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)

1. Over the course of treatment with angiotensin-converting enzyme inhibitor (ACEI), plasma levels of aldosterone have been shown to increase and this increase would blunt the effectiveness of the ACEI (aldosterone escape phenomenon). 2. In the present study, we assessed a potential renal benefit of additional aldosterone blockade with spironolactone in hypertensive diabetic patients treated with ACEI showing the phase of aldosterone escape. 3. The present clinical study was a randomized prospective study to assess difference between the clinical effects of spironolactone and furosemide. Thirty hypertensive type II diabetics (DM2) with a urinary alubumin:creatinine ratio (ACR) above 30 mg/g creatinine (showing albuminuria) and plasma B-type natriuretic peptide (BNP) levels above 100 pg/mL (showing mild heart failure) were treated with an ACEI (imidapril 5 mg/day) for 1 year and then randomly divided into two groups, one group receiving additional spironolactone (25 mg/day) treatment and the other receiving furosemide (20 mg/day) treatment. Blood pressure, ACR and plasma BNP levels were monitored in both groups. 4. Treatment with the ACEI reduced ACR initially but, in 1 year, ACR tended to increase. Additional spironolactone treatment progressively reduced ACR, whereas furosemide treatment did not show any effect. Plasma BNP levels were reduced by ACEI and were further reduced by additional spironolactone treatment, but not furosemide treatment. Blood pressure levels in both groups were comparable. 5. In conclusion, additional therapy with spironolactone in ACEI treatment exerts a renoprotective, as well as cardioprotective, effect in hypertensive diabetes.
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PMID:Spironolactone further reduces urinary albumin excretion and plasma B-type natriuretic peptide levels in hypertensive type II diabetes treated with angiotensin-converting enzyme inhibitor. 1670 Aug 81

Type 2 Diabetes mellitus (DM2) is a complex, multifactorial and worldwide metabolic disease that affects quality and lifestyle of patients. Patients with diabetes can have a 15-year or more reduction of lifetime and the high mortality is due to cardiovascular (CV) complications. Effective strategies for the reduction of the impact of DM2 on CV disorders for the next years and attention concerning to strategies of prevention, mainly for the populations with larger risk of developing the disease, are essential. In that context, impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG) must suffer intervention strategies in order to minimize the risk for diabetes. Behavior modification (diet therapy and physical activity) must be stimulated, and pharmacological agents have to be used when indicated. Studies worldwide have been confirming the effectiveness of lifestyle strategies and even the use of pharmacological agents for the prevention of DM2.
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PMID:[Prevention of type 2 diabetes mellitus]. 1676 90

Metabolic syndrome (MS) is a risk condition for the development of systemic atherosclerotic disease. Morbid obesity is a state of insulin resistance (IR) associated with visceral fat accumulation, which is involved in the development of MS. In severe obesity, conservative therapies promote an improvement of MS, but weight regain is frequent, whereas bariatric surgery promotes a more significant and sustained weight loss. Bariatric surgery is recommended for patients with unsatisfactory response to clinical treatment and with IMC > 40 kg/m(2) or > 35 in case of co-morbidities. In those cases, surgical risk must be acceptable and patients submitted to surgery must be informed about complications and postoperative care. Prevention, improvement and reversion of diabetes (DM2) (70 to 90% of cases) are seen in several bariatric surgery modalities. Disabsorptive are more efficient than restrictive procedures in terms of weight reduction and insulin sensitivity improvement, but chronic complications, such as malnutrition, are also more frequent. Vertical gastroplasty with jejunoileal derivation is a mixed surgery in which the restrictive component predominates. In this modality, reversion of DM2 is due to an increase in insulin sensitivity associated with improved beta cell function. Reversion of MS and its manifestations after bariatric surgery are associated with reduction of cardiovascular mortality and, thus, in severe obesity cases, MS can be considered a surgical condition.
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PMID:[Does bariatric surgery cure the metabolic syndrome?]. 1676 6

Studies have shown that hepatitis C (HCV) is associated with type 2 diabetes mellitus (DM2) possibly due to insulin resistance and inflammation. Metabolic syndrome is a risk factor for DM2. Our objectives were to assess the relationship between HCV and metabolic syndrome and inflammatory markers. We used data from The Third National Health Nutrition and Examination Survey (NHANES-III). We excluded pregnant women, subjects with diabetes, those taking non-steroidal anti-inflammatory drugs, and those diagnosed with concomitant infection. We analyzed the data controlling for demographic variables, body mass index, use of contraceptives, had arthritis, and had gout. Among the 10,383 subjects, 2.3% had HCV and 16.7% had metabolic syndrome using the ATP III criteria. After controlling for the confounders, HCV was not associated with metabolic syndrome but associated with HOMA insulin resistance and inflammatory marker ferritin. Among subjects with both HCV and metabolic syndrome, the adjusted HOMA insulin level was higher than those without HCV and metabolic syndrome. In addition, the serum ferritin level was a strong predictor of HOMA insulin resistance. In clinical practice, serum ferritin can be obtained along with routine blood tests in any laboratory, and it has a potential to be a surrogate marker of insulin resistance in people with HCV and metabolic syndrome.
Diabetes Res Clin Pract 2007 Mar
PMID:Hepatitis C, metabolic syndrome, and inflammatory markers: results from the Third National Health and Nutrition Examination Survey [NHANES III]. 1691 55

