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

Albeit physical exercise and training have been recommended as an integral part of diabetes therapy only limited data are available to prove such beneficial effects of physical exertion in normalizing the metabolism in diabetes. It is the purpose of this review to critically summarize studies concerning the effects of physical training in maturity-onset diabetes. Based upon available evidence in animal experimentation, i.e. in normal and fat ZUCKER rats, as well as on data in non-diabetic man, physical training is expected to increase peripheral insulin sensitivity; thus a decrease of insulin requirements might be achieved in the course of a physical training program. So far, however, the preliminary evidence of only two studies on the effect of training in maturity-onset diabetes has been presented: slight improvements of glucose tolerance and a considerable, but--at least in one study--short-lived decrease of circulating insulin levels have been described. These improvements have to be weighed against the possible hazards of physical training programs in maturity-onset diabetic patients who--as a group--have to be considered at high coronary risk. More and more detailed and prolonged studies, however, are urgently needed to document and to prove beyond any doubt the benefits of physical training in the metabolic syndrome of maturity-onset diabetes mellitus.
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PMID:Physical training as a part of the therapy for adult-onset diabetes. 675 75

The cardiovasculary risk profile of 138 old grown long term diabetics (mean age 71,1 years, mean duration of the disease 19,9 years) was analysed in the frame of the so called metabolic syndrome and put in relation to the corresponding value of serum creatinine. With increasing concentration of creatinine the mean value of diabetes-associated cardiovasculary risk factors grew with old age, where only the frequency of hyperuricaemia correlated positively to the creatinine level. With comparable level of uric acid in serum the part of pathological increasing of creatinine in older age was more marked distinctly than with younger long term diabetics et respective time of disease (n = 112, mean age 45,7 years, mean duration of the disease 19,6 years). 42,0 per cent of the younger and 60.9 per cent of the older long term diabetics showed increased values of serum creatinine (p less than 0,01). The reduction of the cardiovasculary risk factors should also be forced with old grown long term diabetics.
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PMID:[Diabetes mellitus in the aged. 4. Cardiovascular risk profile of aged long term diabetics from the viewpoint of their kidney function]. 686 55

Of 250 diabetics with a duration of the disease between 15 and 54 years the relations between the renal function and the cardiovascular risk profile were examined. The clearly increased serum creatinine values the frequency of persons with overweight was lower than in diabetics with very favourable creatinine levels. The increasing concentration of the serum led to an increase of the frequency of hyperuricaemia, whereas the frequencies of hypertension hypertriglyceridaemia and hypercholesterolaemia did not show any significant changes. The habits of smoking of long-term diabetics with and without renal insufficiency did not differ from each other qualitatively. Particularly after the 50th year of age long-term diabetics more frequently had diabetic blood-relatives than newly detected diabetic patients of the same age. Patients with familial occurrence of diabetes (relatives of 1st degree) in comparison to diabetics without known diabetic relatives showed an identical cardiovascular risk profile, so that there is no influence of the heredity of diabetes on the formation of the non-diabetic sizes of influence of the metabolic syndrome.
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PMID:[The cardiovascular risk profile of long-term diabetics and its relation to kidney function]. 710 5

The essential hypertension, at present scarcely existing as isolated and unique disease, proves to be one of the main participants in multimorbidity. The evaluation of the own patients of the past 10 years according to the concomitant diseases of hypertension leads unconventionally to a subdivision in two groups: a "coloured" in which hypertension together appears with another chronic disease or also various diseases and a second group, in which the hypertension appears in a constantly composed "standardized" connection of diseases: with adiposis, hyperlipoproteinaemia, diabetes, frequently still with hyperuricaemia and cholelithiasis. In this hypertensive-metabolic syndrome we have to acknowledge a characteristic form of manifestation of hypertension, under simultaneous degradation to the symptom of a more comprehensive complex of disturbances. From the cooperation of the present individual diseases results a unique concentration of arteriosclerotic risk factors, so that course and result in the hypertensive-metabolic syndrome are characterized by the arteriosclerosis with its organ manifestations, above all on heart and brain.
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PMID:[Hypertension as a clinical syndrome]. 721 Jul 53

