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

The decreased glucsoe utilization in diabetes mellitus justifies the use of sugar substitutes ("diabetic sugar") if two conditions are fulfilled: 1)The sugar substitute should be a carbohydrate which does not lead, or only to a slight degree, to hyperglycaemia and thus, in this respect, differs distinctly from sugars such as glucose and saccharose. 2) The sugar substitute must not cause undesired side-effects. The absorption, utilization and side-effects of the sugar substitutes fructose, sorbitol and xylitol were investigated. They were found to be more slowly absorbed than glucose and thus to offer the advantage of better utilization under conditions of limited insulin production. However, the particularly slow passive absorption of sorbitol and xylitol can sometimes be a disadvantage, since osmotic diarrhoea may occur after administration of high oral doses. The sugar substitutes enter the metabolism enzymatically and are utilized mainly in the liver. The peripheral state was investigated after intravenous, intraduodenal and oral administration of glucose and fructose to healthy subjects. Liver metabolism was examined (Dietze) by comparing hepatic venous and arterial concentrations after intravenous administration of the sugars. Also, diabetic patients received glucose and fructose orally. As previously demonstrated, the investigations using several techniques showed a smaller influence on blood glucose and serum insulin concentrations after administration of fructose, sorbitol and xylitol than after glucose. If no metabolic changes occur after intravenous administration of high doses, no such changes need be expected after oral administration of small doses. Nor did measurements in hepatic venous blood (Dietze) show any marked effect of fructose on the blood glucose level. The healthy subjects showed no significant changes in blood glucose or serum insulin concentration after either intraduodenal or oral administration of fructose, whereas they showed a considerable increase after glucose administration. Investigations in adult-type diabetics revealed a better utilization of fructose than glucose. With correct dosage, sugar substitutes are able to increase the carbohydrate tolerance and, under certain conditions, to achieve a relative stabilization of the metabolism of unstable diabetics. The antiketogenic activity of sugar substitutes is particularly pronounced. Side-effects such as high blood levels of urea, lactate, triglycerides and bilirubin or a decrease in hepatic adenin nucleotides do not occur after oral administration, nor are they of importance after intravenous administration with correct dosage. The osmotic diarrhoea occurring after intake of sorbitol or xylitol is caused by their slow absorption and limits the consumption of these sugar substitutes. In the often obese adult-type diabetics, the calorie intake inherent in the consumption of diabetic sugars may have an unfavourable influence on their weight...
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PMID:[Sugar substitutes in the diabetic diet]. 78 58

In ten previously undiagnosed patients, we have found erstwhile-"primary" nonhereditary amyloidosis as an overlooked cause of a predominately sensory, painful, and hyperesthetic distal neuropathy occurring in middle-age and older patients. These symptoms, associated with orthostatic hypotension, diarrhea or constipation, cardiac abnormality, and male impotence are virtually diagnostic (in the absence of diabetes mellitus). Tissue diagnosis is quickly made by crystal-violet metachromasia of amyloid in fresh-frozen sections of a muscle biopsy specimen. Immunoglobulin and bone marrow evidence of plasma cell dyscrasia in eight of the ten patients suggests that the neuropathy in this form of amyloidosis is actually secondary to a plasma-cell-originating dysproteinemia. Therapy with melphalan and prednisone was not of benefit.
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PMID:Amyloidosis with plasma cell dyscrasia. An overlooked caused of adult onset sensorimotor neuropathy. 84 55

A patient with chronic active hepatitis developed vomiting, dyspnoea, tachycardia, diarrhoea and diffuse pains. For several years she had been treated with azathioprine and for a few weeks before admission with phenformin for mild diabetes. Laboratory examination revealed acute disseminated intravascular coagulation and lactacidaemia. Despite intensive treatment the patient died a few hours after admission, the post-mortem examination revealing diffuse pulmonary haemorrhages. The present case report and those published in the literature suggest that phenformin should not be given to diabetics who also have renal or hepatic disease. In any case, if phenformin is given, it should be stopped if hepatic, renal, infectious or thrombotic complications occur. In these cases and those of sudden unexplained deterioration in diabetics, hospitalisation is essential and lactic acid levels should be determined and coagulation tests performed.
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PMID:[Lactacidaemia and disseminated intravascular coagulation associated with phenformin medication (author's transl)]. 114 86

The gastrointestinal complications of diabetes mellitus are the outward forms of the diabetic visceral neuropathy. The diabetic damage of the vagus nerve leads to disturbances of the tonus and the motility resembling to postvagotomy like conditions in the following clinical forms: diabetic dysphagia, diabetic gastroparesis, diabetic diarrhoea, diabetic megacolon, diabetic cholecystomegaly. These are in general late complications of labile diabetes. The mild abdominal symptoms are not in proportion to the severe radiological changes, proper diagnosis may be obtained only by means of roentgenological examinations in most cases.
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PMID:[Gastrointestinal complications of diabetes mellitus]. 117 96

Diabetic neuropathy in some form or other afflicts a majority of patients with diabetes mellitus. Neuropathic disturbance of sensory, motor or autonomic nerves may occur singly or in combination. Cranial nerve and other mononeuropathies generally resolve spontaneously. Autonomic neuropathy which can result in orthostatic hypotension, gastroparesis diabeticorum, nocturnal diarrhea, atonic bladder and impotence, although chronic, may wax and wane in clinical severity. Neuritis, disesthesias and painful sensory neuritis may resolve with good diabetic control; on occasion, diphenylhydantoin has been of therapeutic benefit.
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PMID:Diabetic neuropathy, A review of clinical manifestations. 124 87

