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

The female patient initially showed the acquired type of total lipoatrophy at about 8 years of age. At 12 years of age, the onset of diabetes mellitus was speculated from advanced pyodermia and dedentition. At 29 years of age, glucosuria was found, and she developed proteinuria, ascites, and pretibial edema. The physical examination revealed: hepatosplenomegaly, complete absence of subcutanous fat, cutaneous xanthomas, and emaciated facies with pronounced zygomatic arches. Diabetic retinopathy was revealed in the ophthalmological examination, and nephropathy was evident in renal biopsy specimens. She also had peripheral diabetic neuropathy. No adipose tissue was found in the mesenterium under peritoneoscopy. The hepatic biopsy specimen revealed advanced portal liver cirrhosis. Laboratory findings included: hyperlipidemia, elevation of BMR without evidence of hyperthyroidism, impaired renal function, and undetected anti-insulin antibodies and anti-insulin antibodies. Endocrinological examinations revealed normal value, except for an impaired hGH response in the arginine test. C-peptide immunoreactivity was high. Her condition was fairly well controlled by 140 units of insulin injection daily.
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PMID:Lipoatrophic diabetes. Report of a case. 15 92

The significance of genetic factors in the origination of a diabetes mellitus is generally recognized. Besides this, the possibility of a virus etiology and an autoimmune etiology is discussed. The numerous very complex actions of insulin on the cells of liver, muscle and other organs take place with the assistance of special receptors, the number of available receptors probably being important. A great advance in therapy is the development of the monocomponent insulins. They are primarily indicated in the labile forms, especially in infantile and juvenile diabetes, in insulin resistance, for high antiinsulin titiers, insulin allergy, lipoatrophy and microangiopathy. We must wait and see how far transplantation of a pancreas or Langerhans islet cells or the "artificial" pancreas can be used in future treatment.
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PMID:[New thoughts on diabetes mellitus (author's transl)]. 40 46

To treat insulin lipoatrophy, small amounts of dexamethasone (4 micrograms/unit) were added to insulin injections in nine patients. Six cases showed significant improvement of dexamethasone-treated sites over that of control sites in six months. With the continued use of dexamethasone-containing insulin, they remained mostly free of atrophic areas during the follow-up period of over two years. Our experience suggests the usefulness of this therapy.
Diabetes 1977 Apr
PMID:Use of dexamethasone in treatment of insulin lipoatrophy. 84 10

Twenty children with insulin-induced lipoatrophy were successfully treated by injecting the insulin into the lipoatrophic area. In 10 children insulin therapy was replaced by monocomponent insulins, while the other 10 children were treated with the insulins they previously used. It is concluded that both monocomponent and less purified insulins are suitable for treating the complication of insulin therapy when the insulin is injected into the lipoatrophic area.
Diabetes 1976 Nov
PMID:Treatment of insulin-induced lipoatrophy. 99 25

The clinical role of insulin-antibody formation, with reference to the monocomponent insulin treatment (MC), is discussed in a series of diabetological conditions. On the basis of a five-year-experience, personal results with a MC Lente treatment are presented in 32 cases of juvenile diabetes subdivided as follows: 3 cases with insulin allergy, 5 cases with insulin lipoatrophy, 13 cases with high insulin requirement, 4 cases with brittle diabetes, 7 cases with diabetic microangiopathy (retinal and, or renal). The circulating antibody level was estimated by IgG-Insulin-Binding Capacity (IB), according to Christiansen. After transfer from conventional to MC insulin treatment it was observed: -- disappearance of allergy and total remission of lipoatrophy, in parallel with a reduction of IB titer; -- decrease in insulin requirement and stabilisation of labile diabetic control, not always in concomitance with IB reduction; -- deterioration of advanced diabetic retinopathy and, or nephropathy in spite of IB reduction. It is concluded that MC insulin constitutes a major tool in the treatment of the above mentioned diabetic conditions, except for advanced microangiopathy. Thus a MC insulin treatment should be started, as a rule, in newly diagnosed diabetics, to possibly prevent such complications. However further development of insulin purification techniques, with removal of residual pro-insulin antigenic sites, is to be considered.
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PMID:[Long-term clinical results with monocomponent insulin (MC lente) in infantile and juvenile diabetes]. 102 49