The cardiovasculary risk profile of 105 newly detected, but still untreated, high age diabetics with an average of 69,1 years showing diabetes heredity in relatives of first degree was compared with a corresponding group (same age and same number of patients) without diabetes heredity. Taking into consideration exclusively the danger magnitudes overweight, hypertension, hypertriglyceridaemia, hypercholesterolaemia and hyperuricaemia, one sees an identical risk profile for both groups (the groups of patients were chosen according the principle of biostatistical gemini forming). For the showing of pathogenic magnitudes of influence within the metabolic syndrome the environmental factors seem to have a far greater importance than hereditary diabetogenic ones.
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PMID:[The influence of diabetes heredity on cardiovasculary risk profile in patients with high age diabetes (author's transl)]. 730 31

A large segment of the population gradually develops insulin resistance, and the related metabolic syndrome is one of the most frequent causes of atherosclerosis. Searching for a practical indicator of insulin resistance, we studied the correlations between fasting serum insulin level, the general manifestations of insulin resistance syndrome, and various aspects of coronary artery disease in 797 men and 322 women. After we classified patients according to the quartiles of serum insulin level, we noted in the top quartile the presence of practically all manifestations of insulin resistance syndrome in persons of both sexes (e.g., increased waist/hip ratio, body mass index, glucose, uric acid, triglycerides, apolipoprotein B and decreased high-density lipoprotein cholesterol levels as well as apolipoprotein A-I/B ratios, and so forth). We also noted a higher prevalence of hypertension, diabetes mellitus, and type IV hyperlipidemia. Significantly more women in the fourth than in the first quartile had angiographically documented significant stenosis of the coronary arteries (p = 0.0016, odds ratio 2.9, 95% confidence interval 1.5 to 5.6) and previous myocardial infarction (p = 0.0297, odds ratio 2.1, 95% confidence interval 1.1 to 4.1). Men in both the first and the fourth quartile had a more disturbed lipid profile and a higher prevalence of significant stenoses of coronary arteries and/or previous myocardial infarction than women; there was a tendency toward a lower prevalence of alcohol consumption (p = 0.0503), a higher prevalence of gout (p = 0.0634), and previous myocardial infarction (p = 0.0791) in men in the fourth than in the first quartile.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fasting hyperinsulinism, insulin resistance syndrome, and coronary artery disease in men and women. 748 1

Epidemiological studies have revealed that elevated fibrinogen concentrations are associated with an increased risk of myocardial infarction, stroke, intermittent claudication, and cardiovascular mortality. The manner in which fibrinogen operates in atherogenesis has not yet been elucidated, but genetic control of fibrinogen levels is partially responsible. Fibrinogen frequently acts in concert with hyperlipidemia, diabetes, hypertension, physical inactivity, and age, variables that are influenced by insulin action. Because the offspring of hypertensive men tend to be hyperinsulinemic and insulin resistant from a young age, we hypothesized that their increased fibrinogen levels might reflect decreased insulin action and thus play a role in the metabolic syndrome. We chose 48 adult offspring (mean age, 38.4 years) of 30 fathers who had been treated for hypertension, and the former were matched by age, body mass index, sex, and smoking habits with 37 control subjects. Elevations in fibrinogen concentration (3.63 +/- 0.93 versus 2.87 +/- 0.54 g/L, P < .001) paralleled increases in blood glucose and insulin levels, estimates of insulin resistance, and blood pressure. In the offspring, in contrast to the control group, correlations between fibrinogen and metabolic-syndrome variables (ie, insulin, glucose, and waist and hip circumferences) were found. In stepwise multiple regression analyses, age and smoking habits were entered as variables in both study groups, but postload insulin and high-density lipoprotein cholesterol were entered as variables in the offspring group only. We propose that familial predisposition influences the relationship between insulin concentration and fibrinogen, an effect that may contribute to the clinical importance of the metabolic syndrome.
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PMID:Increased fibrinogen levels in the offspring of hypertensive men. Relation with hyperinsulinemia and the metabolic syndrome. 748 47

