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

Recently, nicotinic acid has been recommended as a first-line hypolipidemic drug. To determine the effectiveness of nicotinic acid in dyslipidemic patients with non-insulin-dependent diabetes mellitus, 13 patients were treated in a randomized crossover trial. Patients received either nicotinic acid (1.5 g three times daily) or no therapy (control period) for 8 weeks each. Compared with the control period, nicotinic acid therapy reduced the plasma total cholesterol level by 24%, plasma triglyceride level by 45%, very-low-density lipoprotein cholesterol level by 58%, and low-density lipoprotein cholesterol level by 15%, and it increased the high-density lipoprotein cholesterol level by 34%. However, nicotinic acid therapy resulted in the deterioration of glycemic control, as evidenced by a 16% increase in mean plasma glucose concentrations, a 21% increase in glycosylated hemoglobin levels, and the induction of marked glycosuria in some patients. Furthermore, a consistent increase in plasma uric acid levels was observed. Therefore, despite improvement in lipid and lipoprotein concentrations, because of worsening hyperglycemia and the development of hyperuricemia, nicotinic acid must be used with caution in patients with non-insulin-dependent diabetes mellitus with dyslipidemia. We suggest that the drug not be used as a first-line hypolipidemic drug in patients with non-insulin-dependent diabetes mellitus.
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PMID:Nicotinic acid as therapy for dyslipidemia in non-insulin-dependent diabetes mellitus. 228 21

Coronary arteriography was performed in 1,029 consecutive patients with ischemic heart disease and the relationship between the arteriographic features of coronary atherosclerosis and coronary risk factors was analyzed by case control studies. Patients were divided into four groups according to coronary arteriographic findings. Patients with normal or near normal coronary arteriograms (Group I) showed a high prevalence of smoking habit and a higher value of serum uric acid compared with the control group, so smoking and hyperuricemia were considered to be the risk factors for coronary atherosclerosis in patients of group. Four selected variables: smoking, hyperuricemia, hypertension and hyperlipidemia, were identified to be risk factors for the patients with minor plaques in the coronary arteries (Group II). As in Group I, smoking and hyperuricemia had a close relationship to solitary tight plaque in a branch of the coronary artery (Group III). Multiple tight stenoses in the coronary arteries (Group IV) correlated closely with smoking, hyperuricemia, hypertension, hyperlipidemia and diabetes mellitus. Thus, there were many strong risk factors for patients with diffuse, extended coronary atherosclerosis (Group II and Group IV), while only two factors, smoking and hyperuricemia, were considered to be risk factors for the patients with near normal coronary arteries ies or a solitary plaque in a branch of the coronary artery. These findings suggest that the role of the coronary risk factors on the pathogenesis of coronary atherosclerosis is not uniform but variable depending on the morphologic variability of the coronary atherosclerosis and on the pathophysiology of the ischemic heart disease.
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PMID:Relationship between coronary risk factor and arteriographic feature of coronary atherosclerosis. 239 25

In this double-blind trial, the clinical and biochemical side-effects of cicletanine 150-200 mg/day were compared with those of indapamide 2.5 mg/day in a population of hypertensive with such metabolic disorders as diabetes mellitus, obesity, hyperlipidaemia or hyperuricaemia. Sixteen patients received cicletanine and 15 indapamide; 2 patients in the indapamide group were excluded, one for undesirable effect, the other for unexpected effect. The two treatments did not produce any significant change in natremia, glycaemia, uricemia, creatininemia or blood lipid level. Kalemia remained stable under cicletanine but was significantly reduced under indapamide, requiring supplementation with potassium salts in 5 patients. Both cicletanine and indapamide proved to be effective as antihypertensive drugs, although blood pressure levels at inclusion were different in each of the two groups.
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PMID:[Cicletanine tolerance in hypertensive patients with metabolic disorders]. 251 53