Since their first description 50 years ago severe forms of lipoatrophy appearing above all in girls and women are occasionally a cosmetically significant and therapeutically problematic side effect of the insulin treatment of diabetes mellitus. On two own female patients is shown, how the hitherto recommended measures failed in distinctive cases and only the treatment with monocomponent-insulin of the pig led to the restoration of the fatty tissue. The successful therapy of lipoatrophy with monocomponent insulin in all cases hitherto published confirms the hypothesis that a local antigen-antibody-reaction to highly molecular constituents of the commercial mixed insulins causes the atrophy of fatty tissue.
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PMID:[Insulin lipoatrophy and its elimination through the use of monocomponent insulin]. 103 52

A study was made of the isolated adipose tissue of 9 healthy women and the adipose tissue from the zone of lipoatrophy obtained from 7 women suffering from diabetes mellitus treated with insulin. In difference to the adipose tissue of healthy persons, in the lipoatrophic adipose tissue there occurred under the effect of insulin-novocain mixture a marked increase in the incorporation of C-14-labeled glucose into the total lipids of the adipose tissue. The data obtained served as an argument in favour of the neurotrophic genesis of the postinjection insulin lipoatrophies and proved the neuro-trophic mechanism of the therapeutic effect of the insulin-novocain mixture.
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PMID:[Changes in the sensitivity of lipoatrophic tissues to insulin under the effects of novocaine]. 114 16

The chemical and biochemical properties of highly purified insulin (termed "monocomponent insulin") are discussed. The clinical indications for this mc-insulin are immunologic side effects of conventional insulin therapy such as resistance, allergy and lipoatrophy. Furthermore, highly purified insulins can be tried in high insulin requirement, in juvenile diabetes and intermittent insulin therapy. Case histories for these clinical indications are presented. It is advised that the use of mc-insulin should be restricted to precise clinical indications until enough pure pig insulin is available for treatment of all insulin-dependent diabetics.
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PMID:[The place of "monocomponent" insulins in diabetes mellitus therapy]. 121 60

Urine from 5 patients with congenital generalized lipodystrophy has been fractionated by protein precipitation and Sephadex gel filtration. A fraction with a molecular weight in the range of 1000 was observed to be metabolically active in mice, rats, and rabbits. Hypophysectomized rats got hypoglycaemia following an injection, and the lipolytic-hyperglycaemic effect of ACTH was reduced after injection into intact mice. This effect was probably due to insulin release, because no insulin-like activity was observed on isolated fat cells in vitro. Persistant changes were observed in the animals after 3 weeks of daily injections of the urinary fraction. Adult mice and rabbits developed lipoatrophy with decrease of body weight in spite of a doubling of the food consumption. The metabolic rate and the body temperature were raised. Infantile animals developed a lipodystrophic state with increased growth velocity, and 50 per cent increase of the body weight, although no fat depots were observed. The treated animals got hyperglycaemia, hypertriglyceridaemia, hyperinsulinaemia, and insulin resistance. The rabbits developed manifest diabetes. The corresponding fraction prepared from the urine from the lipoatrophic rabbits produced lipoatrophy after injection into the mice. It is suggested that the lipodystrophic urinary fraction is of hypothalamic origin, and that it acts through the pituitary gland. The fraction is still heterogenous, and was observed to contain thyrotrophin releasing activity.
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PMID:Lipoatrophy produced in mice and rabbits by a fraction prepared from the urine from patients with congenital generalized lipodystrophy. 124 74

Lipoatrophic diabetes, known by pediatricians as Lawrence-Seip disease or Berardinelli lipodystrophy syndrome, is an infrequent condition of which approximately one hundred cases have been published to date. A case in a 24-year-old female with a fifteen-year follow-up is reported. Manifestations included acanthosis nigricans, generalized lipoatrophy, hirsutism, muscle hypertrophy, and intellectual impairment. Biologic tests revealed insulin-resistant diabetes mellitus with major diet-dependent type V hypertriglyceridemia. The patient had nephrotic syndrome (focal and segmental endocapillary proliferative glomerulonephritis without dense deposits). Phosphorus and calcium determinations were normal, as were the endocrinologic tests. Roentgenograms of the bones disclosed increased density of axial bones and large epiphyseal defects with increased bone density as determined by osteodensitometric studies. The bone manifestations of this syndrome have been documented but are often overshadowed by the severe metabolic alterations.
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PMID:[Bone and visceral manifestations of lipoatrophic diabetes. Apropos of a case]. 130 98


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