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

Findings from studies showing an increased incidence of gallstones in diabetic patients do not control for other variables, such as obesity. There is no proof that diabetic patients have more gallstones. Gallstones do not cause diabetes mellitus. The principal gallbladder pathologic feature in diabetic patients is a functional deficit of uncertain etiologic factors, creating a large, flaccid, poorly emptying organ. Bile acid and lipid composition are usually increased in diabetic patients. Cholecystitis seems to be a more serious disease in diabetic patients, with worse infectious sequelae and more rapid disease progression. This conclusion has not been examined statistically. Even with modern care, the complication rate for operations upon the biliary tract in patients with diabetes is increased. Those with diabetes are generally older than other patients requiring cholecystectomy. Systemic changes of aging partly explain increased morbidity and mortality. Diabetic patients with symptomatic gallbladder disease usually require operation. Risk of cholecystectomy in diabetic patients is similar to that in nondiabetics. Prophylactic cholecystectomy for diabetic patients with "silent" gallstones was formerly recommended because of an apparent high risk of cholecystitis. Until the natural history of gallstones in those with diabetes has been defined, such patients should be considered in danger of serious illness. The risk of acute cholecystitis in diabetic patients with stones is probably significant enough to warrant the performance of early cholecystectomy.
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PMID:Gallstones, cholecystitis and diabetes. 224 90

In a group of 166 type II diabetics hospitalized in a medical department the authors made clinical and ultrasonographic examinations focused on the presence of cholecystolithiasis. The control group was formed by 67 subjects with normal glucose tolerance. None of the patients were hospitalized on account of biliary disease. The purpose of the work was to 1. evaluate the difference in the incidence of cholecystolithiasis in diabetic patients and controls with regard to age and sex, 2. to assess differences in the incidence of obesity, impaired lipid metabolism and a positive biliary family--history in diabetics and controls with lithiasis, 3. to evaluate diabetes and the presence of microalbuminuria. In the authors' group cholecystolithiasis is significantly more frequent in diabetics as compared with controls, in men, women and people above 65 years (p less than 0.01). The group of diabetics and controls with lithiasis does not differ as to the incidence of obesity, hyperlipoproteinaemia and positive family-history of biliary disease. No significant differences in parameters of compensation of diabetes nor differences in the incidence of microalbuminuria were found between diabetics with and without lithiasis. The results suggest that it is useful to screen cholecystolithiasis in diabetic subjects.
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PMID:[Cholecystolithiasis in type II diabetics]. 225 72

This study was undertaken to analyse the clinical spectrum of chronic liver disease (cirrhosis, and others with portal hypertension) in Kuala Lumpur. Eighty patients were diagnosed over a 6-year period. Twenty-two had biopsy proven cirrhosis while 58 others had portal hypertension with clinical and biochemical evidence of chronic liver disease. The commonest aetiology was alcohol (36%), followed by the idiopathic variety and hepatitis B. The male to female ratio was 4.4:1. Indians had a high prevalence of alcohol-associated chronic liver disease. Overall, ascites was the commonest presentation. Eight patients presented with hepatocellular carcinoma. Spontaneous bacterial peritonitis was diagnosed in 13% of patients undergoing abdominal paracentesis. Gallstones were detected in 37% of patients who underwent ultrasonography. Diabetes mellitus and peptic ulcer disease were noted in 22% and 31% of patients respectively.
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PMID:Chronic liver disease in Kuala Lumpur, Malaysia: a clinical study. 225 36

Gallstone disease has been recognized to be linked to others metabolic disorders such as obesity, atherosclerosis, hyperlipidemia and diabetes. Previous studies demonstrated a close relationship between abnormal eating habits and gallstone disease. The total caloric intake should be calculated on each individual energy requirement and should be restricted in over-weight patients. The diet should contain approximately 15-20% of the daily calories from proteins, 30-35% from fat (mainly vegetable fat for the higher content in polyunsaturated fat) and 40-55% from carbohydrate (especially complex carbohydrate). In addition the nutritional plan should consist of adequate amount of minerals and vitamins and the fiber consumption should be increased to 30-40 g/day. Finally, at last the Authors recommends (6279-8372 Kj- a regular subdivision of the meals (small and frequent) dressed in the very natural wag.
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PMID:[The dietary problem in cholelithiasis and patients at risk]. 295 22

