirrhosis (1), diabetes (1), or multiple causes (12). Sixty-four patients had acute purulent empyema; 9, tuberculous empyema (often a mixed infection); 2, tuberculous pleural effusion with complications; 2, lung abscesses requiring open drainage; 2, chronic bronchopleural fistulae; and 1, empyema secondary to an esophageal perforation. Fifty-three (66%) were treated with tube thoracostomy only and 27 required additional procedures, including open drainage (19 patients), decortication (5), lung resection (2), chest wall resection (1), and parietal pericardiectomy (1). Overall mortality was high (30%); mortality had a strong correlation with malnutrition or immune deficiency. Very low serum albumin levels were common and were the most important single determinant of a fatal outcome: (table; see text) Other important determinants of mortality were: total lymphocytes less than 1000 (50% mortality); anergy to tests for delayed hypersensitivity (39% mortality); AIDS or AIDS-related complex (54% mortality). Analysis of the records of the 24 patients who died has led to the conclusion that despite the advanced disease present and the poor condition of most patients at least one third of the deaths could have been avoided if important errors in diagnosis and medical or surgical management could have been prevented.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Malnutrition: an important determinant of fatal outcome in surgically treated pulmonary suppurative disease. 274 75

We investigated in vitro the effect of the polyol pathway on the formation of advanced Maillard reaction products which have fluorescence and cross-links. Bovine serum albumin supplemented with various concentrations of glucose, fructose or sorbitol was incubated for 14 days. The fluorescence intensity was higher after incubation with fructose than after incubation with glucose. However, no significant increase in fluorescence intensity was found after incubation with sorbitol. These results suggest that in the polyol pathway fructose plays an important role in the formation of advanced Maillard products.
Diabetes Res Clin Pract 1989 Aug 01
PMID:Fructose-related glycation. 277 53

In 485 long-term geriatric inpatients (mean age 80 years), serum ionized calcium (CaI) concentrations were significantly associated with 2-year mortality. The cumulative 2-year survival was 37% in the hypocalcaemic group (CaI less than 1.17 mmol/l), 49% in the hypercalcaemic group (CaI greater than 1.29 mmol/l) and 57% in the normocalcaemic group. The association of calcaemia and survival remained significant even when patients with low serum albumin and high serum creatinine were excluded. However, serum total calcium concentrations, whether or not 'corrected' for albumin, were not significantly associated with survival. The use of diuretics may have had some influence on the calcaemic grouping of the patients, but the excess mortality in the hypercalcaemic group was not explained by heart failure or hypertension. The impaired survival in dyscalcaemic groups was not associated with sex, age, immobility, diabetes, hypertension, or renal failure.
 ...
PMID:Association of calcaemic status with survival of elderly inpatients. 281 55

A high-affinity macrophage receptor has been shown to mediate the removal of proteins modified by advanced nonenzymatic glycosylation end products (AGEs) in both animals and humans. To characterize the effect of diabetes on this receptor system, resident peritoneal macrophages from experimentally induced and genetically diabetic mice were studied. Binding and degradation of radioiodinated AGE-bovine serum albumin (AGE-BSA) were determined from saturation kinetics and compared with glucose and insulin levels of each subgroup. Scatchard plot analysis of nondiabetic mouse macrophages has indicated 1.5 X 10(5) receptors/cell, with a binding affinity of 1.7 X 10(7) M-1. The in vitro exposure of macrophages to either elevated glucose or insulin concentrations failed to demonstrate a short-term regulatory effect on AGE-receptor function. However, macrophages from hypoinsulinemic alloxan-induced diabetic mice indicated a two- to threefold increase in AGE-receptor number per cell (2.98 +/- 0.25 X 10(5)/cell), and macrophages from C57BL/KsJ (db/db) mice showed an almost threefold greater receptor number (2.86 +/- 0.2 X 10(5)/cell), with binding affinity remaining essentially unchanged (1.24 +/- 0.05 X 10(7) and 1.21 +/- 0.07 X 10(7) M-1, respectively). In addition, a moderate increase (25-30%) of 125I-labeled AGE-BSA degradation was observed in these two insulin-deficient diabetic macrophage groups compared with the normal control group. In contrast, macrophages from hyperinsulinemic and hyperglycemic C57BL/6J (db/db) mice demonstrated a distinct reduction in both AGE-receptor number (0.67 +/- 0.03 X 10(5)/cell) and binding affinity (0.37 +/- 0.03 X 10(7) M-1), with a decrease of AGE-BSA degradation of approximately 50% compared with the control group.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes 1988 Apr
PMID:Specific macrophage receptor activity for advanced glycosylation end products inversely correlates with insulin levels in vivo. 283 19

Rat hepatocytes were incubated in monolayer culture in modified Leibovitz L-15 medium containing either 10% (v/v) newborn-calf serum or 0.2% (w/v) fatty-acid-poor bovine serum albumin. The addition of 100 nM-dexamethasone increased the activities of both phosphatidate phosphohydrolase and tyrosine aminotransferase by about 3.5-fold after 8h, and these activities continued to rise until at least 24h. Incubating the hepatocytes in the albumin-containing medium with 10 microM- or 100 microM-8-(4-chlorophenylthio)adenosine 3',5'-cyclic monophosphate increased the activities of the phosphohydrolase and aminotransferase by 2.6- and 3.4-fold respectively after 8h. These increases were blocked by actinomycin D. The increases in the activities that were produced by the cyclic AMP analogue and dexamethasone were independent and approximately additive. Insulin when added alone did not alter the phosphohydrolase activity, but it increased the aminotransferase activity by 34%. The dexamethasone-induced increase in the phosphohydrolase activity was completely blocked by 7-144 microM-insulin, whereas that of the aminotransferase was only partly suppressed. Insulin had no significant Effects on the increases in the activities of phosphatidate phosphohydrolase and tyrosine aminotransferase that were produced by the cyclic AMP analogue, but this may be because the analogue is fairly resistant to degradation by the phosphodiesterase. The activity of glycerol kinase was not significantly changed by incubating the hepatocytes with insulin, dexamethasone and the cyclic AMP analogue alone or in combinations. It is proposed that high concentrations of cyclic AMP and glucocorticoids increase the total activity of phosphatidate phosphohydrolase in the liver and provide it with an increased capacity for synthesizing triacylglycerols and very-low-density lipoproteins, which is expressed when the availability of fatty acids is high. There appears to be a co-ordinated hormonal control of triacyglycerol synthesis and gluconeogenesis in diabetes and in metabolic stress to enable the liver to supply other organs with energy.
 ...
PMID:Effects of cyclic AMP, glucocorticoids and insulin on the activities of phosphatidate phosphohydrolase, tyrosine aminotransferase and glycerol kinase in isolated rat hepatocytes in relation to the control of triacylglycerol synthesis and gluconeogenesis. 285


<< Previous 1 2 3 4 5 6 7 8 9 10