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

Pregnancy in 207 diabetic women managed at a diabetic antenatal unit over a six-year period (1970 to 1976) resulted in a perinatal mortality of 16 (7-8%). One hundred and fifty-nine women (70%) were receiving insulin before pregnancy and 20% had evidence of diabetic microangiopathy. Still birth was twice as frequent as neonatal death, and severe respiratory distress syndrome was uncommon, resulting in only one death. Bad control of diabetes was associated with a poor prognosis. This was contributed to be lack of cooperation, anxiety and poor knowledge of diabetes. The accurate assessment of gestation and maturity, the monitoring of fetal-placental function, careful blood glucose level control, and an understanding of neonatal physiology have contributed to a reduction in fetal mortality. Close cooperation between an obstetrician, physician and neonatal pediatrician experienced in the problems encountered in the management of pregnant diabetic women is essential if the best results are to be obtained.
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PMID:Pregnancy in diabetic women. 89 23

The therapy of diabetes mellitus is always connected with the observation of an adapted diet, the aim of which is the obtaining of the optimal weight. Still more intensive concentric educational measures for patients and persons endangered by diabetes are necessary, in which cases muscular action is of increasing importance. Sulfonylureas furthering the secretion of insulin are to be used only as far as necessary. Peripherally acting anti-diabetics, such as biguanides have an indication in diabetes mellitus which is exactly defined and to be observed. Also with regard to the combat against adiposity their influence on the lipometabolism needs further clarification. Metabolic and immunologic insulin resistance are complications of the insulin therapy. The extensive technical preparation of the human synthetic insulin may contribute to the improvement of the prognosis of diabetes. At present the introduction of artifical beta-cell-systems is a problem of the diminishing of the apparatuses. The genetic consultation for diabetics is important and in many cases possible.
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PMID:[Therapy of diabetes mellitus today]. 123 19

Still, there are a lot of questions about the pathogenesis of neonatal diabetes mellitus. In the author's opinion neonatal diabetes mellitus is a distinct entity which differs from the well-known types of diabetes in children (type 1 diabetes, MODY-diabetes) and transient neonatal hyperglycemia regarding pathogenesis, pathophysiology and prognosis. Casuistics of three children two of whom were sibs are reported in detail to demonstrate the characteristics of neonatal diabetes mellitus. Regarding the reported sibs we suppose genetic origin of the disease. Autosomal-recessive mode of inheritance must be assumed.
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PMID:[Neonatal diabetes mellitus and microcephaly. Indications for autosomal recessive inheritance]. 147 Jan 85

Overall 42 normotensive patients suffering from type I diabetes mellitus without proteinuria were examined for the effect of hyperfiltration on renal glomerular function and for changes in glomerular function seen during medicamentous treatment of hyperfiltration. Glomerular function was evaluated from the basal level of glomerular filtration (GF), the status of filtration reserves (i. e. according to the dynamics of the GF level in response to oral protein administration), and from the magnitude of albuminuria. Three groups of diabetes mellitus patients were distinguished: with filtration reserves, with decreased filtration reserves, and with no reserves. All the three groups did not differ in the age, diabetes standing or the degree of carbohydrate disorders compensation (HBA1c). Still, the patients with no filtration reserves significantly differ from the other groups with a high level of GF and albuminuria. In 9 patients, a study was made of the effect produced by captopril (an inhibitor of the angiotensin-transforming enzyme) on filtration reserves and albuminuria. After 3 to 6 months of the treatment five patients with no filtration reserves manifested a fall of the basal level of GF down to normal, the recovery of filtration reserves, and a decline of albuminuria. It is assumed that elimination of hyperfiltration due to the treatment with the inhibitors of the angiotensin-transforming enzyme may be an effective means of diabetic nephropathy prevention.
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PMID:[The recovery of the kidney filtration functional reserve in diabetes mellitus patients on captopril treatment]. 194 47

The 5-years-survival rate of patients with liver cirrhosis is limited to about 25%. Still, one of the most important therapeutic procedures in case of bleeding oesophageal and fundic varices is a portasystemic shunt 6 randomized studies have been performed to compare the complete portacaval shunt with the incomplete splenorenal Warren-shunt: The hospital mortality rate (8-10%) and the 5-years-survival rate (43-47%) do not differ; but the rate of postoperative encephalopathy significantly is higher after PCA (40-26%) and the rate of recurrent bleeding significantly is higher after Warren-shunt (13-6%). In case of massively or early recurrent bleeding, we favour an emergency PCA: the mortality rate amounts to 12% in case of the socalled "early operation" (after initially successful balloon tube or sclerotherapy, 52 patients) and 47% in case of "absolute emergency shunt" because of continuing bleeding (119 patients). In the elective situation (58 patients) we favour the Warren-shunt in elderly patients with diabetes mellitus, preexisting encephalopathy or Child-B-classification.
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PMID:[Status of the portosystemic shunt in the therapy concept of portal hypertension]. 265 46