Gallstones are often complicated with diseases such as liver cirrhosis, hemolytic anemia, post-valvular replacement, post-gastrectomy, biliary tract cancers, diabetes mellitus, and during clofibrate therapy. The frequency of gallstones, types of stones and their pathogenesis in these situations are discussed in this chapter. In liver cirrhosis, hemolytic anemia and post-valvular replacement, black stone formation is enhanced due to bilirubin over-production, caused mainly by hemolysis. Bilirubin stone formation is accelerated gastrectomy and by biliary tract cancer, because of the decrease in gallbladder contraction, cholestasis and bacterial infection, etc. The incidence of cholesterol gallstone is high in patients with diabetes mellitus and with clofibrate therapy.
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PMID:[Diseases with high incidence of gallstone complication]. 836 89

Several health hazards and social disabilities are associated with obesity. Increased mortality is associated with increased body weight. A high rate of mortality results from heart disease, diabetes mellitus, gallbladder disease, high blood pressure, and cancer. Physiologic cardiovascular changes occur, leading to left ventricular hypertrophy and lipid abnormalities. Hypertension, stroke, and venous stasis are increased. Pulmonary abnormalities include obstructive sleep apnea, which can be associated with secondary polycythemia and right ventricular hypertrophy. Gallstones, gallbladder disease, and accumulation of fat on the liver are significantly increased. Gout and reproductive abnormalities in women are common. Osteoarthritis of the knees and spine occur, although osteoporosis is rare. Risk for endometrial and breast cancer is increased, particularly in the presence of increased central fat. Changes in the skin include stretch marks, acanthosis negricans, hirsutism, intertrigo, and multiple papillomas. Impaired psychosocial function is manifested as social isolation, loss of job mobility, increased employee absenteeism, and economic and social discrimination.
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PMID:Health hazards of obesity. 897 52

Acute cholecystitis is a common disease which may carry the risk of complications, including empyema, perforation, abscess, peritonitis and sepsis. Percutaneous transhepatic drainage of the gallbladder (PTGBD) with antibiotics can provide prompt decompression of gallbladder in acute cholecystitis and interrupt the natural history of the disease effectively. From July 1986 to June 1996, 154 patients with acute cholecystitis were reviewed retrospectively in Kaohsiung Medical College Hospital. The chief symptoms and signs were pain (98.1%), fever (57.1%) and jaundice (37.7%). WBC count more than 10,000 was noted in 116 (75.3%) patients. Associated diseases included empyema: 42 (27.3%), septic shock: 14 (9.1%), diabetes mellitus: 13 (8.4%), pancreatitis: 10 (6.5%), perforation: 7 (4.5%), liver cirrhosis: 6 (3.9%) and respiratory failure: 1 (0.6%). All of them underwent ultrasound-guided PTGBD immediately after the diagnosis was established. The symptoms and signs disappeared soon after this procedure. Bacterial culture was found positive in 104 (67.5%) of 154 patients in which Escherichia coli (51.9%) was the most common organism, followed by Klebsiella pneumonia (20.2%). After acute stage, 138 patients obtained the cholangiography via PTGBD tube. Gallbladder stones were only noted in 56 (40.6%) patients, gallbladder stone concomitant with common bile duct stone in 26 (18.8%), cystic duct obstruction in 25 (18.1%), acalculous cholecystitis in 21 (15.2%), gallbladder perforation in 1 (0.7%), choledochocyst in 1 (0.7%), and cholecystocolonic fistula in 1 (0.7%). There were 135 patients to undergo surgery after the clinical condition was stable. The operative findings included gallbladder stones only in 88 (65.2%), gallbladder stone concomitant with common bile duct stone in 34 (25.2%), acalculous cholecystitis in 13 (9.6%), choledochocyst in 1 (0.7%), and cholecysto-colonic fistula in 1 (0.7%). The postoperative complications included wound infection 8 (5.9%), UGI bleeding 3 (2.2%), acute renal failure 1 (0.7%) and acute respiratory failure 1 (0.7%). The postoperative mortality rate was 0.7% (1/135), which was much lower than those of previous reports, which not undergoing PTGBD initially. It led us to conclude that PTGBD, as an initial preoperative modality to treat acute cholecystitis, is effective in decreasing postoperative morbidity and mortality.
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PMID:Ultrasound-guided percutaneous transhepatic drainage of gallbladder followed by cholecystectomy for acute cholecystitis--10 years' experience. 951 85