Several authors have suggested a positive association between diabetes type 2 (DM2) and the C282Y and H63D mutations of the hereditary hemochromatosis gene but others have disputed it. There are also papers reporting an increased iron load in diabetes type 2 and a possible association with the pathogenesis of the disease. We therefore performed a study in 100 type 2 diabetics and 100 age and sex matched controls to assess the possibility that C282Y and H63D mutations constitute a risk factor for DM2 in Greece. We also evaluated the iron load in 500 diabetes type 2 patients and 423 age and sex matched controls. We did not find any differences in the allele frequencies of the above mutations between patients with diabetes type 2 and controls. The allele frequencies were estimated to be 0.0075 for the C282Y and 0.115 for the H63D mutation. Subjects with even one mutation (C282Y or H63D) had higher transferrin saturation compared to those with no such mutations. This seems to apply to both diabetics (49+/- 8,6 vs 44,5+/- 5,4, p<0,01) and controls (49,3+/- 7,3 vs 42,6+/- 3,3 p<0,01). Patients with DM2 had higher transferrin saturation compared to the general population. These differences were found among men (n=250, mean+/- SD 31,8+11 vs n=73, mean+/- SD 29,5+8, p=0,05) as well as among women (n=250, mean+/- SD 28.5+10 vs n=350, mean+/- SD 25.5+9.6, p=0.001). The DM2 patients had higher ferritin levels compared to controls. In conclusion, DM2 patients have increased iron load. The C282Y and H63D mutations contribute to increased iron load in both DM2 and controls. There was no difference in the frequency of C282Y and H63D alleles between DM2 and controls in the Hellenic population.
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PMID:The role of Hemochromatosis C282Y and H63D mutations in the development of type 2 diabetes mellitus in Greece. 1700 3

The purpose of this study was to validate the Brazilian version of the Problem Areas in Diabetes Scale (B-PAID) in a sample of outpatients with type 2 diabetes (DM2) and to identify the characteristics of individuals at high risk for emotional distress. A cross-sectional study was conducted in a sample of 146 patients randomly selected among those attending outpatient clinics at a University Hospital in Porto Alegre, Brazil. Information was collected regarding age, gender, known duration of diabetes, type of treatment and level of schooling, and a blood sample was taken to measure HbA1c. B-PAID was compared with the already validated Brazilian versions of Satisfaction with Life (SWL) and WHO Quality of Life-Brief (WHOQOL) Scales. One-hundred forty-six DM2 patients (48% males, 59.7+/-9 years, BMI: 29.7+/-5.2kg/m(2), mean duration: 8.63+/-8 years, HbA(1c): 7.2+/-1.7%) were included. There were significant correlations between B-PAID and SWL (r(p)=0.55, p<0.001) and WHOQOL (r(p)=-0.33, p<0.05) Scales. In a multiple regression analysis the B-PAID Scale was associated with younger age (p=0.006) and lower education level (p=0.05). In conclusion, B-PAID is a reliable, valid outcome measure for Brazilian DM2 patients and identifies patients at increased risk for emotional distress who should be prioritized in psychosocial intervention.
Diabetes Res Clin Pract 2007 Jun
PMID:Brazilian version of the Problem Areas in Diabetes Scale (B-PAID): validation and identification of individuals at high risk for emotional distress. 1708 45

Erythrocytes of humans have been reported to stimulate nitric oxide (NO) synthesis in the circulation as a consequence of their ability to release ATP in response to both mechanical deformation and exposure to reduced oxygen tension. It has been proposed that the ability of the erythrocyte to affect local vascular resistance permits it to participate in the regulation of blood flow such that oxygen delivery is matched with metabolic need. A signal transduction pathway that relates deformation and exposure to reduced oxygen tension to ATP release from human erythrocytes has been described. The heterotrimeric G protein, Gi, is a critical component of this pathway. Importantly, stimulation of Gi results in activation of adenylyl cyclase and ATP release from these cells. Recently, in a model of diabetes mellitus in rats, expression of Gi was reported to be decreased in the aorta. We report that expression of G alpha 12 is selectively decreased in erythrocytes of humans with type 2 diabetes (DM2) and that these erythrocytes fail to release ATP in response to incubation with mastoparan 7 (10 microM), an agent that activates Gi. These results provide support for the hypothesis that ATP release from erythrocytes of humans with DM2 is impaired and this defect in erythrocyte physiology could contribute to the vascular disease associated with this clinical condition.
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PMID:Expression of the heterotrimeric G protein Gi and ATP release are impaired in erythrocytes of humans with diabetes mellitus. 1708 91

