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Query: UMLS:C0011849 (diabetes)
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An insulin-dependent diabetic presenting with thirst, polyuria and weight loss was noted to be hypertensive and shown subsequently to have a right adrenal phaeochromocytoma. Pre-operative control of both diabetes and hypertension was achieved with propranolol and phenoxybenzamine, but not with propranolol alone. Full recovery with restoration of normal glucose tolerance and blood pressure followed successful surgery. Analysis of this patient's response to medical therapy provides further evidence that alpha 2 receptors inhibit insulin release in man. Since as many as one-third of phaeochromocytomas are not detected during life, this diagnosis should be considered as an uncommon cause of carbohydrate intolerance in patients with diabetes mellitus, especially if accompanied by continuous or paroxysmal hypertension.
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PMID:Phaeochromocytoma and diabetes mellitus: further evidence that alpha 2 receptors inhibit insulin release in man. 630 36

The long-term remission of insulin-dependent diabetes mellitus is an unusual occurrence. The present report describes three cases of typical insulin-dependent diabetes in which the metabolic abnormalities greatly improved after the patients abstained from excessive ethanol intake. Our patients presented with polyuria, polydipsea, and weight loss of several weeks duration and laboratory studies revealed marked elevations in blood glucose concentrations and, in two of the three patients, mild ketosis. When these patients subsequently abstained from excessive ethanol intake, the elevations in blood glucose levels and the clinical symptoms of diabetes resolved. Two of our three patients have a strong family history of diabetes mellitus and we have therefore hypothesized that excessive ethanol intake only results in hyperglycemia in individuals with either an underlying predisposition to develop diabetes or mild unrecognized preexisting diabetes. It is important that clinicians recognize that excessive ethanol intake can lead to hyperglycemia and that abstention from ethanol may result in the marked improvement of the metabolic abnormalities.
Diabetes Care
PMID:Normalization of fasting blood glucose levels in insulin-requiring diabetes: the role of ethanol abstention. 634 24

Administration of alloxan (150 mg/kg body weight, i.p.) to male Wistar rats induced a reproducible and persistent diabetes mellitus as evidenced by elevated serum glucose and low serum insulin concentrations. Administration of either (-)epicatechin or (+)catechin (250 mg/kg, i.p. on each occasion) at 36, 24, 12 and 1 hour before and at 12 and 24 hours after alloxan administration did not prevent the induction of the diabetes. Similarly, treatment of animals with (-)epicatechin or (+)catechin (125 mg/kg i.p. twice daily) for 21 days commencing 24 hours after alloxan administration did not reverse the persisting elevated serum glucose and low serum insulin concentrations. Moreover, administration of these compounds did not relieve any of the symptoms of the alloxan-induced diabetes such as poor weight gain, polyuria or polydipsia. Thus, this study does not confirm previous reports of prophylactic and curative effects of (-)epicatechin against alloxan-induced diabetes in rats, in spite of the high dosages of the compounds used in these experiments.
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PMID:Alloxan-induced diabetes in the rat - protective action of (-) epicatechin? 636 64

The risk for healthy sibs to develop type I diabetes is 3-5%. HLA Dr 3 und Dr 4 plus islet-cell antibodies predispose for the disease. Polyuria, polydipsia etc. plus a blood sugar greater than 200 mg/dl establish the diagnosis in symptomatic-and an OGT in asymptomatic patients. Initially non-ketoacidotic patients can be effectively treated with an insulin mixture of 1/3 regular + 2/3 NPH in a dose of 1 U/kg bw per day with 2/3 in the morning and 1/3 in the evening. Manifestation and duration of remission (= no glucose excretion, insulin less than 0.5 U/kg/day, measurable C-peptide) are related to initial decompensation. At present no therapy is available to prolong remission. The "tailored" therapy for diabetics of long duration is favoured: individual insulin mixtures of less than 1 U/kg/day in 2 divided doses, with 6 of more meals. Metabolic control should achieve a glucose excretion of less than 5% of the consumed carbohydrates, a 2-h postprandial blood sugar of less than 200 mg/dl (140-200 mg/dl) and a HbAlc-concentration below 8% (= less than + 3 SD).
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PMID:[Insulin-dependent diabetes: clinical aspects and therapy]. 639 62

The present study was undertaken to devise an electrophysiological method for detecting diabetic retinopathy in rats. The electroretinogram (ERG) and visual evoked potential (VEP) were recorded from unanesthetized and unrestrained rats rendered diabetic with a single i.v. injection of streptozotocin (STZ) at 35 or 40 mg/kg. The STZ-treated rats showed signs of diabetes: hyperglycemia, glucosuria, hypoinsulinemia, polyuria and increased water intake. Amplitudes of the ERG a- and b-waves and oscillatory potentials (OPs) on the b-wave were decreased and latencies of these waves were prolonged gradually after STZ was administered. Especially, latencies of the OPs became significantly different from the pre-treatment values. Latency of the VEP N1 wave showed a slight prolongation, which might be secondary to the depression of retinal function. Histological examination showed swelling and proliferation of the lens epithelium and swelling and vacuolization of the lens fiber were observed in the eyeball 9 weeks after STZ-treatment. Moreover, thinning of each retinal layer was observed in a few rats. Daily s.c. injection of insulin at 10 units/rat/day started from the 4th week. The ERG values returned to the control values after 2-3 weeks of insulin therapy. These results indicate that the ERG and VEP recording procedure used in the present study is useful for early detection of the diabetic retinopathy in rats and that the OP of the ERG appears to be vulnerable to diabetes in the rat as it is in the human.
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PMID:[An electrophysiological method for detecting diabetic retinopathy in rats]. 639 51

