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

The ultimate object of all types of dietary management before the introduction of insulin was to prevent emaciation and death: the consequences of metabolic derangements due to lack of insulin. Now, while dietary therapy continues to be important in minimizing the requirement for endogenous insulin or in balancing administered insulin, the major objects are changing to prevention of large vessel and microvascular disease. The next decade will probably see a more widespread introduction of diets containing a lower proportion of energy derived from fat. The increased carbohydrate intake will almost inevitably result in increased dietary fibre intake. Whether David Jenkins' Lente carbohydrate foods (those containing viscous unabsorbable polysaccharides) will prove to be of lasting value is not yet known. Since galactomannans occur in legumes perhaps we should consider the possibility of diets containing large proportions of legumes: a twentieth century 'Legume cure'? If this should prove of value it would not have excited ancient Indian physicians who wrote (in the Caraka-Samita) of their use of legumes in the treatment of glycosuria, at least as early as the first century AD, before Aretaeus had applied the term diabetes.
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PMID:The dietary management of diabetes in adults. 39 52

A 69-year-old-female with a history of rheumatoid arthritis since 1975 had suffered from dysesthesia of extremities since October 1989. Radiating pain and weakness occurred when she tried to stand up on Dec. 25 in 1989. She was admitted to our hospital in October 1990. Physical examination showed emaciation, hypesthesia of extremities, hypesthesia over the right chest and back, impaired vibration and position sense, and hyperreflexia. Laboratory findings revealed that the erythrocyte sedimentation rate was elevated to 46mm/hr, rheumatoid factor (RF) to 83.1IU/ml and CRP to 3.7mg/dl. Her blood sugar was high and she was diagnosed as having diabetes mellitus. Cervical X ray film showed atlanto-axial subluxation. A pseudotumor around the odontoid process bulging into the spinal canal and compression of the upper cervical cord was observed by MRI. In spite of administration of bucillamine (100mg/day), the size of pseudotumor did not change. Methotrexate (MTX) at a dose of 5mg/week was started in February 1991 and the pseudotumor decreased in size with a concurrent reduction of ESR, RF and CRP. However, the high intensity lesion by T2 weighed image did not change and dysesthesia persisted. The pseudotumor was thought to be due to pannus and it was revealed that MTX was effective for reduction. The persistent dysesthesia was probably due to the degeneration of the upper cervical cord, although diabetic neuropathy may also have played a role.
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PMID:[A case of rheumatoid arthritis complicated with pseudotumor around odontoid process successfully treated by methotrexate]. 144 85

A 27-year-old woman with type 1 diabetes mellitus was admitted to the Shimane Medical University Hospital because of secondary amenorrhea. She had been treated with insulin since July, 1986. Fasting plasma glucose and HbA1c levels were controlled within normal limits. However, body weight gradually decreased and amenorrhea started in 1988. Physical examination revealed emaciation with BMI of 17.3. Basal levels of plasma T3, somatomedin C, LH, FSH and estradiol levels were low, whereas HGH levels were slightly elevated. Plasma LH markedly increased in response to LHRH administration. She was diagnosed as having weight loss-related hypothalamic amenorrhea. Induction of ovulation was not obtained with clomiphene citrate. Treatment with subcutaneous pulsatile administration of LHRH (20 micrograms every 120 min) resulted in an increase in plasma levels of LH, FSH and estradiol, which was accompanied by ovulation and corpus luteum formation. Further treatment with pulsatile LHRH administration was followed by conception. Two gestational sacs were detected by ultrasonography. One of them was absorbed at the early stage of pregnancy. She was delivered of one healthy female infant without complications. These findings suggest that it is important not only to control plasma glucose levels but to keep the appropriate weight and support the psychological aspects of the subject in the treatment of diabetes mellitus. Subcutaneous pulsatile LHRH therapy may be effective for the induction of ovulation in clomiphene-resistant hypothalamic amenorrhea; however, it will be necessary to solve the problem of dosage and the interval of LHRH administration in the future.
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PMID:[A case of type 1 diabetes mellitus with hypothalamic amenorrhea: successful pregnancy following subcutaneous pulsatile administration of LHRH]. 158 22

A 60 year-old Japanese man having a 20-year history of diabetes mellitus presented with truncal neuropathy. The severe pain, especially its nocturnal exacerbation, prevented him from sleeping and eating, resulting in rapid emaciation. However, he recovered from the condition with oral mexiletine, which dramatically controlled the pain.
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PMID:Relief of severe diabetic truncal pain with mexiletine. 183 66