OBJECTIVES: To determine the feasibility of a resident physician-based, culturally appropriate method of decreasing the disease burden of Type 2 Diabetes Mellitus (DM2) in a group of Pacific Islanders, Marshallese living in Hawai'i. METHODS: Thirty one Marshallese with diabetes who live on the island of Oahu, Hawaii were recruited. Baseline health status of the participants was characterized. Health parameters included HgbA1c, random blood sugar (RBS), lipid panels, body mass index (BMI), blood pressure, and medical history, along with qualitative information. A focus group was held with participants prior to beginning the curriculum to determine cultural views on diabetes, health, treatment, and to identify potential obstacles to health improvement. A DM2 educational curriculum culturally relevant to Marshallese populations was then started, including instruction in lifestyle modification, adherence to medication regimens, and planned quarterly assessment of health improvement. RESULTS: Baseline quantitative analysis revealed Marshallese with diabetes to be obese and hyperglycemic, with average BMI of 30 kg/m(2), RBS of 285, and HgbA1c of 9.3. Qualitative analysis revealed that nearly half the participants admitted to symptoms of severe hyperglycemia. The initial focus group had a substantial turnout. Attendance rapidly declined, becoming so low that classes were eventually terminated. However, in two participants who attended more than three classes there was evidence of major improvements in HgbA1c, cholesterol, and qualitative markers, which were sustained after one year. CONCLUSIONS: This pilot study of Marshallese with diabetes on Oahu showed that the majority had poor glycemic control with secondary co-morbid conditions. Although many barriers exist for successful implementation of a diabetes health improvement project in this group, the groundwork for translation of this project to the Republic of Marshall Islands (RMI) has been laid; curriculum translation and patient recruitment is currently underway to advance the project.
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PMID:Characteristics of Marshallese with Type 2 Diabetes on Oahu: A Pilot Study to Implement a Community-Based Diabetic Health Improvement Project. 1713 36

The daily use of aspirin in patients with type 2 diabetes mellitus (DM2) reduces significantly cardiovascular events (CVE). In the absence of contraindications, American Diabetes Association (ADA) recommends the use of aspirin to all DM2 patients older than 40 years of age. To evaluate aspirin use among 636 out patients with DM2 who participate in a regional multicenter study in Southern Brazil, a standard questionnaire was used. Patients also underwent a physical examination and laboratorial tests. All patients were older than 40 years (mean 58 +/- 11 years old; 42% male) and by ADA guidelines most of them should be using aspirin. However, only 177 (27.5%) were on this medication. The use of aspirin was higher when any CVE were present. However, the percentage of users was still below the expected, not even reaching 50%. In conclusion, even though the use of aspirin is greater in patients with CVE, and its benefits are well documented, it is still underutilized. Strategies to enhance the use of aspirin should be developed to reduce the morbidity and mortality from cardiovascular diseases in patients with DM2.
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PMID:Aspirin therapy is still underutilized among patients with type 2 diabetes. 1722 Nov 6

To investigate if routine education by nurses is associated with improved metabolic control in type 2 diabetic (DM2) outpatients, we randomly selected 143 patients (81 women), not using insulin, at the Endocrine or Internal Medicine clinics, to be interviewed and submitted to a clinical and laboratory evaluation. Age was 59.1+/-10.1 years; duration of DM2 7.5+/-6.3 years; BMI 29.7+/-5.2 kg/m(2). Patients were grouped according to HbA(1c) (<7.0% or > or =7.0%). Age, gender, DM2 duration, BMI, and lipid profile were not different. Patients with HbA(1c)> or =7.0% (n=49) were more likely to be taking oral agents, and to be treated by internists rather than endocrinologists (P=0.04). Nurse education was associated with a greater proportion of patients with HbA(1c)<7.0%, especially among those attending the Internal Medicine clinic. In logistic regression, education by nurses remained associated to HbA(1c)<7.0% (OR: 3.29, P=0.005), after controlling for use of oral agents (OR 0.067, P=0.01), attending the Endocrine clinic (OR 4.11, P=0.002), self-reported adherence to diet ("yes" or "no"), known DM duration, and instruction level (NS). Nurse education contributes significantly and independently for better metabolic control in DM2 outpatients in a teaching hospital.
Diabetes Res Clin Pract 2007 Sep
PMID:Type 2 diabetic patients attending a nurse educator have improved metabolic control. 1729 41


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