DHEA, a steroid precursor of androgens and estrogens has also an inhibitory effect on several enzymes, namely on 11 beta-hydroxylase, NADH oxidase and glucose 6-phosphate dehydrogenase. The latter is the rate limiting enzyme of the pentose phosphate cycle. This metabolic pathway provides the cells with extramitochondrial NADPH and pentose phosphates. NADPH is used for the synthesis of fatty acids and steroids. Together with ribose 5-phosphate, NADPH (as coenzyme of folate reductases) is required for the synthesis of nucleic acids. A deficient production of DHEA has been found to be responsible for several diseases obesity, diabetes type 2, hypertension, arteriosclerosis and hyperuricemia as well as malignant growth (low DHEA syndrome). DHEA administration favourably modified several of these metabolic disorders. These studies were started in our laboratory in 1962 and stopped in 1976 because we were short of DHEA. At that time the response to our results was rather theoretical, but the last years a new wave of interest in DHEA called for two consecutive symposia, where important findings were presented (Paris in January and Jena in April 1989). It is a damage that this new trend, started in our laboratory, could not be pursued up to now without interruption.
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PMID:[Dehydroepiandrosterone. Renaissance after 13 years]. 252 67

Rates of elevated urinary albumin concentration, defined as microalbuminuria (30-299 micrograms/ml) and macroalbuminuria (greater than or equal to 300 micrograms/ml), were determined on random morning urine specimens in the population of Nauru, which has a high prevalence of non-insulin-dependent diabetes mellitus. The prevalence of elevated urinary albumin levels in the total Nauruan population was very high: 26 and 30% of men and women, respectively, had microalbuminuria, whereas 13% of both sexes had macroalbuminuria. Of the subjects with macroalbuminuria, 66% had diabetes. The prevalence increased with worsening glucose tolerance; 26% of subjects with normal glucose tolerance had either micro- or macroalbuminuria, increasing to 43% of subjects with impaired glucose tolerance, 63% of newly diagnosed diabetic subjects, and 75% of previously diagnosed diabetic subjects. Associations between elevated urinary albumin concentration and putative risk factors were assessed for both the total population (n = 1184) and the diabetic subgroup alone (n = 318). Fasting plasma glucose and hypertension were the most important independent correlates for the whole population, whereas plasma creatinine was also important in diabetic subjects. Age at onset and duration of diabetes were not found to be significantly associated with elevated albumin concentration. In subjects with normal glucose tolerance, hypertension and hyperuricemia were the most important associated factors. These results suggest that blood glucose, blood pressure, and possibly obesity and plasma uric acid are important modifiable risk factors for both micro- and macroalbuminuria in this population.
Diabetes 1989 Dec
PMID:Prevalence and risk factors for micro- and macroalbuminuria in diabetic subjects and entire population of Nauru. 258 79

The fertile woman is generally protected by her hormone status from myocardial infarct. Since the introduction of oral contraceptives, however, isolated cases of myocardial infarct have been observed in young women. Although some authors have assigned a causal effect to oral contraceptives, other studies have indicated a simultaneous occurrence of such risk factors as smoking, high blood pressure and hyperlipoproteinemia (HLP). In this study 68 women who had undergone definite myocardial infarct and who had not reached 49 years of age or menopause were studied for the occurrence of these risk factors. None of the patients were found to be without other risk factors. Oral contraceptives, carbohydrate intolerance, hyperuricemia and obesity were never observed as single risk factors. High blood pressure and obesity affected 2 out of 5 under 40 years old, 4 out of 5 between 40-44 years, and 17 out of 18 between 45-49 years. The combination of carbohydrate intolerance and obesity rose in the 3 age groups from 1 in 5 to 2 in 5 to 10 in 18. 86% of the patients with body weight 120% of normal also had high blood pressure. Obesity was always associated with other risk factors among these patients. With a prevalence of 38%, diabetes was an important factor in the 45-49 year group. Before prescribing oral contraceptives, the physician should always determine the presence of other factors such as smoking, HLP, diabetes and obesity and attempt to remove these factors before proceeding with oral contraception.
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PMID:[Profile of cardiovascular risk factors in females with a definitive myocardial infarct up to 49 years of age]. 272 60

