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

The present study was undertaken in order to establish whether muscarinic cholinergic receptors are involved in the anomalous GH response to GnRH in men with insulin-dependent diabetes mellitus and in male patients with major depression. For this purpose, 16 male diabetics, 18 depressed men and 9 normal controls were tested with GnRH (25 micrograms iv) with and without previous treatment with the muscarinic cholinergic receptor blocker pirenzepine (40 mg iv 10 min before GnRH). Additional experiments with TRH (200 micrograms iv 10 min after pirenzepine) were performed in the same subjects and used for comparison between responders to TRH and GnRH. The administration of GnRH stimulated GH release in 12 out of the 16 diabetics and in 8 out of the 18 depressed patients, but not in the normal controls. Control and diabetic non-responders to GnRH did not respond to TRH. In contrast, all diabetic responders to GnRH, except 2, showed paradoxical GH responses to TRH. All depressed responders to GnRH and 3 of the non-responders, were responsive to TRH. The pattern and magnitude of the secretory responses to TRH and GnRH were similar in depressed and diabetic patients. When the effects of GnRH and TRH were restudied in the presence of pirenzepine, neither GnRH nor TRH enhanced the serum concentrations of GH in any patient. These data indicate that a muscarinic cholinergic mechanism is involved in the anomalous responses of GH to GnRH and TRH in diabetic men and in male patients affected by major depression.
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PMID:Simultaneous inhibition by pirenzepine of the GH responses to GnRH and TRH in insulin-dependent diabetics and in patients with major depression. 249 6

A 31-year-old woman with advanced diabetes mellitus with secondary autonomic and peripheral neuropathy was admitted for treatment of major depression. Previous therapy with desipramine resulted in exacerbation of the patient's orthostatic hypotension. After admission to the psychiatric facility she was initially stabilized medically and treated with psychotherapy. Subsequent treatment with low-dose fluoxetine 5 mg resulted in a decrease of the patient's diabetic neuropathy pain. Further increases in the fluoxetine dosage resulted in improvement of her depression and increased pain relief. Therapy with fluoxetine did not result in exacerbation of the orthostatic hypotension. This preliminary case report indicates that fluoxetine may be an alternative to the tricyclic antidepressants and trazodone in the treatment of diabetic peripheral neuropathy.
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PMID:Relief of diabetic neuropathy with fluoxetine. 278 34

Little is known about the course of affective illnesses in patients with diabetes or in other physically ill patients. We report a follow-up study of 37 diabetic adults with major depression (according to DSM-III), 28 (76%) of whom were located and reinterviewed 5 yr after the index evaluations. At follow-up, 18 (64%) of the 28 depressed patients had experienced an episode of major depression within the previous 12 mo; 12 of these patients satisfied diagnostic criteria for depression at the time of reevaluation. The 18 patients with recurrent depression had a mean of 4.2 depressive episodes over the 5-yr period. An additional 4 patients met criteria for current dysthymic disorder, bringing the number to 22 (79%) of the total patients ill with affective disorder during the 5-yr follow-up period. In contrast, the likelihood of symptomatic affective disorder was only 10% over the same follow-up period in a comparison group of diabetic subjects without depression at the index evaluation (P less than .001). Occurrence of depressive episodes appeared independent of diabetes complications because both the depressed and comparison groups had similar rates of neuropathy, retinopathy, and nephropathy. These data suggest that the natural course of depression in diabetes is malevolent, possibly more so than depression in the medically well.
Diabetes Care 1988 Sep
PMID:Depression in adults with diabetes. Results of 5-yr follow-up study. 321 66

To examine the prevalence of psychiatric disorders in patients with long-standing type I diabetes mellitus, we assessed a series of candidates for pancreas transplantation. Using the Diagnostic Interview Schedule, six-month and lifetime prevalences of psychiatric disorders were established for the candidates and their potential donors (first-degree relatives). Excluding tobacco use disorder and psychosexual dysfunction, 38 diabetic subjects (51%) received one or more psychiatric diagnoses. The lifetime prevalence of major depression was comparable for female (11 of 48 [22.9%]) and male (seven of 27 [25.9%]) diabetics; both rates were significantly higher than rates in first-degree relatives and the general population. Among female diabetics, the six-month and lifetime prevalences of simple phobia were increased vs donors and the general population; among male diabetics, the lifetime prevalence of antisocial personality disorder was greater than that in the general population. None of these disorders was found to be related to the duration of diabetes or the presence of various complications. The data suggest that increased rates of psychiatric disorder in type I diabetics have both gender-independent and gender-related components.
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PMID:Prevalence of major depression, simple phobia, and other psychiatric disorders in patients with long-standing type I diabetes mellitus. 325 79

To investigate the specificity of the dexamethasone suppression test (DST) for the diagnosis of major depression in patients with diabetes mellitus, we administered 1 mg of dexamethasone to 30 nondepressed diabetics and to 58 normal controls at 11 PM. Diabetic subjects received hemoglobin A1 (Hb A1) determinations, the Hamilton Rating Scale for Depression (HRSD), and five to eight blood glucose determinations during the 48 hours surrounding the DST. Results demonstrated a significantly higher rate of nonsuppression (plasma cortisol level, greater than or equal to 5 micrograms/dL) at 4 PM the following day among diabetics (43%) than among controls (7%) but no difference between these groups in the rate of nonsuppression at 8 AM. Plasma cortisol level at 4 PM correlated with Hb A1 level but not with duration of illness, HRSD score, mean blood glucose level, or maximum blood glucose excursion. These results suggest that the results of the DST used as a diagnostic test for major depression must be interpreted with caution in patients with diabetes.
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PMID:Abnormal results of dexamethasone suppression tests in nondepressed patients with diabetes mellitus. 649 71