The relationship between insulin resistance and hyperinsulinaemia on one hand and hypertension on the other hand has become apparent during the last few years. Insulin resistance, which may be genetically determined, is, according to our present understanding, the 'key player' in the metabolic syndrome. However, the pathophysiology of the combination of factors has not yet been fully elucidated. Early therapeutic intervention for insulin resistance, hyperinsulinaemia and hypertension may prevent the clinical manifestation of non-insulin-dependent (type 2) diabetes. Preliminary results of an ongoing study investigating the effects of trandolapril or the diuretic combination of hydrochlorothiazide and triamterene on serum glucose and insulin levels are presented.
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PMID:Hypertension and insulin resistance. Glycaemia and insulinaemia in overweight hypertensive patients. 751 73

The metabolic syndrome is discussed in terms of insulin resistance linked to an increased regulation of metabolism by cortisol and fatty acids. This change in hormonal balance is associated with diabetes, android (visceral) obesity, hypertension, hypertriglyceridemia, hyperapobetalipoproteinemia and low concentrations of HDL; a cluster of risk-factors that predisposes to the development of premature atherosclerosis. It is proposed that the metabolic syndrome is accompanied by a derangement in the hypothalamic-pituitary-adrenal-axis such that the effects of cortisol are exaggerated relative to those of CRF. Excessive action of fatty acids and cortisol causes insulin resistance and increase the hepatic secretion of glucose and VLDL. Furthermore, cortisol can decrease the uptake of LDL by the liver. Cortisol in the presence of relatively high insulin concentrations can promote the deposition of energy and lead to obesity. Chronic treatment of rats with D-fenfluramine has been shown to decrease the release of cortisol and fatty acids in response to stress, and to improve insulin sensitivity. The effects of D-fenfluramine were also tested in male JCR:LA corpulent rats which are prone to develop atherosclerosis and myocardial lesions. D-fenfluramine improved insulin sensitivity, decreased the hypertriglyceridemia, and prevented the development of necrotic myocardial lesions caused by ischemia. The data presented demonstrates a link between excessive action of cortisol and fatty acids in predisposing to insulin resistance and the pathologies that are associated with the metabolic syndrome.
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PMID:Role of glucocorticoids and fatty acids in the impairment of lipid metabolism observed in the metabolic syndrome. 755 May 41

Currently available data and clinical observations which suggest that there is a pathogenetic relationship between hypertension, diabetes mellitus, and atherosclerosis have provided a concept of the X syndrome, by which hypertensive patients, mainly males, have impaired insulin tolerance along with hyperinsulinemia and concurrent atherogenic disorders of lipid metabolism. The paper discussed the specific pathogenetic mechanisms, clinical manifestations, and prospects for drug correction of the metabolic syndrome. The treatment of arterial hypertension with the calcium antagonist Lomir has indicated there are no negative changes as a control of non-insulin-dependent diabetes mellitus in the presence of effective correction of arterial hypertension and atherogenic dyslipidemias. With the monotherapy of essential hypertension concurrent with hypercholesterolemia with the alpha 1-adrenoblocker Doxazosin, in addition to the agent's high antihypertensive effects, the authors noted its favourable action on lipid spectral parameters and platelet functional activity. There is abundant evidence for the use of specific hypolipidemic agents in patients with essential hypertensive refractory to current antihypertensive drugs. The data obtained with the use of Lescol (fluvastatin) in patients with hypertensive disease and hypercholesterolemia suggest that by substantially reducing the levels of total cholesterol, triglycerides, low density lipoprotein cholesterol and its transport protein apo B does not deteriorate the quality of correction of arterial hypertension in this group of patients.
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PMID:[Hypertension, diabetes mellitus, atherosclerosis: clinical manifestations of metabolic syndrome X. Prospects of pharmacological treatment]. 762 78


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