Analyses of 5-year mortality data from the Hypertension Detection and Follow-up Program (HDFP) were performed with stratification according to several baseline traits. The HDFP participants were 10,940 white and black men and women ages 30-69 at baseline who were randomized to either stepped-care (SC) or referred-care (RC) groups. All-causes mortality rates were lower for the SC than the RC group, both overall and for the 90-104 mm Hg stratum, for both cigarette smokers and nonsmokers, and for persons with and without hypercholesterolemia, hyperglycemia, diagnosed diabetes, hyperuricemia, or rapid pulse rate. The SC group also fared better than RC for all strata of body mass index, with an apparent trend toward an inverse relationship between body mass index and degree of benefit. Several of the traits--cigarette smoking, fasting hyperglycemia, and hyperuricemia--were associated with significantly higher 5-year mortality rates in both SC and RC participants, in both univariate and multivariate analyses, and a significant U-shaped relationship was recorded between body mass index and mortality for both SC and RC groups. These findings indicate the broad benefit of vigorous antihypertensive stepped-care treatment for hypertensive patients regardless of the presence or absence of the other major risk factors. They also underscore the need for comprehensive management of persons with high blood pressure to control not only their hypertension but also other risk factors associated with negative impact on long-term prognosis.
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PMID:Mortality findings for stepped-care and referred-care participants in the hypertension detection and follow-up program, stratified by other risk factors. The Hypertension Detection and Follow-up Program Cooperative Research Group. 286 25

Major risk factors have been identified that enhance the chances of cardiovascular morbidity and mortality. These include such modifiable factors as hypertension, hyperlipidemia, obesity, diabetes mellitus, smoking and hyperuricemia. Other factors that also increase risk are not modifiable and include advancing age, male gender and black race. The development of left ventricular (LV) hypertrophy imposes another significant risk for increased morbidity and mortality. Development of LV hypertrophy may be produced by hemodynamic as well as nonhemodynamic mechanisms. Included in the latter group are some of the same factors that in and of themselves participate in the production of increased LV mass (i.e., aging, gender and race, obesity, coronary disease, diabetes and the underlying mechanisms that subserve the hypertensive disease). This article discusses the concept, drawn from clinical and experimental studies, that demonstrate that the additional increased risk of LV hypertrophy may be ascribed to loss of reserve cardiac function, accelerated atherosclerosis, development of abnormal cardiac rhythm secondary to ischemia, fibrosis or drug-induced hypokalemia, inherent predisposition to ventricular dysrhythmias and sudden death, risks directly or coincidentally related to associated diseases or perhaps even the paradoxical risk of beneficial antihypertensive therapy.
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PMID:Potential mechanisms explaining the risk of left ventricular hypertrophy. 294 82

The antihypertensive efficacy of enalapril and its effects on the metabolism and kidney function were investigated in 11 insulin-dependent diabetic subjects with uncomplicated mild to moderate hypertension. During a short-term single-blind controlled trial, one daily dose of 20 or 40 mg enalapril significantly reduced both systolic and diastolic blood pressure. In the supine position, mean systolic blood pressure declined from 169 +/- 6 to 142 +/- 6 mmHg (P less than .01) and mean diastolic blood pressure from 101 +/- 1.5 to 85 +/- 2 mmHg (P less than .001). No changes in heart rate or postural hypotension were observed. During 1 yr of treatment, the antihypertensive efficacy of enalapril did not decline, and no clinical side effects were observed. Inhibition by enalapril of angiotensin-converting enzyme did not modify daily insulin requirements, glycemic control, uricemia, or lipid metabolism; kalemia and the markers of diabetic nephropathy were not significantly altered. These results suggest that enalapril once daily should be used as the first step in the treatment of diabetic patients with mild to moderate hypertension.
Diabetes Care
PMID:Effects of enalapril in insulin-dependent diabetic subjects with mild to moderate uncomplicated hypertension. 303 32

Common electrocardiographic manifestations (CEM) are predictors of ischemic heart disease (IHD). If precursors of the disease, their risk factors should be similar to those of IHD. This hypothesis has been assessed on results of multiphasic screening recorded in 1976 and 1981, in 1,347 45-65 year old men. Risk factors are social class (blue collar relative risk rr = 2.3), physical activity at work (sedentariness rr = 2.4), systolic blood pressure, no beer consumption and blood urea nitrogen with an exponential risk curve. Cholesterolemia, smoking, diabetes mellitus, overweight and uricemia are not predictors of CEM incidence within 5 years. These results support the idea that CEM are partially asymptomatic expression of IHD; they also have another significance. Subgroups should be individualized and analysis yielded on larger samples. Correlation analysis has been performed between IHD mortality and beer consumption on basis of French counties. A positive correlation (r = 62, p less than 0.01) is opposed to individual results.
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PMID:[Epidemiology of minor electrocardiographic anomalies predictive of the occurrence of ischemic cardiopathy]. 310 84


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