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

Oral contraceptive agents are expected to be legalized in Japan in the near future. Although pills are more convenient and effective than other methods used in Japan such as condom (73%), IUD (12.4%) and Ogino Method (11.0%), they are not safe for many women. Neither will legalization of pills necessarily reduce the number of abortions. The abortion rate per 1000 women aged 15-44 is 29.3 in America where pills are legal, and 22.5 in Japan where they are illegal. Steroid hormones affect the overall physical and mental functioning of the human body. Pill-users who are near 40 and/or smokers may have such side-effects as high blood pressure, cerebrovascular-related syndrome, and thrombosis. Among very young pill users, side-effects include temporary amenorrhea after stopping pills, 4 times more cases of thrombosis triggered by emergency operations on appendixes and fractured bones, and development of uterine myoma. Side effects are more prevalent among those who have a family history of diabetes, circulatory organ dysfunction, high blood pressure, breast or ovarian cancer. Minor side-effects include weight increase, nausea, blemishes, acne and pigmentation.
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PMID:[Oral contraceptive agents]. 364 11

Diabetes mellitus has been associated with a variety of gastrointestinal motor disturbances. Pyloric activity, however, has not been specifically investigated. We have quantified the pyloric manometric profile in 24 diabetics with recurrent nausea or vomiting, or both, without evidence of mechanical obstruction. Twelve healthy volunteers served as controls. A multilumen pneumohydraulic perfusion assembly with five side openings, each 1 cm apart, was positioned fluoroscopically across the antroduodenal junction and used to monitor pressure activity for 5 h (3 h fasting and 2 h fed). Three patterns of pyloric activity were defined and quantified: (a) baseline elevation of greater than or equal to 3 mmHg for greater than or equal to 1 min (tonic pattern); (b) antral-type phasic pressure activity mixed with duodenal phasic activity (phasic pattern); and (c) phasic pattern superimposed on tonic activity (combined tonic-phasic pattern). The duration of the total pyloric activity before and after the meal was greater in diabetics than in controls (p less than 0.005). Furthermore, episodes of unusually prolonged (greater than or equal to 3 min) and intense (greater than or equal to 10 mmHg) tonic contraction, "pylorospasm," were observed in 14 of 24 diabetics but in only 1 control (p = 0.025). In diabetics, episodes of pylorospasm had a peak amplitude of tonic activity of 13 +/- 1 mmHg and a duration of 7 +/- 0.7 min (mean +/- SE). We conclude that pyloric dysmotility forms part of the widespread disruption of gut motility that affects some patients with diabetes.
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PMID:Pyloric dysfunction in diabetics with recurrent nausea and vomiting. 369 9

Gastroparesis diabeticorum is a common complication that develops in patients with diabetes mellitus. Although the pathogenesis remains unclear, the clinical symptoms of nausea, vomiting, and gastric dilatation frequently respond to metoclopramide hydrochloride, an agent that stimulates gastric emptying in addition to acting centrally as an antiemetic. Occasionally, patients are encountered whose severe gastroparesis is unresponsive to oral metoclopramide and who require intravenous therapy or drainage procedures (eg, pyloroplasty or gastrojejunostomy). Rectal administration of metoclopramide successfully controlled the clinical symptoms of gastroparesis diabeticorum in an outpatient after failure of oral dosing, thus avoiding the need for intravenous therapy. Gastric emptying studies and serum metoclopramide levels following a 25-mg rectal dose of metoclopramide hydrochloride verified the efficacy of therapy.
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PMID:Metoclopramide suppositories in the treatment of diabetic gastroparesis. 377 59

A prospective study on 184 consecutive patients presenting with the chief complaint of recurrent chest pain (RP) for diagnostic coronary arteriography (CA) was conducted utilizing a simple questionnaire of historical, physical and electrocardiographic variables. A linear logistic regression analysis yielded a final data set of 13 variables. Concurrently, staff cardiologists who obtained the questionnaire data through direct questioning rendered a clinical diagnosis of either angina (coronary artery disease [CAD]) or noncardiac chest pain. Utilization of the regression analysis increased diagnostic accuracy from 69 to 86% (p less than 0.0003); sensitivity from 83 to 88% (NS) and specificity from 49 to 84% (p less than 0.0001). The best predictive variables for the presence or absence of obstructive CAD documented by CA were in order of decreasing value: age, electrocardiogram, pain aggravated by sex, sex (gender), pain aggravated by movement, diabetes mellitus, pain described as prickling, pain described as burning, pain relieved by rest, pain with radiation to both arms, associated nausea, associated dyspnea, and a history of a lipid disorder. Four variables were predictive of normal coronary anatomy (NCA), pain aggravated by movement, prickling, nausea, and dyspnea. Although this set of predictor variables may not apply equally well to all populations of cardiac patients, the availability and relative simplicity of the program allow for adding or deleting variables and thus provide for considerable potential in the diagnostic assessment of RP. An inexpensive pocket computer can utilize the coefficients generated by the logistic regression program to calculate the probability of CAD as the cause of RP.
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PMID:Analysis of historical variables, risk factors and the resting electrocardiogram as an aid in the clinical diagnosis of recurrent chest pain. 388 75

