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)

We report a cardiovascular risk factor survey of "native" Hawaiians 20-59 years old (70 percent, or 257), living on the Hawaiian Homestead lands on the island of Molokai, Hawaii. More than 60 percent of both sexes were overweight. Among males, 42 percent were smokers. The percent of the population with systolic blood pressure greater than 140 mm Hg or a diastolic pressure greater than 90 mm Hg or taking hypertensive medications was 14 percent of those ages 20-39 and 36 percent of those ages 40-59. The percent with serum cholesterol greater than or equal to 6.2 mmol/L ranged from 8 percent of those 20-29 years old to 46 percent in those 50-59 years old. Two percent of those ages 20-29 had a history of diabetes, or 2 + or greater glycosuria by dipstick, as did 23 percent of those ages 50-59. The majority of the known diabetics exhibited glycosuria and elevated glycohemoglobin levels, indicating poor control. Hypertension, although usually known to the participant, was frequently uncontrolled. From these data, it appears that among this group of Hawaiians major risk factors for cardiovascular disease were frequent, while at the same time the levels of awareness and/or control for most of these factors were low.
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PMID:Cardiovascular risk factor levels in ethnic Hawaiians. 199 Aug 52

To determine whether intensive insulin therapy has the same beneficial effects on lipoprotein composition that it has been shown to have in insulin-dependent diabetes mellitus (IDDM) on the routinely measured plasma lipids, we studied 10 patients after 6 months of conventional therapy (CIT) and again after 6 months of therapy with continuous subcutaneous insulin infusion (CSII). While the mean of home blood glucose levels (8.1 +/- 0.5 v 7.9 +/- 0.5 mmol/L) decreased no further, plasma triglycerides (TG) (CIT, 102.7 +/- 25.0; CSII, 89.6 +/- 27.1 mg/dL; P less than .001) decreased after CSII, and high-density lipoprotein cholesterol (HDL-C) increased significantly, primarily as a consequence of an increase in HDL2 (CIT, 12.2 +/- 6.0; CSII, 18.1 +/- 6.3 mg/dL; P less than .02). Low-density lipoprotein cholesterol (LDL-C) was unchanged (CIT, 82.2 +/- 32; CSII, 84.0 +/- 27.8 mg/dL). After CIT, two indices of lipoprotein surface composition were altered: (1) the free cholesterol (FC) to lecithin ratio, which is a new cardiovascular risk factor, was abnormally increased in plasma, very-low-density lipoprotein (VLDL) + LDL, and HDL, and (2) the sphingomyelin to lecithin ratio, an index of the surface rigidity of lipoproteins, was increased in the HDL subfractions. While CSII treatment resulted in favorable changes in whole plasma lipids, it failed to correct these disturbances in composition. Since the participation of lipoproteins in certain steps in reverse cholesterol transport appears to be impaired when their surface constituents are altered, persistence of these disturbances may sustain the increased cardiovascular risk of IDDM patients, even when their clinical control is very good and their plasma lipids are normal.
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PMID:Effects of continuous insulin infusion therapy on lipoprotein surface and core lipid composition in insulin-dependent diabetes mellitus. 202 30

To determine whether rigorous insulin therapy, which normalized the routinely measured plasma lipids, also reversed qualitative abnormalities in the composition of lipoproteins in noninsulin-dependent diabetes mellitus (NIDDM), we studied 18 NIDDM patients (eight men and 10 women) before and 2 months after intensive insulin therapy. Glycosylated hemoglobin levels (11.7% vs. 8.7%), plasma triglyceride (TG) (250 +/- 91 vs. 164 +/- 56 mg/dl, p less than 0.001), and cholesterol (214 +/- 43 vs. 198 +/- 31 mg/dl, p less than 0.025) all fell, and both HDL2 cholesterol and HDL3 cholesterol increased (59.1% and 10.9%, respectively, p less than 0.001). However, abnormalities in two indices of lipoprotein surface constituents, which were present before insulin therapy, remained so thereafter. The first of these, the new cardiovascular risk factor, the plasma free cholesterol/lecithin ratio, which was increased before treatment, fell only slightly after therapy (pre-therapy 1.02 +/- 0.29 vs. post-therapy 0.90 +/- 0.17, p less than 0.4; reference group, 0.83 +/- 0.14), and remained elevated in very low density lipoprotein (VLDL) and low density lipoprotein (LDL). Secondly, the sphingomyelin/lecithin ratio, an index of the surface rigidity of lipoproteins, was abnormal before treatment in VLDL, HDL2, and HDL3, and this alteration persisted after insulin therapy in HDL3 (p less than 0.001). Lipoprotein core lipid abnormalities were also present before treatment: the TG/cholesteryl ester ratio was reduced in VLDL and increased in LDL, HDL2, and HDL3. Rigorous insulin therapy improved, but failed to fully correct, this disturbance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Persistent abnormalities in lipoprotein composition in noninsulin-dependent diabetes after intensive insulin therapy. 218 Mar 97