Many reports of diabetic ophthalmoplegia have been published from the clinical points of view. However, there have been only three autopsied cases in which the ocular nerves were investigated histopathologically. A 72-year-old housewife was diagnosed to have glycosuria at the age of 67, but no medical treatment was done. She admitted to the hospital, because of acute onset of right eyelid drooping and diplopia for previous four days. She showed complete eyelid ptosis, moderate dilatation of right pupil, loss of light reaction, and extraocular muscle palsy except abduction on the right. Blood pressure was normal. A glucose tolerance test was diabetic and HbA1c was moderately increased. Her diabetes was fairly well-controlled with a diet therapy and injection of lente insulin. Two and a half months after admission, the course of illness became regressive. Seven months later, external ophthalmoplegia was disappeared and only slight anisocoria was seen. She readmitted to the hospital one year and eleven months later, because of anorexia and emaciation. She died of adenocarcinoma of the stomach without chemotherapy. The duration from onset of ocular symptoms to death was two years and one month. At postmortem examination, stomach cancer infiltrated extensively to the abdominal and pelvic viscera, but no metastasis to the nervous system or intraorbital tissues was found. There were mild to moderate atherosclerotic changes in the small-and middle-sized arteries of the kidneys, pancreas and adrenal glands corresponding to her age. Moderate atherosclerosis was found in all of the major arteries including Willis ring, siphon of the right internal carotid artery and Vertebro-basilar one.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diabetic ophthalmoplegia--a clinico-pathological study of the first case in Japan]. 269 31

We investigated the possible involvement of reactive oxygen radical-related processes in chronic (12-wk) diabetes induced in rats by streptozocin (STZ). Diabetes was associated with significantly increased activities of catalase (CAT), glutathione reductase (GSSG-RD), and CuZn-superoxide dismutase (SOD) in the pancreas and of CAT and GSSG-RD in the heart. On the other hand, the liver of diabetic rats showed a generalized decrease in CAT, glutathione peroxidase (GSH-PX), and SOD as well as in the levels of reduced glutathione (GSH). Diabetic kidney also showed decreases in CAT and SOD, but the activities of GSH-PX were increased. Insulin treatment (9-12 U/kg body wt) that was started after 8 wk of diabetes and continued for 4 wk reversed all of the foregoing alterations in tissue antioxidant status. Our results suggest the presence of increased oxidative stress in uncontrolled diabetes as manifested by the marked alterations in tissue antioxidant enzyme activities, the magnitude of which increased with the degree of emaciation. The complex patterns of changes observed in the various tissues examined are believed to be the result of compensatory increases in enzyme activities (usually involving enzymes whose activity in control tissues is low) and direct inhibitory effects, possibly resulting from an increased tissue-oxidant activity. Our findings support the view that tissue antioxidant status may be an important factor in the etiology of diabetes and its complications.
Diabetes 1987 Sep
PMID:Alterations in free radical tissue-defense mechanisms in streptozocin-induced diabetes in rat. Effects of insulin treatment. 330 71

A new, spontaneously occurring diabetic syndrome has been observed in the aged males of an inbred strain of Wistar rats, WBN/Kob. The main clinical sign, glycosuria, was first detected at about 60 weeks of age, and thereafter some animals developed hyperlipidaemia and gradual emaciation. Prior to the onset of glucosuria, male rats showed impaired glucose tolerance after a glucose load at 21 weeks of age. The histopathologic lesions of the pancreas in the diabetic males consisted of multifocal fibrosis, decreased in number and size of islets and atrophy of exocrine tissue. Multifocal inflammatory foci of varying stages were the main pancreatic lesion in prediabetic male rats. This inflammatory change was detected even in 12-week-old rats and tended to occur around the islets. Therefore focal fibrosis and the decrease in the number and size of islets were considered to result from post-inflammatory scarring. The maturity-onset of this syndrome and the impaired glucose tolerance in younger animals suggested that diabetes mellitus of this rat strain is insulin-independent type II. However, the histological lesions of the pancreas were somewhat different from previous reports of both type I and II diabetes mellitus in man and animals.
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PMID:A new diabetic strain of rat (WBN/Kob). 403 61