Pressure activity in the stomach and upper intestine was studied in 104 patients referred to the Mayo Clinic for evaluation of functional symptoms (nausea, vomiting, upper abdominal pain, or other dyspeptic symptoms in the absence of structural gut abnormalities). Manometric abnormalities were found in 75 patients. Forty-three of these had gastric abnormalities and 32 patients had both gastric and intestinal abnormalities. In the stomach, decreased antral phasic pressure activity after a solid meal was the most common abnormality. In the upper intestine, unpropagated bursts of phasic and tonic contractile activity were a relatively frequent abnormality but a number of other altered manometric patterns also were observed. Digestive tract symptoms were not good predictors of the presence or site of the gastrointestinal manometric abnormalities. Patients with associated neurologic, urologic, or metabolic (diabetes) disease were more likely to exhibit manometric abnormalities than were those without evidence of disease outside the gut. Almost two-thirds of the patients with symptoms and normal manometry presented features suggestive of psychiatric disease. We conclude that in patients with severe functional-type symptoms gastrointestinal manometry is a useful technique to evidence the underlying gut motor disturbance that is present in a relatively high proportion of these patients.
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PMID:Manometric evaluation of functional upper gut symptoms. 397 47

Forty-six pregnant patients with potential diabetes were studied to compare the use of glucose and a glucose polymer for carbohydrate tolerance testing. The first 26 patients had a glucose tolerance test and a glucose polymer tolerance test in randomized order an average of one week apart. The mean tolerance curves and insulin curves were similar for both agents. Patients preferred glucose polymer to glucose because of a lower incidence of associated nausea. A second group of 20 patients was randomly divided so that patients had two glucose tolerance tests or two glucose polymer tolerance tests an average of one week apart. Comparison of the variability and correlation of the incremental areas under the paired tolerance curves showed that the reproducibility of the glucose polymer tolerance test exceeded that of the glucose tolerance test.
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PMID:Comparison of glucose and a glucose polymer for testing oral carbohydrate tolerance in pregnancy. 637 52

Metoclopramide tablets were compared with placebo in the treatment of gastrointestinal symptoms in 40 patients with diabetic gastroparesis. Results of a 3-wk double-blind study indicate that metoclopramide at a dosage of one 10-mg tablet four times daily reduced nausea, vomiting, fullness, and early satiety and improved meal tolerance better than placebo. Statistically significant differences were noted for nausea and postprandial fullness. Mean gastric emptying assessed by radionuclide scintigraphy was significantly improved in the metoclopramide-treated group when compared with their baseline result. Metoclopramide is an effective agent for improving the upper gastrointestinal motor function in diabetic patients with gastroparesis.
Diabetes Care
PMID:A multicenter placebo-controlled clinical trial of oral metoclopramide in diabetic gastroparesis. 640 Jul 7

During 1880 patient-months of treatment with continuous subcutaneous insulin infusion in 101 patients with IDDM, 36 episodes of acute, severe loss of glycemic control, including 29 with significant ketoacidosis, occurred in 20 patients. Fifteen episodes were attributable to failure of insulin delivery to the patient while 13 were precipitated by infection. Insufficiently frequent blood glucose monitoring, failure by patients to detect mechanical and technical problems with infusion systems, failure to adhere to "sick day" regimens, and delay in seeking medical help all contributed to the progression of a number of episodes. Thirst, nausea, and vomiting were the common clinical manifestations of decompensation; and the degree of acidemia was often mild in relation to the degree of hyperglycemia. Response to conventional management was usually prompt.
Diabetes Care
PMID:Diabetic ketoacidosis during long-term treatment with continuous subcutaneous insulin infusion. 642 52

The clinical and biochemical data obtained in 85 patients with diabetic ketoacidosis (DKA) are presented. DKA is an acute exacerbation of diabetes, a characteristic clinico-biochemical syndrome including increasing thirst, polyuria, adynamia, dryness of the skin and mucous membranes, anorexia, nausea, vomiting, occasionally abdominal pain, Kussmaul's breath, acetone odour in the exhaled air, circulatory collapse, prerenal azotemia, stupor, coma. Glycemia level exceeds 19 mmol/l, blood pH over 7.3. The disease is marked by neutrophilic leukocytosis, blood count shift to the left, elevated blood content of creatinine and urea. It was established that the degree of consciousness abnormality does not always correlate with the degree of the clinico-biochemical manifestations of DKA. During DKA, coma occurs relatively seldom (5.9%). It is suggested to use the term "diabetic ketoacidosis", incipient or marked, indicating the degree of consciousness abnormality (stupor, coma).
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PMID:[Diabetic ketoacidosis (causes, clinico-biochemical correlations and terminology problems)]. 644 Dec 97

A phase I trial of chlorozotocin was completed for the single dose every six week schedule. At 250 mg/m2 i.v. push, excessive thrombocytopenia, nausea, and anorexia occurred. Two cases of cholestatic jaundice were seen, and one patient had worsening of his diabetes mellitus after one course. Partial response or prolonged disease stabilization with increased survival was documented in four of seven patients with non-small cell carcinoma of the lung. A starting dose of 225 mg/m2 is recommended for good risk patients with little or no prior bone marrow toxicity from chemotherapy or irradiation. A dose of 200 mg/m2 is recommended for patients with limited previous treatment and good bone marrow reserve.
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PMID:Phase I evaluation of chlorozotocin: single dose every six weeks. 644 79


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