Cardiovascular risk factor patterns were examined cross-sectionally in 856 Hispanic and Anglo subjects aged 20-74 years enrolled in the population-based San Luis Valley Diabetes Study of Colorado. Risk factor levels and prevalence were compared for 279 individuals with non-insulin-dependent diabetes mellitus, 89 with impaired glucose tolerance, and 488 with normal glucose tolerance. Sex-specific comparisons of continuous risk factors were made by diabetic status and ethnicity, adjusting for age using two-way analysis of covariance; similar comparisons of discrete variables were made using logistic regression. A number of vascular, metabolic, lipid, obesity-related, family history, and life-style risk factors for cardiovascular disease were examined. In general, biologic risk factors tended to be more strongly associated with diabetic status, while life-style risk factors varied more by ethnicity. Age-adjusted levels of systolic and diastolic blood pressure, hypertension history, triglyceride, and body mass index were lowest among normal subjects, intermediate for those with impaired glucose tolerance, and highest in subjects with non-insulin-dependent diabetes mellitus, while the trend was reversed for high density lipoprotein (HDL) cholesterol and its subfractions. Hispanics had lower serum uric acid levels and greater central obesity than Anglos; they were less likely to have a Type A personality, less physically active at work, and more likely to be a current smoker than Anglos. Hispanic males had a lower body mass index and a higher HDL cholesterol level than Anglo males. These results indicate that an adverse cardiovascular risk factor pattern is present not only in subjects with non-insulin-dependent diabetes mellitus but also in subjects with impaired glucose tolerance who are at increased risk of developing diabetes. This suggests that an adverse risk factor pattern may develop concurrently with or prior to the onset of impaired glucose tolerance. Future prospective studies will help to clarify the temporal sequence involved in the development of adverse cardiovascular risk factor patterns and impaired glucose tolerance.
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PMID:Cardiovascular risk factors and impaired glucose tolerance: the San Luis Valley Diabetes Study. 229 53

Cardiovascular disease risk factors were measured 10-15 years (mean, 11.9 years) prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in Rancho Bernardo, California. There were 1,847 men and women aged 40-79 years who had no known diabetes or fasting hyperglycemia at baseline (1972-1974). At the follow-up examination (1984-1987), 1,115 men and women (60.4%) had normal glucose tolerance, 513 (27.8%) had impaired glucose tolerance, and 219 (11.9%) had non-insulin-dependent diabetes mellitus as defined by World Health Organization criteria. Rates of impaired glucose tolerance and non-insulin-dependent diabetes mellitus increased with age, and impaired glucose tolerance was approximately twice as common as non-insulin-dependent diabetes mellitus. Those with non-insulin-dependent diabetes mellitus were older and more overweight and had higher levels of blood pressure, fasting plasma glucose, and triglyceride at baseline than those whose glucose tolerance remained normal; those with impaired glucose tolerance generally had intermediate levels of the same risk factors. When it was examined in a prospective fashion, in general, the age-adjusted risk of non-insulin-dependent diabetes mellitus increased with increasing quartile of each risk factor, and the risk of non-insulin-dependent diabetes mellitus in a given quartile was greater than that for impaired glucose tolerance. Logistic regression analyses showed these factors to be positively associated with a subsequent diagnosis of impaired glucose tolerance as well as non-insulin-dependent diabetes mellitus in women, and to a lesser degree in men, independent of baseline age and body mass index (weight (kg)/height (m)2). These data illustrate that a less favorable cardiovascular risk factor profile precedes the diagnosis of both non-insulin-dependent diabetes mellitus and impaired glucose tolerance.
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PMID:Cardiovascular disease risk factors prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in a community of older adults. 230 54

Although type II diabetes is associated with both microvascular and macrovascular complications, duration of diabetes and severity of glycemia are strongly associated only with the former. Since prediabetic individuals are hyperinsulinemia, and since hyperinsulinemia may be a cardiovascular risk factor, we hypothesized that prediabetic individuals might have an atherogenic pattern of risk factors even before the onset of clinical diabetes, thereby explaining the relative lack of an association of macrovascular complications with either glycemic severity or disease duration. We documented the cardiovascular risk factor status of 614 initially nondiabetic Mexican Americans who later participated in an 8-year follow-up of the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Individuals who were nondiabetic at the time of baseline examination, but who subsequently developed type II diabetes (ie, confirmed prediabetic subjects, n = 43), had higher levels of total and low-density lipoprotein cholesterol, triglyceride, fasting glucose and insulin, 2-hour glucose, body mass index, and blood pressure, and lower levels of high-density lipoprotein cholesterol than subjects who remained nondiabetic (n = 571). Most of these differences persisted after adjustment for obesity and/or level of glycemia, but were abolished after adjustment for fasting insulin concentration. When subjects with impaired glucose tolerance at baseline (n = 106) were eliminated, the more atherogenic pattern of cardiovascular risk factors was still evident (and statistically significant) among initially normoglycemic prediabetic subjects. These results indicate that prediabetic subjects have an atherogenic pattern of risk factors (possibly caused by obesity, hyperglycemia, and especially hyperinsulinemia), which may be present for many years and may contribute to the risk of macrovascular disease as much as the duration of clinical diabetes itself.
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PMID:Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes? 233 55