A case of probable exacerbation of an undiagnosed diabetic uropathy by a tricyclic antidepressant in a 67-year-old man with hypothyroidism, diabetes mellitus, and recurrent major depressive disorder is reported. The presumed mode of interaction is discussed and pertinent literature reviewed. It is emphasized that the clinician must be alert to the possibility of psychotropic drugs producing physiologic changes that can interact with or aggravate preexisting disorders.
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PMID:Tricyclic exacerbation of undiagnosed diabetic uropathy. 707 34

Forty-one adults with established hypopituitarism and deficiency of growth hormone (GHD) were compared to an age and sex-matched group with another chronic metabolic disorder (diabetes mellitus) using standardized psychiatric rating and diagnostic measures. Nineteen (46%) of the GHD group were identified as definite psychiatric cases compared with 10 (24%) of the diabetics (odds ratio 1:9:1). The most frequent DSM III-R axis I psychiatric diagnoses were major depression (32% GHD patients and 10% of diabetic patients) and dysthymia. The risk of being a psychiatric case showed an association with duration of illness in the diabetic group, but not in the GHD group. Biochemical indices were not related to the risk of being a case in either group. Hypopituitarism is associated with a higher prevalence of psychiatric disturbance than can be attributed solely to the presence of a chronic disorder.
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PMID:Psychiatric morbidity in adults with hypopituitarism. 774 79

The association between major depressive disorder (MDD) and self-reported histories of specific physical illnesses was investigated in 320 controls and 1968 first-degree relatives and 254 spouses of probands in the NIMH Collaborative Depression study. The Schedule for Affective Disorders and Schizophrenia-Lifetime Version was used to assign Research Diagnostic Criteria (RDC) diagnoses and a structured self-report instrument was used to assess lifetime medical history. Lifetime MDD was diagnosed in 914 subjects, 402 of whom had been hospitalized or received somatic treatment ('treated' MDD). Strong associations were observed between MDD (either treated or untreated) and both frequent/severe headaches and migraine headaches. There was a marked gender effect such that the relative odds for a woman with treated MDD to report migraine were over 5:1. Other associations were found between MDD and skin infections, respiratory illness, ulcer, hypotension, and diabetes. This is the largest non-patient sample using standardized assessment of mental disorders by direct interview in which associations between specific physical illnesses and MDD have been demonstrated. Implications for clinical practice and neurobiological research in depression are discussed.
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PMID:Association between major depressive disorder and physical illness. 823 81

The objective of the work was to evaluate the effect of short-term hospitalization on metabolic compensation in type 1 diabetics with an intensified insulin regime who are admitted to hospital with the main purpose to participate in an intense educational and therapeutic programme. Twenty patients were examined, mean age 26.3 +/- 6.5 years, mean duration of diabetes 13.2 +/- 8.0 years, who participated in a 5-day educational therapeutic programme which takes place in the authors' department. The level of metabolic compensation was evaluated at the onset and at the end of the hospitalization by means of fructosamine (F), mean blood sugar level, Michaelis index, MAGE (mean amplitude glycaemic excursion), the M value, MDD. During hospitalization in the whole evaluated group an average 6% drop of F was recorded. In the sub-group of patients with a baseline F > 2.6 mmol/l a statistically significant decline occurred from 2.91 +/- 0.14 mmol/l to 2.44 +/- 0.31 mmol/l (p < 0.05). The changes of different indexes calculated from the whole group did not reach statistical significance. In the sub-group with a poorer compensation (F > 2.6 mmol/l), however, the mean blood sugar level declined from 13.48 +/- 2.45 mmol/l to 9.17 +/- 2.05 mmol/l (p < 0.05) and the M value improved from 141.4 +/- 56.6 to 60.5 +/- 40.7 (p < 0.05). The MAGE index deterioration significantly during hospitalization only in the sub-group with a baseline F < 2.6 mmol/l from 2.70 +/- 1.11 to 3.65 +/- 1.28 (p < 0.05). The results indicate that in patients with type 1 diabetes mellitus short-term hospitalization with an educational therapeutic programme need not be associated with a deteriorated metabolic compensation. In those whose compensation is unsatisfactory marked improvement is recorded.
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PMID:[Short-term hospitalization for patient education--effect on metabolic compensation in type I diabetics]. 862 52

Aim of the present study is the evaluation of psychopathological and clinical features of these outpatients followed by the Outpatient Clinic of the Section of Metabolic Diseases and Diabetes, University of Florence. 84 obese patients and 217 non-obese control subjects were studied using the Structured Clinical Interview for DSM-III-R (SCID), and applying DSM-IV criteria for Binge Eating Disorder. BITE self-reported questionnaire, STAI inventory and Ham-D rating scale were also used. Lifetime prevalence of Binge Eating Disorder in obese patient was 11.9%, markedly lower than that reported in studies on North American samples. Prevalence of depressive disorder (Major Depression and Dysthymia) was significantly higher (p < 0.005) in obese patients than in control subjects. This confirms the important relationships between eating and mood disorders. The prevalence of subclinical eating disorders resulted to be significantly higher in obese patients (p < 0.01) when compared with control subjects. Significant correlations (p < 0.01) of BITE scores were observed with STAI and Ham-D scores, but not with body mass index. These results underline the need for an accurate psychopathological assessment in obese patients, in order to formulate a correct diagnosis and plan adequate therapeutical interventions.
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PMID:[Psychopathological and clinical features among the ambulatory population of obese patients]. 892 58


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