A 36 year old woman was admitted because of upper abdominal pain, fullness and weight loss. Pancreatic scintigram revealed abnormal accumulation of the radioisotope in the pancreatic head, and hepatic scintigram showed multiple filling defect in the bilateral lobe. Celiac angiogram demonstrated a tumor stain at the pancreatic head, encasement of the splenic artery and metastasis to the liver. The diagnosis of malignant glucagonoma was substantiated by high serum glucagon level of 1,100 pg/ml. Streptozotocin of 1.5g was administered intravenously once a week, totalling 9g. Thereafter, blood level of glucagon declined to the normal range, accompanied by improvement of diabetes mellitus and weight gain. At laparotomy, there was an over fist-sized mass at the body and tail of the pancreas, infiltrating the pancreatic head and periaortic region, and was found unresectable. On light microscopy, biopsied specimen was seen to be a tumor that contained glucagon. Secretary granules resembling A cell granules were observed by electron microscopy. She died of emaciation 6 years after the onset of the disease. Eighteen cases of glucagonoma reported in Japan, and 64 cases in Europe and the United States were reviewed in terms of the diagnosis and treatment.
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PMID:[Glucagonoma]. 609 16

Histologic and immunohistochemical studies were carried out on four young cattle with diabetes mellitus associated with persistent bovine viral diarrhea (BVD) virus infection. Clinical findings included persistent hyperglycemia, decreased glucose tolerance, glycosuria, polydipsia, and severe emaciation. Macroscopically, multiple erosions and ulcers in the mucosa of upper and lower alimentary tracts and swollen lymph nodes were commonly observed. Erosions and ulcers in the mucosa of tongue, esophagus, and forestomach were represented histologically by necrosis of squamous epithelium with neutrophilic infiltration. In the small and large intestines, villous atrophy and suppurative cryptitis were often observed, along with diffuse infiltration of lymphocytes and macrophages and fibroplasia in the lamina propria. In the pancreas of all cattle, there was a reduction in the number of islet cells, and most of the residual islet cells had hydropic degeneration and a decreased number of secretory granules. Immunohistochemical examination confirmed that these cells were severely degranulated beta-cells. In addition, many islets containing necrotic islet cells were observed. These islet cells had increased eosinophilia and shrinkage of cytoplasm, as well as pyknotic nuclei. Inflammation of the islets with mild infiltration of lymphocytes was observed in all pancreatic lobes. In addition, bovine IgG-immunoreactive cells were identified immunohistochemically in the affected pancreatic islets. The BVD virus antigen was not identified in the cytoplasm of the islet cells by immunohistochemical study, although it was identified in the epithelial cells of the small intestine. The histologic and immunohistochemical studies demonstrated that the pancreatic lesions in these animals were similar to those caused by acute insulin-dependent diabetes mellitus (IDDM) in human beings.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Spontaneous diabetes mellitus associated with persistent bovine viral diarrhea (BVD) virus infection in young cattle. 760 88

In order to investigate whether so-called risk factors relating to treatment difficulty are true risk or not, treatment results of 520 in-patients originally treated for pulmonary tuberculosis during 12 years' period from 1980 to 1991 in our hospital were analyzed. The proportion of cases with so-called risk factors among total 520 cases was as follows: Aged patients (70 years of age and over) 31.5%. Cases discharging abundant bacilli in sputum (Gaffky scale VII or above or culture, +3 positive) 29.4%. Adverse reactions to drugs 18.1%. Far advanced cavitary lesions (GAKKAI Classification I or II3) 15.6%. Relative risk of various risk factors in cases of group A (died of tuberculosis), group B (showed delay in the negative conversion of bacilli; namely, cases converted to negative only 4th month of treatment or later) and group C (cases of groups A and B) were calculated comparing with cases of the control group (pretreatment negative bacilli cases or cases converted to negative within 3 months). In cases of group A died of tuberculosis, the results were as follows; pretreatment abundant bacilli discharge 3.1, far advanced cavitary lesions 4.6, emaciation and/or malnutrition 5.1. Other risk factors identified were the following; unhealthy life style 4.0, severe gastrointestinal tract disease 3.9, impaired pulmonary function 3.3, complicated infections 3.2, cerebrovascular injuries including psychosis and nervous system diseases 2.3, diabetes mellitus 2.0, and the adverse reactions to drugs 1.9. In cases of group B showing delay in the negative conversion of bacilli, significant risk factors were pretreatment abundant bacilli discharge, far advanced cavitary lesions, emaciation and/or malnutrition and diabetes mellitus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An investigation on risk factors relating to the treatment difficulty in originally treated pulmonary tuberculosis cases]. 793 76


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