Insulin has been used for the treatment of diabetes mellitus for 65 years. Still, little is known about the processes governing its absorption after subcutaneous injection. Since normoglycaemia is the general aim nowadays, knowledge about the absorption process is important. In this review, the physiology and the pharmacological and clinical factors influencing the absorption rate are dealt with, resulting in recommendations for the injection procedure of insulin.
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PMID:The absorption of subcutaneously injected insulin. 265 57

Previous reports have shown the prevalence of non-insulin-dependent diabetes to be high amongst several populations living in the South and Central Pacific region, and a number of factors including a sedentary life-style, urban residence, obesity and genetic factors have been implicated in its aetiology. Amongst some populations increasing parity has been shown to be associated with abnormal glucose tolerance, but the cross-sectional data available did not suggest any such association amongst the five Pacific Island populations surveyed. Still-birth rates are high amongst all these populations, particularly so amongst the older women, and several methods of analysis suggest that abnormal glucose tolerance is associated with a significantly increased risk of still-birth. This association appears more marked amongst younger women in all populations, with the overall relative risk of a still-birth occurrence for diabetic women aged less than 45 years being 2.6 (95% confidence interval being 1.4-4.8), and for women aged less than 45 years with impaired glucose tolerance being 2.2 (95% confidence interval being 1.3-3.7). As many of the women diabetic at the time of surveys would not have been during their pregnancies, these risk estimates are probably underestimates. Longitudinal studies may suggest even higher figures. Nonetheless the results of these surveys suggest that the high prevalence of abnormal glucose tolerance in these populations may be at least partly responsible for their high levels of still-birth occurrence.
Diabetes Res Clin Pract 1986 Jun
PMID:The association of non-insulin-dependent diabetes with parity and still-birth occurrence amongst five Pacific populations. 374 57

Male rats were injected with streptozotocin (STZ), 60 mg/kg, i.p., on 2 successive days. Six hours after the last STZ injection, some STZ-diabetic rats began receiving daily injections of insulin that were insufficient to control blood glucose. Another group of STZ-diabetic rats received insulin injections after 2 wk duration of untreated diabetes. Still other STZ-diabetic rats received no insulin treatment. Under sodium pentobarbital anesthesia, kidneys from each treatment group were isolated and perfused with an artificial "plasma" containing 45Ca. As urine was collected, urine-to-perfusate ultrafiltrate (U/P) ratios for 45Ca were determined. The results of the studies showed that: STZ diabetes reduced 45Ca reabsorption by the kidney; the increased urinary excretion of calcium was not due to an osmotic effect or to a direct nephrotoxic action of STZ; and insulin therapy instituted early, but insufficient to control blood glucose, reduced the diabetes-induced calcium loss via a direct action on the kidney, whereas insulin therapy instituted late failed to reverse renal loss of calcium.
Diabetes 1984 Oct
PMID:Evidence for a direct action of insulin to increase renal reabsorption of calcium and for an irreversible defect in renal ability to conserve calcium due to prolonged absence of insulin. 638 7

Urinary glucose excretion reflects the blood glucose levels and is therefore recommended and used as a relevant and practical method for self-control in juvenile diabetes. The purpose of this study was to estimate the attitudes of of diabetic children and their parents towards such daily urinalysis. In 1975 69 juvenile diabetics 6-18 years old and their parents were studied and three years later another 69 patients were added. Still a year later 31 of the children were studied again. Standardized interviews, questionnaires and a special attitude test were used. The results indicate that a great majority of the patients and the parents accept the self-testing method and regard it as a valuable tool in the management of the disease. Almost nobody experienced the urine tests as a psychological problem. As urinalysis has become established as a self-evident part of the treatment, the attitudes have become even more positive among a growing number of patients. Parallel to this feeling of usefulness the patients are honest and the urine tests thus give reliable information.
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PMID:Attitudes towards self-control with urinalysis in juvenile diabetes. 693 21

The renin-angiotensin-aldosterone hormonal servo-control system plays a major role in defending normotension and sodium and potassium balance. Derangements of the system involving either excess renin-angiotensin vasoconstriction or too much sodium-volume retention for the plasma-renin level can be implicated in sustaining the hypertension of most human hypertensive disorders. When plasma renin levels are inappropriately or inordinately increased, ischemic vascular injury to the heart, brain and kidneys becomes increasingly evident. In this setting, pharmacologic suppression or blockade of plasma renin activity protects from further cardiovascular damage in experimental models, in human hypertensive disorders and in human congestive heart failure. Still other studies suggest that excessive plasma prorenin levels may be involved in the vasodilator hyperperfusion vascular injury of diabetes mellitus. Recent findings provide considerable promise for pharmacologic strategies that suppress or block plasma renin activity in patients with hypertension or with congestive heart failure for achieving long-term protection from the major cardiovascular sequellae that shorten useful life. Future research to define better the factors that control renal renin gene expression and renal renin secretion could lead to even better treatment and prevention strategies.
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PMID:Renin-angiotensin-aldosterone system for blood pressure and electrolyte homeostasis and its involvement in hypertension, in congestive heart failure and in associated cardiovascular damage (myocardial infarction and stroke). 747 15


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