Skiagram proved 35 cases of fibrocalculus pancreatic diabetes in order to analyse the clinical profile and its correlation with different descriptive epidemiological parameters were studied. Mean age was 25.17 +/- 7.85 years and male to female ratio was 6:1; 65.7% patients were poor (income < Rs 500 per month) and another 28.6% having average income (Rs 500 to Rs 1,000 per month); 74.3% came from rural areas having a family size of about > or = 7 members and sanitation was poor in all the cases. Mean body mass index was 15.93 +/- 3. Severe diabetes (ie, fasting blood sugar level > 251 mg%) and moderately severe diabetes (ie, fasting blood sugar level > 181 mg% but < 250 mg%) were noted in 51.4% and 11.4% cases respectively. Recurrent pain abdomen, infections, neuropathy, retinopathy, nephropathy and keto-acidosis were observed in 52.2%, 40.0%, 42.9%, 8.6%, 11.4% and 2.9% cases respectively. Mean soluble insulin requirement was 41.81 +/- 13.94 units. Four cases in whom pancreatic lithotomy was done, showed less insulin requirement and disappearance of pain. Parotid swelling, chronic diarrhoea and insulin resistance were not observed. Insulin requirement, epidemiological and biochemical parameters were similar to other young diabetics.
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PMID:Fibrocalculus pancreatic diabetes in western Orissa. 128 95

The pre-travel medical evaluation of elderly patients and patients with chronic illness requires special assessment and advice. Screening and special precautions are reviewed for traveling patients with respiratory disease, cardiac disease, sinusitis, diabetes mellitus, HIV infection, and other chronic medical conditions. Current guidelines for empiric therapy and prophylaxis of travelers' diarrhea are reviewed, with emphasis on concerns in geriatric or chronically ill travelers. Special considerations such as potential drug-drug interactions and insurance coverage are also discussed.
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PMID:The pre-travel medical evaluation: the traveler with chronic illness and the geriatric traveler. 129 Feb 73

Four Japanese black cattle and four Holstein-Friesian cows were diagnosed with diabetes mellitus. Based on intravenous glucose tolerance tests, all these animals were believed to be insulin-dependent diabetics. Moreover, bovine viral diarrhea-mucosal disease (BVD-MD) virus was isolated and mucosal lesions and diarrhea were recognized in all cases. There was no genetic relation among the affected cattle. The breeding places of these cattle were different to each other. Therefore, it is suggested that BVD-MD virus induced the diabetes mellitus.
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PMID:Diabetes mellitus in cattle infected with bovine viral diarrhea mucosal disease virus. 133 90

We determined the amylase levels in serum samples from six callitrichid species. The normal serum amylase values for all of these species was within or higher than the normal human range. Amylase values higher than the normal range occurred not only in association with pancreatitis but also pyometra, bone fracture, abscesses, diabetes mellitus and gastrointestinal conditions leading to diarrhea. We concluded that although serum amylase activity may be helpful in diagnosing pancreatitis, it is, as in humans, not specific for this condition in callitrichids.
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PMID:Serum amylase values in callitrichids. 137 20

Diabetic nephropathy is currently the leading cause of new patients requiring dialysis in the United States. Management of the diabetic patient with ESRD is complicated by the frequent coexistence of complications affecting other organ systems, including retinopathy, cardiovascular disease, peripheral neuropathy, or autonomic neuropathy, manifested as gastroparesis, diarrhea or obstipation, cystopathy, or orthostatic hypotension. Associated clinical syndromes must be followed and treated, if possible, while preparing the patient to receive renal replacement therapy. Both the clinical condition and the psychosocial environment are key factors in choice of ESRD therapy for an individual patient. Rehabilitation data are best for patients who undergo kidney transplantation, but these data are confounded by the fact that the healthiest patients are referred for this treatment modality. Living, related kidney transplant is the preferred initial choice for the diabetic patient with kidney disease. At most centers, both in the United States and abroad, the cadaveric transplant is the second choice for uremia therapy. At the appropriate institution, the patient with type I diabetes may also be considered for a simultaneous cadaveric pancreas transplant. While awaiting cadaveric transplantation, or if contraindication to transplantation is present (chronic infection, recent malignancy, or severe cardiac disease), diabetic patients with severe impairment of the glomerular filtration rate (less than 10-15 ml/min) are referred for vascular access placement and/or insertion of a peritoneal catheter. The decision regarding the choice of CAPD vs. hemodialysis must be made on an individual basis. Rehabilitation and survival data for these therapies are similar, although technique survival rates for CAPD decline dramatically as time progresses because of infectious complications. In-center hemodialysis has the worst survival and rehabilitation profile, but the sickest, most debilitated patients with the highest number of comorbid conditions tend to be referred for that therapeutic modality. Most studies of rehabilitation were performed before use of recombinant human erythropoietin, and comparison between ESRD treatment modalities will have to be reevaluated now that the drug is routinely used.
Diabetes Care 1992 Sep
PMID:Diabetic nephropathy. Management of the end-stage patient. 139 19


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