Diabetes Mellitus represents an important public health problem in the most developed industrialized countries. Clinical presentations of diabetes are strongly related to the cardiovascular system, namely, coronary disease and angiopathic renal failure. Diabetes modifies the clinical course of arteriosclerosis by carrying the angiopathic process to a microvascular level, where typical microangiopathic lesions can be observed. The risk of developing atherosclerotic disease is 2-3 fold higher in diabetics than in nondiabetics and arterial hypertension reaches a prevalence of 40 to 80%. Authors analyse Arterial Hypertension in the context of Diabetes putting focus on the underlying pathophysiological mechanisms. Where considering the coronary disease (CD), its high prevalence among the diabetics is also emphasized, which is expressed by an increase of morbidity and mortality when compared to normal subjects. In diabetics not only the incidence of Acute Myocardial Infarction is higher, but also the long term prognosis is more complicated, a reality that the authors try to explain by anatomic and metabolic factors. The association of Diabetes plus hyperlipidemia represents undoubtedly one of the major factors that justify the worsening and progression of CD. Briefly, some interesting points that allow the understanding of this topic are described, pointing the pathogenic differences of types I and II and the clinical implications of their knowledge. Finally, the approach of Diabetes as a cardiovascular risk factor is discussed in a prophylactic perspective.
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PMID:[Diabetes mellitus and coronopathy]. 269 90

Coexisting hypertension and diabetes mellitus is common particularly in the obese, minorities, and the socioeconomically disadvantaged. Hypertension contributes substantially to the vascular complications of diabetes mellitus and to the increased mortality of diabetes mellitus. Nondrug treatment of both conditions consists of cardiovascular risk factor reduction, emphasizing weight management, salt restriction, smoking cessation, and alcohol moderation. With observing a few precautions the drug treatment of hypertension in diabetes mellitus is similar to that of the nondiabetic.
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PMID:Diabetes, hypertension and other associated diseases. 329 Sep 18

Obesity has been associated with numerous metabolic complications, such as changes in the concentration and/or composition of plasma lipoproteins, glucose intolerance and hyperinsulinemia leading to diabetes and hypertension. The relation of obesity to cardiovascular disease has not, however, been consistently reported. Recent prospective studies have clearly indicated that the distribution of adipose tissue was a significant cardiovascular risk factor and numerous studies have shown that metabolic disturbances were more closely associated with the level of abdominal fat than excess adiposity per se. As obese men generally store their energy excess in the abdominal region and women in the peripheral fat depots, the metabolic complications of obesity seem to be more closely related to adiposity in men than in women. It is suggested that the sex dimorphism observed in adipose tissue localization could partly explain the greater cardiovascular risk associated with obesity in men than in women. Indeed, obese women with a "male" (abdominal) distribution of body fat have greater metabolic complications than women with lower body fat. When aerobic exercise-training is used to induce weight loss, men generally lose more fat than women. In men, the loss of adipose tissue appears to be central, potentially reducing the risk of cardiovascular disease, whereas a relative resistance to fat loss is observed in women compared to men. Although resistance to fat loss is noted in women, those with a "male" distribution of adipose tissue (high waist-to-hip ratio and high intra-abdominal fat deposition) and with associated metabolic complications greatly benefit from aerobic exercise-training.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Physical training and changes in regional adipose tissue distribution. 329 59

In the longitudinal Schwabing study, unselected insulin-treated diabetic patients were followed for major vascular complication (MVC) (stroke, myocardial infarction, gangrene) and asymptomatic, early detectable peripheral vascular disease (PVD). In the group of insulin-treated NIDDM multiple logistic regression analysis revealed the number of daily injected insulin units as a significant predictor for MVC and PVD (t = 1.98; p less than 0.04; x +/- S.D.: PVD yes 57.6 +/- 21.4 U/d; PVD no 44.3 +/- 17.7; age-adjusted univariate p less than 0.001). Daily insulin dose correlated highly significantly with serum triglycerides (r = 0.40, p less than 0.001) as well as with blood glucose (r = 0.33, p less than 0.001). These data suggest that insulin resistance is characteristic for atherosclerotic disease in NIDDM and the hyperinsulinemia-hypertriglyceridemia-syndrome might be a powerful cardiovascular risk factor in diabetes mellitus.
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PMID:Daily insulin dose as a predictor of macrovascular disease in insulin treated non-insulin-dependent diabetics. 330 65


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