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

Rats were fed on diets containing either sucrose or starch as the carbohydrate component (55%) for eight months. Diabetes was induced in animals of both groups by injecting streptozotocin (50 mg/kg body weight). Diabetic rats failed to gain weight, had enlarged kidneys, polyuria and elevated blood glucose levels. Starch and sucrose fed rats gained weight normally and had normal blood glucose levels. Sucrose fed rats had enlarged kidneys. Regional thickening of the glomerular basement membrane was present in sucrose-fed and diabetic rats but not in starch-fed controls. Glomerular basement membrane isolated from pooled kidney cortices from rats in the different experimental groups were analysed for amino acid, disaccharide and hexosamine content. Hydroxylysine (9 to 20%), hydroxyproline (21 to 24%), disaccharide (27%) and hexosamine (26%) were increased in membranes insolated from the three experimental groups, compared with starch-fed non-diabetic controls. An increase in low molecular weight components of the glomerular basement membrane of sucrose-fed and diabetic rats was observed using electrophoresis in sodium dodecyl sulphate. Significantly higher (p < 0.001) glucosyltransferase activity was present in kidney supernatants prepared from sucrose-fed (1050 +/- 60 nmol/2h/kidney) compared to starch-fed rats (510 +/- 40 nmol/2h/kidney). Sucrose feeding induces changes similar to those found in diabetes and the induction of diabetes made little difference over the feeding of sucrose alone.
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PMID:Modification of the glomerular basement membrane in sucrose-fed and streptozotocin-diabetic rats. 644 59

Fasting blood glucose, erythrocyte counts hemoglobin levels of 131 Libyan diabetic women of Tripoli , Libya were determined. The respective mean values were 223 +/- 7 mg X dl-1, 4.97 +/- 0.034 X 10(6) X mm-3 and 14.4 +/- 0.127 g X dl-1. Sixty-five percent of these diabetic women were obese. The highest percent of diabetics belong to the age group 46-55 years. The increase in prevalence of diabetes correlates with an increase in obesity. A significant positive correlation was found between body surface area and fasting blood glucose levels (r = 0.65; P less than 0.001). Elevated levels of erythrocyte count and hemoglobin were present in these diabetic patients. Significant correlations were found between body surface area and erythrocyte count, as well as between fasting blood glucose levels and erythrocyte count, indicating the effect of obesity and diabetes on erythrocyte numbers. A significant correlation was found between fasting blood glucose levels and hemoglobin (r = 0.35; P less than 0.001). The elevated levels of hemoglobin present in these patients may be the result of haemoconcentration due to polyuria, which is always present in poorly controlled diabetic patients. The results suggest a close relationship between diabetes and obesity. Regulation of body weight/surface area is an important factor in the control of diabetes. The elevated levels of erythrocyte count and hemoglobin reflect poor control of blood glucose levels in these diabetic patients.
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PMID:Erythrocyte count and hemoglobin levels in diabetic women. 653 78

Direct measurement of plasma AVP and indirect assessment of antidiuretic activity during standard dehydration tests were made in 21 polyuric and polydipsic patients to establish the efficacy of each method in determining the cause of polyuria. Patients with acquired nephrogenic diabetes insipidus (e.g. diabetes mellitus, renal failure, hypercalcaemia) were excluded from the study. Cranial diabetes insipidus was diagnosed by plasma AVP responses to osmotic stimulation during infusion of hypertonic 5% saline which were subnormal in 13 patients, 4 of whom had undetectable plasma AVP and 3 who had reduced but osmoregulated AVP release. Standard water deprivation tests confirmed cranial diabetes insipidus in all but 2 patients who were diagnosed as partial nephrogenic diabetes insipidus. The remaining 8 patients had normal, osmoregulated AVP secretion; the cause of their polyuria was determined by their renal response to desmopressin. Two patients had nephrogenic diabetes insipidus and 6 had primary polydipsia. The majority of polyuric patients could be accurately diagnosed by carefully performed dehydration tests. We suggest that direct measurements of plasma AVP during osmotic stimulation are only necessary to distinguish mild forms of cranial from nephrogenic diabetes, or to define precisely the characteristics of AVP secretion.
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PMID:A comparison of diagnostic methods to differentiate diabetes insipidus from primary polyuria: a review of 21 patients. 665 43

We evaluated the clinical information value of the glycosylated hemoglobin assay by comparing it with practitioners' estimates of glucose control over the preceding 10 weeks in 216 patients with diabetes. Twenty-four per cent of the practitioners' estimates, which were based on historical and laboratory data collected during a routine office visit, differed by more than +/- 75 mg per deciliter from the actual mean blood glucose levels calculated with the glycosylated hemoglobin assay. One third of the mean blood glucose concentration fell outside the confidence intervals physicians used to bound their estimates. When examined individually or in the aggregate, historical information, such as polyuria, nocturia, or home urine testing for glucose, and laboratory information, such as fasting or random blood glucose levels, were weak predictors of the actual mean concentration of blood glucose. We conclude that the glycosylated hemoglobin assay provides information about the degree of long-term glucose control that is not otherwise obtainable in the usual clinical setting.
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PMID:The clinical information value of the glycosylated hemoglobin assay. 669 Sep 62


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