We report on a case of an atypically located gallstone ileus as a rare complication of cholecystolithiasis. A 61-year old lady with a history of diabetes type II and nephrolitiasis presented with abdominal pain lasting for 8 days and with vomiting and diarrhoea. Physical examination revealed a palpable tumour and pain in the left lower abdomen. An extensive elevation of blood sugar, CRP and leukocytosis was found. Initially X-ray of the abdomen and sonography showed signs of a subileus. Additionally a 5 x 2 cm mass with dorsal shadowing was detected by ultrasound. Gallbladder and the biliary system were normal. The sonographic suspicion of a gallstone ileus was confirmed by a subsequent CT scan. Under operation the gallstone was found in the distal Jejunum. A gallstone ileus must be included in the differential diagnosis of a tumour in the left lower abdomen. A tumour with dorsal shadowing and signs of a subileus may be the only sonographic findings of a gallstone ileus.
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PMID:[Atypical gallstone ileus: radiologic and sonographic findings]. 1040 80

The authors evaluated the results assembled in 5397 patients where between Jan. 1 1999 and Oct. 31 2000 sonographic examinations of the abdominal cavity and retroperitoneum were made with the objective to assess whether there are any statistically significant differences of results in diabetic patients, as compared with a group without this disease. The group of patients was divided into a sub-group of 4287 patients without diabetes and a sub-group of 1100 diabetics. For statistical evaluation of the significance of differences in the incidence of the investigated parameters Fisher's exact test was used. The image of "light liver" was significantly more frequent in diabetics type 1 and 2, as compared with non-diabetics (p < 0.001). The sonographic picture, consistent with the diagnosis of cirrhosis of the liver, was at the same level of significance more frequent in non-diabetics, similarly as the incidence of haemangioma. The finding of cholecystolithiasis and the number of patients with a history of CHCE on account of cholecysolithiasis was significantly higher (p < 0.05) only in type 1 diabetics as compared with non-diabetics. The incidence of sonographic changes consistent with acalculous cholecystitis was statistically higher in both groups of diabetics (p < 0.001), as compared with non-diabetics. On examination of the pancreas only the incidence of changes consistent with acute or chronic pancreatitis was significantly higher (p < 0.05) in the group of type 2 diabetics as compared with non-diabetics. Evaluation of sonographic findings of the kidneys revealed statistically significant differences only in the higher incidence of cysts in the group of type 2 diabetics as compared with type 1 diabetics and as compared with non-diabetics (p < 0.01). The impact of the presented findings and their comparison with data reported in the literature is discussed.
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PMID:[Are ultrasonic images in diabetics different?]. 1139 78

Overweight and obesity have become a frequent phenomenon among pregnant women during last thirty years. They result in increased morbidity rates of different chronic, health- or even life-threatening diseases. Among different perinatal complications associated with obesity the most important are: hypertension, diabetes, varices, cholecystolithiasis, prolonged pregnancy, intrauterine growth retardation. Increased rates of operative deliveries, intrapartal and postpartal infections, thrombotic complications, anaemia, urinary infections and lactation disorders can be observed.
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PMID:[Overweight and obesity as the risk factor in perinatology]. 1188 35


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